ed rosy appearance on the face and greatly reduced eliminations are among the features of
- A. Hypothermia neonatorum
- B. Hypoglycemia neonatorum
- C. Hyperthermia neonatorum
- D. Hypocalcemia neonatorum
Correct Answer: C
Rationale: Step-by-step rationale for why choice C is correct:
1. Hyperthermia neonatorum refers to elevated body temperature in newborns.
2. The ed rosy appearance on the face is a common symptom of hyperthermia due to increased blood flow to the skin.
3. Greatly reduced eliminations can be a sign of dehydration associated with hyperthermia.
4. The other choices (hypothermia, hypoglycemia, hypocalcemia) do not align with the symptoms described.
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Jake is a 32-year-old patient who is recovering from major abdominal surgery and organ resection following a catastrophic motor vehicle accident. Due to the nature of his injuries, a large portion of his jejunum had to be resected. In planning for his recovery and nutritional needs, the AGACNP considers that
- A. He will probably be able to transition to oral nutrition but will have lifetime issues with diarrhea
- B. His procedure has put him at significant risk for B12 absorption problems
- C. Most jejunum absorption functions will be assumed by the ileum
- D. Enteral nutrition will need to be delayed for 3 to 6 months to facilitate adaptation
Correct Answer: B
Rationale: The correct answer is B: His procedure has put him at significant risk for B12 absorption problems.
Rationale:
1. Jejunum is primarily responsible for nutrient absorption, including B12.
2. Resection of a large portion of the jejunum can lead to malabsorption of B12.
3. B12 is essential for neurological function and red blood cell production.
4. Patients with significant jejunum resection are at high risk for B12 deficiency.
5. Monitoring B12 levels and potentially requiring supplementation is crucial for patients like Jake.
Summary of other choices:
A: Incorrect. Lifetime issues with diarrhea are not necessarily expected following jejunum resection.
C: Incorrect. The ileum may assume some functions of the jejunum but cannot fully compensate.
D: Incorrect. Enteral nutrition should not be delayed for months as it is essential for Jake's recovery and nutritional needs.
Effects of pregnancy on malaria are
- A. Development of severe anaemia and severe jaundice
- B. Blood smear is always positive and severe anaemia
- C. Therapy limitation and few parasites in severe cases
- D. Loss of pregnancy and severe condition in few parasites
Correct Answer: A
Rationale: Step-by-step rationale for why choice A is correct:
1. Pregnancy can lead to severe anaemia due to increased demand for iron and folate.
2. Pregnancy-induced physiological changes can exacerbate malaria-related anaemia.
3. Severe jaundice may occur in pregnant women with malaria due to liver dysfunction.
4. These effects are common during pregnancy and can worsen with malaria infection.
Summary of why other choices are incorrect:
- Choice B: Blood smear positivity is not always guaranteed in malaria, and severe anaemia is not the only effect.
- Choice C: Therapy limitations can occur, but the presence of few parasites in severe cases is not a defining feature.
- Choice D: Loss of pregnancy can happen, but it is not a universal effect of malaria during pregnancy, and severity is not based on parasite count alone.
The term used to describe the situation whereby there is the presence of more than one part of the fetus on the pelvic brim at the onset of labor is
- A. Unstable lie
- B. Fetal malpresentation
- C. Fetal malposition
- D. Compound presentation
Correct Answer: D
Rationale: The correct answer is D: Compound presentation. This term refers to the situation where there is more than one part of the fetus on the pelvic brim at the onset of labor. This can include a hand or arm alongside the head or another body part. The other choices are incorrect because: A: Unstable lie refers to the fetus being in a transverse position. B: Fetal malpresentation indicates an abnormal presentation of the fetus, such as breech or transverse. C: Fetal malposition refers to the fetus being in a suboptimal position, like occiput posterior. Thus, the best choice is D as it specifically describes the scenario of multiple fetal parts on the pelvic brim.
Jasmine is a 31-year-old female who presents with neck pain. She has a long history of injection drug use and admits to injecting opiates into her neck. Physical examination reveals diffuse tracking and scarring. Today Jasmine has a distinct inability to turn her neck without pain, throat pain, and a temperature of 102.1F. She appears ill and has foul breath. In order to evaluate for a deep neck space infection, the AGACNP orders
- A. Anteroposterior neck radiography
- B. CT scan of the neck
- C. White blood cell (WBC) differential
- D. Aspiration and culture of fluid
Correct Answer: D
Rationale: The correct answer is D: Aspiration and culture of fluid. Given Jasmine's history of injection drug use, neck pain, inability to turn her neck, elevated temperature, and foul breath, there is a high suspicion of a deep neck space infection. Aspiration and culture of fluid from the affected area will help identify the causative organism and guide appropriate antibiotic therapy. This procedure is essential for definitive diagnosis and management of deep neck infections.
A: Anteroposterior neck radiography is not the most appropriate initial diagnostic test for evaluating deep neck space infections as it may not provide detailed information on the extent or nature of the infection.
B: CT scan of the neck may provide valuable information regarding the extent of the infection, but aspiration and culture of fluid are crucial for identifying the causative organism.
C: White blood cell (WBC) differential may show signs of inflammation, but it does not provide specific information on the causative organism of the infection.
An oedematous swelling on the newborn’s scalp is indicative of
- A. Caput succedaneum
- B. Subgaleal hemorrhage
- C. Intracranial injury
- D. Neonatal cephalhematoma
Correct Answer: A
Rationale: The correct answer is A: Caput succedaneum. This swelling is a result of pressure during birth and typically resolves on its own. Subgaleal hemorrhage involves bleeding into the potential space between the periosteum and skull, presenting as a boggy mass. Intracranial injury refers to damage within the skull, often due to trauma. Neonatal cephalhematoma is a subperiosteal collection of blood, causing a localized swelling. Caput succedaneum is the most likely diagnosis based on the description provided.