Nokea
Complications of unrepaired cleft lip and palate include
- A. Pneumonia and retarded growth
- B. Mental retardation and blindness
- C. Failure to thrive and deafness
- D. Impaired speech and convulsions
Correct Answer: D
Rationale: Failure to thrive and impaired speech are common complications due to feeding and developmental issues with cleft lip and palate.
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P. T. is a 58-year-old female who is admitted with chest pain and shortness of breath and is found to have a large pulmonary embolus. Her systolic blood pressure is falling, and a diagnosis of obstructive shock is made. Cardiac pressure would likely demonstrate
- A. Elevated atrial and decreased ventricular pressures
- B. Elevated right-sided and decreased left-sided pressures
- C. Elevated left ventricular pressure and decreased cardiac output
- D. Elevated left ventricular pressure and decreased systemic vascular resistance
Correct Answer: B
Rationale: Obstructive shock, such as in this case of a large pulmonary embolus causing obstructive shock, results in a sudden increase in right ventricular afterload due to obstruction of blood flow. This leads to right heart failure and decreased left ventricular preload, ultimately resulting in decreased cardiac output. The elevated right-sided pressures will be reflected by elevated right atrial and ventricular pressures, while the left ventricular pressures will be decreased due to decreased preload. This commonly leads to a situation known as acute cor pulmonale, where the right heart becomes dilated and dysfunctional in response to the increased afterload.
A circumscribed swelling on the newborn’s scalp is indicative of
- A. Caput succedaneum
- B. Subgaleal hemorrhage
- C. Intracranial injury
- D. Neonatal cephalhematoma
Correct Answer: D
Rationale: Neonatal cephalhematoma is a circumscribed swelling on the newborn’s scalp due to pressure during delivery.
The presenting diameter in face presentation is
- A. Submento-vertical
- B. Mento-vertical
- C. Suboccipito-bregmatic
- D. Submento-bregmatic
Correct Answer: A
Rationale: In face presentation, the presenting diameter is submento-vertical.
On postoperative day 7 following hepatic transplant, the patient evidences signs and symptoms of acute rejection, confirmed by histologic examination. The AGACNP knows that first-line treatment of acute rejection consists of
- A. Cyclosporine
- B. Azathioprine
- C. Methylprednisolone
- D. Sirolimus
Correct Answer: D
Rationale: The first-line treatment for acute rejection following hepatic transplant is high-dose corticosteroids, such as methylprednisolone. This is because corticosteroids have potent anti-inflammatory and immunosuppressive effects that can help suppress the immune response causing rejection. Cyclosporine, azathioprine, and sirolimus are also commonly used immunosuppressive medications in transplant patients, but in this case of acute rejection, the immediate treatment of choice is methylprednisolone.
A client is declared fit for vaginal birth after cesarean section if
- A. Her previous C/S was due to cephalopelvic disproportion
- B. The current pregnancy is confirmed as a multiple pregnancy
- C. Previous delivery was via cesarean section
- D. Previous delivery was via spontaneous vertex delivery
Correct Answer: D
Rationale: Vaginal birth after cesarean section is possible if the previous delivery was via spontaneous vertex delivery