Nokea
Dwarfism is associated with
- A. Polydactylism
- B. Achondroplasia
- C. Syndactylism
- D. Talipes
Correct Answer: B
Rationale: Dwarfism is typically associated with achondroplasia, a genetic disorder affecting bone growth.
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Signs of obstructed labour per vaginally include
- A. Dry vagina, Oedema of the cervix, Caput succedaneum
- B. Plenty amniotic fluid, Hot/dry vagina, meconium stained liquor
- C. Meconium stained liquor, Hot/dry vagina, Diluted urine
- D. Caput succedaneum, Oedema of the cervix, plenty amniotic fluid
Correct Answer: A
Rationale: Signs of obstructed labor include a dry vagina, oedema of the cervix, and caput succedaneum.
While reviewing the head CT scan of a patient following a motor vehicle accident, the AGACNP appreciates a crescent-shaped fluid collection. This most likely represents
- A. Acute subdural hematoma
- B. Acute epidural hematoma
- C. Acute uncal herniation
- D. Acute brainstem compression
Correct Answer: A
Rationale: A crescent-shaped fluid collection on a head CT scan typically represents an acute subdural hematoma. Acute subdural hematomas result from the tearing of bridging veins that lie between the dura mater and arachnoid mater layers of the meninges. This injury often occurs due to significant head trauma, such as a motor vehicle accident. As blood accumulates within the potential space between the dura and arachnoid layers, it forms a crescent-shaped collection that can compress the underlying brain tissue, leading to symptoms such as altered mental status, headache, focal neurological deficits, and signs of increased intracranial pressure. Treatment may involve surgical intervention to evacuate the hematoma and relieve the pressure on the brain.
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.
On vaginal examination, the findings characteristic of brow presentation include
- A. Presenting diameter is submento-vertical 11.5cm, head partially extended
- B. Back difficult to palpate, fetal heart heard on the same side as the limbs
- C. Presenting diameter is mento-vertical 13.5cm, head partially extended
- D. Presenting diameter is mento-vertical 13.5cm, head completely extended
Correct Answer: A
Rationale: The characteristic presenting diameter in brow presentation is submento-vertical, with the head partially extended.
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