Nokea
An inorganic risk factor to birth injuries includes
- A. Maternal short stature
- B. Prenatal oligohydramnios
- C. External cephalic version
- D. Fetal macrosomia
Correct Answer: D
Rationale: The correct answer is D: Fetal macrosomia. Fetal macrosomia, which refers to a baby being significantly larger than average, is an inorganic risk factor for birth injuries because it can lead to difficult delivery and increase the risk of birth trauma such as shoulder dystocia. Maternal short stature (A) is a biological risk factor, not inorganic. Prenatal oligohydramnios (B) refers to low levels of amniotic fluid and is a maternal condition, not an inorganic factor. External cephalic version (C) is a procedure to turn a breech baby and is not a risk factor for birth injuries.
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Traumatic diaphragmatic hernias present in both acute and chronic forms. Patients with a more chronic form are most likely to be present with
- A. Respiratory insufficiency
- B. Sepsis
- C. Bowel obstruction
- D. Anemia
Correct Answer: A
Rationale: The correct answer is A: Respiratory insufficiency. Chronic traumatic diaphragmatic hernias can lead to gradual compromise of respiratory function due to herniation of abdominal contents into the chest cavity, causing compression of the lungs and reduced lung capacity. This results in symptoms such as dyspnea, cough, and chest pain. Sepsis (B) is more commonly associated with acute traumatic diaphragmatic hernias. Bowel obstruction (C) is a possible complication but typically presents with acute symptoms like abdominal pain and distension. Anemia (D) is not a common presentation of diaphragmatic hernias.
Vaginal delivery is possible in
- A. Brow presentation
- B. Face presentation
- C. Shoulder presentation
- D. Unstable lie
Correct Answer: B
Rationale: The correct answer is B: Face presentation. Vaginal delivery is possible in face presentation as the fetus is in a position where the face is presenting first, allowing for delivery. In this presentation, the chin is usually tucked onto the chest, making it easier for the baby's head to pass through the birth canal.
A: Brow presentation is incorrect because it indicates the baby's head is extended slightly, making it more difficult for vaginal delivery.
C: Shoulder presentation is incorrect as it can lead to a shoulder dystocia, making vaginal delivery dangerous and difficult.
D: Unstable lie is incorrect because it refers to the baby being in a transverse position, making vaginal delivery impossible without intervention.
The AGACNP is evaluating a patient who reportedly fell down a flight of steps. Her history is significant for several emergency room visits, but she denies any significant medical conditions. Some documentation in her chart indicates that she may have been subjected to physical abuse. Today she presents with a periorbital ecchymosis of the left eye and swelling in the left side of the face. Her neurologic examination is within normal limits. Which head imaging study would be most useful in assessing for findings consistent with a history of abuse?
- A. Radiographs
- B. CT scan without contrast
- C. MRI
- D. PET scan
Correct Answer: A
Rationale: The correct answer is A: Radiographs. Radiographs, specifically skull X-rays, are most useful in assessing for findings consistent with a history of abuse in this case. Radiographs can detect fractures, such as skull fractures or facial bone fractures, which are common in cases of physical abuse. These fractures may not always be clinically evident but can be identified on X-rays.
Explanation of other choices:
B: CT scan without contrast - While a CT scan can provide detailed imaging of the head, it may not be necessary in this case as the patient's neurologic examination is within normal limits. Also, radiographs are more cost-effective and can detect fractures effectively.
C: MRI - MRI is not typically used as the first-line imaging modality for suspected head trauma due to its cost and time-consuming nature. Radiographs are more appropriate for initial evaluation.
D: PET scan - PET scans are used to detect metabolic activity in tissues and are not typically indicated for assessing acute traumatic injuries like fractures associated with
Clinical features of facial palsy are
- A. Inability to feed and excessive cry
- B. Reduced facial movement and irritability
- C. Excessively dry eyeball and feeding difficulties
- D. Eyes permanently open and no facial movement
Correct Answer: B
Rationale: The correct answer is B because reduced facial movement is a key clinical feature of facial palsy. This can lead to difficulty in making facial expressions, closing the eye on the affected side, and drooping of the mouth. Irritability may also occur due to discomfort or difficulty in communication.
Choice A is incorrect because inability to feed and excessive cry are not typical features of facial palsy. Choice C is incorrect as excessively dry eyeball and feeding difficulties are not commonly associated with facial palsy. Choice D is incorrect as eyes being permanently open and no facial movement are not characteristic of facial palsy.
Neonate born of a diabetic mother is fed within the first 15 minutes to prevent
- A. Hypocalcaemia
- B. Hypoglycaemia
- C. Hyponatraemia
- D. Hypokalaemia
Correct Answer: B
Rationale: The correct answer is B: Hypoglycaemia. Neonates born to diabetic mothers are at risk of hypoglycaemia due to high insulin levels in utero. Feeding the newborn within the first 15 minutes helps maintain blood glucose levels. Hypocalcaemia, hyponatraemia, and hypokalaemia are not typically immediate concerns in neonates born to diabetic mothers.