Nokea
Complete placenta praevia is also referred to as
- A. Type 4
- B. Type 1
- C. Type 2
- D. Type 3
Correct Answer: A
Rationale: Placenta praevia is classified into four types based on the degree of coverage of the cervix by the placenta. Complete placenta praevia, where the internal os is completely covered by the placenta, is referred to as Type 4. This is the correct answer as it accurately describes the specific condition. Choices B, C, and D are incorrect as they do not correspond to the classification system for placenta praevia.
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Deep transverse arrest is
- A. Where flexion is always well maintained.
- B. Caused by strong uterine contractions throughout labor.
- C. Caused by a sacrum that is well curved.
- D. Where the level of the occiput and the sinciput is the same.
Correct Answer: D
Rationale: The correct answer is D because deep transverse arrest occurs when the level of the occiput and the sinciput is the same, leading to a failure of descent of the fetal head through the pelvis. This alignment issue hinders the progress of labor despite adequate contractions.
A: Incorrect. Flexion being well maintained is not a defining characteristic of deep transverse arrest.
B: Incorrect. While strong uterine contractions can contribute to labor challenges, deep transverse arrest is specifically related to the alignment of the fetal head.
C: Incorrect. The curvature of the sacrum is not directly related to deep transverse arrest.
Which of the following is NOT a source of pain in labour?
- A. Uterine contractions
- B. Socio-cultural norms
- C. Cervical dilatation
- D. Pelvic floor stretching
Correct Answer: B
Rationale: Step 1: Uterine contractions are a physiological process in labor causing pain due to muscle contractions.
Step 2: Cervical dilatation involves the opening of the cervix, which can cause pain and discomfort.
Step 3: Pelvic floor stretching occurs as the baby moves through the birth canal, leading to pain.
Step 4: Socio-cultural norms do not directly cause physical pain in labor, making choice B the correct answer. Other choices directly relate to physical processes causing pain.
In myelodysplastic syndromes, the primary indications for splenectomy include
- A. Major hemolysis unresponsive to medical management
- B. Severe symptoms of massive splenomegaly
- C. Sustained leukocyte elevation above 30,000 cells/µL
- D. Portal hypertension
Correct Answer: C
Rationale: The correct answer is C. In myelodysplastic syndromes, splenectomy is indicated for sustained leukocyte elevation above 30,000 cells/µL to manage symptomatic splenomegaly and cytopenias. This is because an enlarged spleen can sequester and destroy blood cells, leading to low blood cell counts. Choices A, B, and D are incorrect as splenectomy is not typically indicated for major hemolysis unresponsive to medical management, severe symptoms of massive splenomegaly, or portal hypertension in the context of myelodysplastic syndromes.
The baby dies immediately after birth due to the presence of
- A. Pulmonary stenosis
- B. Aortic coarctation
- C. Truncus arteriosus
- D. Ductus arteriosus
Correct Answer: C
Rationale: The correct answer is C: Truncus arteriosus. In this congenital heart defect, a single large blood vessel arises from the heart instead of the normal two separate vessels (aorta and pulmonary artery). This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygen supply to the body. This condition is incompatible with life, causing immediate death after birth.
A: Pulmonary stenosis and B: Aortic coarctation are also congenital heart defects but do not typically result in immediate death after birth. Pulmonary stenosis obstructs blood flow to the lungs, while aortic coarctation causes narrowing of the aorta.
D: Ductus arteriosus is a normal fetal blood vessel that connects the pulmonary artery and the aorta but usually closes shortly after birth. Failure of closure can lead to health issues, but it is not typically a cause of immediate death after birth.
Mr. Costigan is a 50-year-old male patient who recently had a screening colonoscopy because it was recommended by his primary care provider as a screening measure. He received a report that noted inflammatory polyps. He is concerned because one of his friends had polyps that turned into cancer. While advising Mr. Costigan, the AGACNP tells him that
- A. The polyps are considered precancerous, but if he has a colonoscopy every 3 to 5 years, any new polyps can be removed before they become malignant
- B. The primary danger is when there is a family history of colon cancer; he should discuss with his mother and father the presence of any colon cancer in the family
- C. There is no chance that these polyps could become cancerous, and their presence does not require any additional action or concern on his part
- D. He would be best served at this point to discuss with an oncologist the risks and benefits of aggressive versus conservative treatment.
Correct Answer: B
Rationale: Step 1: Family history of colon cancer is a significant risk factor for developing colon cancer.
Step 2: By discussing with his parents, Mr. Costigan can determine if there is a family history of colon cancer.
Step 3: Knowing this information can help assess his own risk and guide appropriate screening and preventive measures.
Step 4: The primary danger for Mr. Costigan lies in potential genetic predisposition rather than the presence of inflammatory polyps.
Step 5: Therefore, discussing with family members about any history of colon cancer is crucial for his overall risk assessment and management.
Summary:
- Choice A is incorrect as the frequency of colonoscopy should be individualized based on the patient's risk factors.
- Choice C is incorrect as all polyps have the potential to become cancerous, especially inflammatory polyps.
- Choice D is incorrect as consulting an oncologist at this stage is premature without first assessing family history.