Nokea
Classical vitamin K deficiency bleeding occurs
- A. Within the first 24 hours of birth
- B. Within the neonatal stage
- C. Within the infancy stage
- D. Within the first week of birth
Correct Answer: B
Rationale: Classical vitamin K deficiency bleeding occurs within the neonatal stage because newborns have low levels of vitamin K, which is essential for blood clotting. This deficiency typically manifests between 1-7 days after birth. Bleeding within the first 24 hours (choice A) is unlikely as it is too early for vitamin K deficiency to cause symptoms. Bleeding within infancy (choice C) is incorrect as it specifically refers to the neonatal stage. Bleeding within the first week of birth (choice D) is a close distractor, but the critical period for classical vitamin K deficiency bleeding is within the neonatal stage, which is slightly more specific than the first week of birth.
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A clinical feature that is suggestive of hypothermia neonatorum is
- A. Bradycardia
- B. Hyperglycemia
- C. Hypoventilation
- D. Hyperventilation
Correct Answer: A
Rationale: The correct answer is A: Bradycardia. Hypothermia neonatorum is characterized by low body temperature in newborns, which can lead to bradycardia as the heart rate decreases in response to the cold stress. Bradycardia is a common physiological response to hypothermia as the body tries to conserve energy and maintain vital functions. Hyperglycemia, hypoventilation, and hyperventilation are not specific clinical features of hypothermia neonatorum. Hyperglycemia is more commonly associated with conditions like diabetes, hypoventilation could be a sign of respiratory distress, and hyperventilation is usually seen in response to metabolic acidosis or anxiety.
Based upon an understanding of the normal relationship between gastrin levels and acid secretion, the AGACNP recognizes that which of the following combinations is almost diagnostic of gastrinoma?
- A. Hypogastrinemia and acid hyposecretion
- B. Hypergastrinemia and acid hyposecretion
- C. Hypogastrinemia and acid hypersecretion
- D. Hypergastrinemia and acid hypersecretion
Correct Answer: D
Rationale: The correct answer is D: Hypergastrinemia and acid hypersecretion. Gastrinoma is a tumor that secretes excessive gastrin, leading to elevated gastrin levels. High gastrin levels stimulate acid secretion in the stomach, resulting in acid hypersecretion. Therefore, the combination of hypergastrinemia and acid hypersecretion is almost diagnostic of gastrinoma.
A: Hypogastrinemia and acid hyposecretion is incorrect because gastrinoma leads to increased gastrin levels and subsequent acid hypersecretion.
B: Hypergastrinemia and acid hyposecretion is incorrect because gastrinoma is associated with acid hypersecretion, not hyposecretion.
C: Hypogastrinemia and acid hypersecretion is incorrect because gastrinoma causes elevated gastrin levels and acid hypersecretion, not hypogastrinemia.
In summary, the correct answer D aligns with the pathophysiology of gastrinoma, while the
A student AGACNP just beginning his clinical rotation is observing his preceptor perform a physical survey on a patient who is brought in following a serious motor vehicle accident. The student observes that the physical examination includes rectovaginal examination, inspection of the urethral meatus, and palpation of the pelvic landmarks. The student knows the patient is being assessed for
- A. Peritoneal bleeding
- B. Retroperitoneal bleeding
- C. Paresthesia
- D. Pelvic fracture
Correct Answer: B
Rationale: The correct answer is B: Retroperitoneal bleeding. The physical survey described focuses on assessing for internal bleeding within the retroperitoneal space following a serious motor vehicle accident. The rectovaginal examination, inspection of the urethral meatus, and palpation of pelvic landmarks help evaluate for signs of pelvic fracture and internal bleeding. These assessments help identify potential sources of retroperitoneal bleeding, which can be a life-threatening complication of trauma. Peritoneal bleeding (choice A) involves bleeding within the abdominal cavity, which is less likely in this scenario. Paresthesia (choice C) refers to abnormal sensations like tingling or numbness, which are not typically assessed through physical examination in this context. Pelvic fracture (choice D) is a possible outcome of trauma but does not directly assess for retroperitoneal bleeding.
The appropriate time to perform external cephalic version in a breech presentation is at
- A. 36 gestational weeks
- B. 38 gestational weeks
- C. 42 gestational weeks
- D. 40 gestational weeks
Correct Answer: A
Rationale: Rationale for correct answer (A): At 36 weeks, the baby has enough room to move, reducing risks of complications during external cephalic version. Earlier intervention also allows for possible repeat attempts if needed. This timing aligns with guidelines for optimal success rates.
Summary of other choices:
B: 38 weeks may be too late as the baby may have less space to turn.
C: 42 weeks is post-term and poses risks for both the baby and the mother.
D: 40 weeks is close to full term and may not allow for adequate time for successful version.
Haematinics, dietary advice, and close surveillance are management plans for
- A. Moderate anaemia
- B. Mild anaemia
- C. Severe anaemia
- D. Anaemia prevention
Correct Answer: A
Rationale: The correct answer is A: Moderate anaemia. Haematinics, dietary advice, and close surveillance are appropriate management plans for moderate anaemia to improve iron levels and overall health. For mild anaemia, dietary changes alone may be sufficient. Severe anaemia often requires more aggressive treatments like blood transfusions. Anaemia prevention focuses on strategies to avoid developing anaemia rather than managing an existing case.