Nokea
Classical vitamin K deficiency bleeding occurs
- A. Within the first 24 hours of birth
- B. Within the first week of birth
- C. Within the neonatal stage
- D. Within the infancy stage
Correct Answer: B
Rationale: The correct answer is B: Within the first week of birth. Classical vitamin K deficiency bleeding typically occurs within the first week of birth due to low levels of vitamin K in newborns. During this time, infants are at a higher risk of bleeding complications if not supplemented with vitamin K. Choice A is incorrect because bleeding usually occurs after the first 24 hours. Choice C is incorrect as it does not specify a specific time frame within the neonatal stage. Choice D is incorrect as classical vitamin K deficiency bleeding is typically seen within the first week, not necessarily during the entire infancy stage.
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A pregnant woman with acute pyelonephritis is advised on a high fluid intake so as to
- A. Promote enough rest
- B. Correct dehydration
- C. Relief irritability
- D. Increase urine output
Correct Answer: B
Rationale: The correct answer is B: Correct dehydration. Acute pyelonephritis can lead to dehydration due to fever, vomiting, and decreased fluid intake. High fluid intake helps correct dehydration by maintaining adequate fluid balance and preventing further complications. Increasing urine output (choice D) is a consequence of correcting dehydration. Promoting enough rest (choice A) is important but not the primary reason for advising high fluid intake. Relief of irritability (choice C) is not directly related to the management of acute pyelonephritis.
The presenting diameter in brow presentation is
- A. Mentovertical
- B. Submentobregmatic
- C. Suboccipitofrontal
- D. Occipitalfrontal
Correct Answer: C
Rationale: The presenting diameter in brow presentation is the suboccipitofrontal diameter. This is because in brow presentation, the fetal head is in a deflexed position, with the largest diameter being from the subocciput (back of the head) to the frontal bone (forehead). This allows the head to enter the pelvis in the transverse diameter.
A: Mentovertical - This refers to the chin to the top of the head, not the correct diameter for brow presentation.
B: Submentobregmatic - This refers to the chin to the bregma, not the correct diameter for brow presentation.
D: Occipitalfrontal - This refers to the back of the head to the forehead, not the correct diameter for brow presentation.
Chemical diabetes mellitus is a classification based on
- A. Symptom are absent and abnormal specific laboratory results
- B. Presence of symptoms and abnormal specific laboratory results
- C. Previous congenital abnormalities and unexplained stillbirth
- D. Previous birth of a baby weighing >4.3kg and spontaneous abortion
Correct Answer: A
Rationale: The correct answer is A: Symptom are absent and abnormal specific laboratory results. Chemical diabetes mellitus refers to a condition where there are abnormal specific laboratory results indicating diabetes without the presence of any symptoms. This classification is based on objective data from laboratory tests rather than subjective symptoms. Choices B, C, and D are incorrect as they do not align with the definition of chemical diabetes mellitus, which focuses on laboratory results rather than symptoms, congenital abnormalities, or pregnancy outcomes.
A patient presents with a 2-day history of abdominal pain, fever, vomiting, and diarrhea. A surgical abdomen is ruled out, and radiography demonstrates inflammation of the small bowel and colon. Microscopy supports a diagnosis of Campylobacter jejuni, and the patient is prepared for discharge from the emergency room. Important patient education includes advising her that
- A. The bacteria may be spread for as long as she has diarrhea
- B. The disorder should resolve on its own; recurrence is rare but represents a much more serious condition
- C. She will need to take a 10-day course of antibiotics
- D. There is no readily identified food source of this bacteria
Correct Answer: D
Rationale: Step 1: Campylobacter jejuni is a bacteria commonly associated with foodborne illness, often found in undercooked poultry and unpasteurized milk.
Step 2: The patient's symptoms and microbiological findings are consistent with Campylobacter infection.
Step 3: Advising the patient that there is no readily identified food source of this bacteria is important for preventing future exposure and potential reinfection.
Step 4: Choices A, B, and C are incorrect as they do not address the specific educational need related to food safety and prevention of Campylobacter infection.
Mr. Novello is an 81-year old male patient who presents with crampy abdominal pain in the hypogastrum and a vague history as to his last normal bowel movement. Physical examination reveals distention and high-pitched bowel sounds. The patient says he has never has this kind of problem before and denies any history of abdominal surgery. Abdominal radiographs reveal a frame pattern of colonic distention. The AGACNP considers
- A. A stimulant laxative to relieve bowel contents
- B. Carcinoma of the bowel as a leading diagnosis
- C. Decompression of the colon with rectal tube
- D. Angiography to rule out mesenteric ischemia
Correct Answer: C
Rationale: The correct answer is C: Decompression of the colon with rectal tube. This is the most appropriate intervention for a patient with acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome. In this condition, there is colonic distention without an actual mechanical obstruction, leading to symptoms like abdominal pain, distention, and high-pitched bowel sounds. Decompression with a rectal tube can help relieve the distention and prevent complications like perforation.
Choice A (stimulant laxative) is incorrect because ACPO is not due to simple constipation, so laxatives would not be effective. Choice B (carcinoma of the bowel) is unlikely given the acute onset and lack of risk factors. Choice D (angiography for mesenteric ischemia) is not indicated in this case as there are no signs of acute ischemia.
In summary, the correct choice is C because it directly addresses the underlying issue of colonic distention in