Nokea
Causes of polyhydramnious include:
- A. Congenital abnormalities and chorioangioma
- B. Severe fetal hypoxia and multiple pregnancy
- C. Uncontrolled diabetes mellitus and anaemia
- D. Rhesus D isoimmunisation and post datism
Correct Answer: A
Rationale: The correct answer is A because congenital abnormalities and chorioangioma can lead to increased amniotic fluid accumulation, causing polyhydramnios. Congenital abnormalities can affect fetal swallowing and urine production, leading to fluid buildup. Chorioangioma is a vascular tumor in the placenta that can disrupt normal fluid dynamics.
Choice B is incorrect as severe fetal hypoxia and multiple pregnancy are more likely to cause oligohydramnios, not polyhydramnios. Choice C is incorrect as uncontrolled diabetes mellitus and anemia are associated with macrosomia and not polyhydramnios. Choice D is incorrect because Rhesus D isoimmunisation and postdatism are not typically linked to polyhydramnios.
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A patient who has been in the intensive care unit for 17 days develops hyponatremic hyperosmolality. The patient weighs 132 lb (59.9 kg), is intubated, and is receiving mechanical ventilation. The serum osmolality is 320 mOsmL kg H2O. Clinical signs include tachycardia and hypotension. The adult-gerontology acute care nurse practitioners initial treatment is to
- A. reduce serum osmolality by infusing a 5% dextrose in 0.2% sodium chloride solution
- B. reduce serum sodium concentration by infusing a 0.45% sodium chloride solution
- C. replenish volume by infusing a 0.9% sodium chloride solution
- D. replenish volume by infusing a 5% dextrose in water solution.
Correct Answer: B
Rationale: The correct answer is B: reduce serum sodium concentration by infusing a 0.45% sodium chloride solution. In hyponatremic hyperosmolality, the primary goal is to correct the low serum sodium levels. A 0.45% sodium chloride solution is hypotonic, which helps to slowly correct the serum sodium concentration without causing rapid shifts in osmolality. Infusing a hypotonic solution will gradually increase the serum sodium levels, addressing the underlying issue. Choices A, C, and D are incorrect because they do not directly address the low serum sodium levels, which is essential in treating hyponatremic hyperosmolality. Infusing a 5% dextrose in 0.2% sodium chloride solution (Choice A) or a 5% dextrose in water solution (Choice D) would not correct the low sodium levels. Replenishing volume with a 0.9% sodium chloride solution (Choice C) would not directly
A major predisposing factor to cardiac disease in pregnancy includes
- A. Rheumatic heart disease
- B. Notable peripheral oedema
- C. Easy fatiguability
- D. Basal crepitation
Correct Answer: A
Rationale: The correct answer is A: Rheumatic heart disease. This is because rheumatic heart disease is a known risk factor for cardiac complications during pregnancy due to the strain pregnancy places on the heart. Choice B, notable peripheral edema, is a symptom of heart failure but not a predisposing factor. Choice C, easy fatiguability, is a non-specific symptom and not a direct predisposing factor. Choice D, basal crepitation, is a sign of possible lung pathology and not directly related to cardiac disease in pregnancy. Therefore, the correct answer is A as it directly relates to an increased risk of cardiac issues during pregnancy.
Neoadjuvant chemotherapy treatment for cancer is given to facilitate surgical resection. When the outcomes of cancer therapies are evaluated, the terms complete response and partial response often are used. Partial response means that
- A. 50% of the patients treated with a given regimen demonstrate remission
- B. 50% of the patients treated survive to the 5-year point
- C. The tumor mass has reduced by > 50%
- D. In 50% of cases, the tumor converts from unresectable to resectable
Correct Answer: C
Rationale: The correct answer is C because partial response in cancer therapy typically refers to a reduction in tumor size by more than 50%. This reduction indicates some positive effect of the treatment on the tumor.
Choice A is incorrect because partial response is not solely based on the percentage of patients demonstrating remission, it is about the tumor response.
Choice B is incorrect because survival at 5 years is related to overall survival rate, not specifically to the tumor response.
Choice D is incorrect because the conversion from unresectable to resectable is more related to the operability of the tumor, rather than the response to chemotherapy.
When a hand or foot lies alongside the presenting part, the presentation is said to be
- A. Footling
- B. Transverse
- C. Cephalic
- D. Compound
Correct Answer: D
Rationale: The correct answer is D: Compound. In compound presentation, a hand or foot is alongside the presenting part, usually the head. This can complicate the delivery process. A: Footling presentation means the foot presents first. B: Transverse presentation is when the baby is lying sideways. C: Cephalic presentation is normal, with the head presenting first. In this scenario, D is the correct answer as it specifically describes the situation where a hand or foot is alongside the presenting part.
Post maturity is a term that is used to describe a pregnancy that is equal to or more than
- A. 40 completed weeks
- B. 38 completed weeks
- C. 41 completed weeks
- D. 42 completed weeks
Correct Answer: D
Rationale: The correct answer is D (42 completed weeks) because a full-term pregnancy is considered to be around 40 weeks. Post maturity refers to a pregnancy that has exceeded the normal 40-week gestation period. At 42 weeks, the risk of complications such as stillbirth or issues with the placenta increases. Choice A (40 completed weeks) is incorrect because this is considered a full-term pregnancy. Choices B (38 completed weeks) and C (41 completed weeks) are incorrect as they do not meet the criteria for post maturity.