Nokea
Flexion-distraction injuries of the thoracolumbar spine are most commonly caused by
- A. Blunt trauma
- B. Rotational injury
- C. Seat belts
- D. Gunshot wounds
Correct Answer: B
Rationale: The correct answer is B: Rotational injury. Flexion-distraction injuries of the thoracolumbar spine are often caused by rotational forces that occur during accidents such as motor vehicle collisions or falls. These forces lead to the spine being twisted, causing separation of the vertebrae. Blunt trauma (A) can cause various spinal injuries but is not specific to flexion-distraction injuries. Seat belts (C) are designed to prevent spinal injuries by restraining the body during a collision. Gunshot wounds (D) can cause spinal cord injuries but are not commonly associated with flexion-distraction injuries of the thoracolumbar spine.
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Sara S. is a 41-year-old patient who has just had a bone marrow transplant. The AGACNP knows that which medication will be used to decrease her risk of graft-versus-host reaction?
- A. Immune globulin
- B. Cyclosporine
- C. Prophylactic antibiotics
- D. Systemic corticosteroids
Correct Answer: A
Rationale: The correct answer is A: Immune globulin. Post bone marrow transplant, immune globulin is used to decrease the risk of graft-versus-host reaction by providing passive immunity. This helps in reducing the chances of the donor's immune cells attacking the recipient's tissues. Immune globulin does not suppress the immune system like cyclosporine (B) or systemic corticosteroids (D) do, which could increase the risk of infections post-transplant. Prophylactic antibiotics (C) are used to prevent infections but do not specifically target graft-versus-host reaction.
Persistent nausea and vomiting related to pregnancy is indicative of
- A. Morning sickness
- B. Multiple gestation
- C. Hyperemesis gravidarum
- D. Hypertensive disorders
Correct Answer: C
Rationale: The correct answer is C: Hyperemesis gravidarum. This condition is characterized by severe nausea, vomiting, weight loss, dehydration in pregnancy. It is more severe than typical morning sickness (choice A) and is not specific to multiple gestation (choice B). Hypertensive disorders (choice D) typically present with high blood pressure, proteinuria, and edema, not just nausea and vomiting. Hyperemesis gravidarum requires medical intervention due to potential complications from dehydration and malnutrition.
Mrs. Jenner is a 41-year-old female who is being evaluated for persistent nausea. She had an abdominal CT scan that reported three hepatic hemangiomas ranging from 3 to 5 cm. The AGACNP knows that the appropriate response to this report is to
- A. Arrange for large-bore needle biopsy
- B. Order hepatic ultrasound annually to follow progression
- C. Consult surgery for resection
- D. Document the finding in the patient’s chart
Correct Answer: A
Rationale: Rationale:
A needle biopsy is appropriate for definitive diagnosis of hepatic hemangiomas, ruling out other liver lesions. It helps determine if they are benign or malignant. This will guide further management decisions.
Summary:
B: Annual ultrasound is unnecessary for benign hemangiomas.
C: Surgery is not indicated for asymptomatic hepatic hemangiomas.
D: Documenting the finding is important but not the appropriate next step in management.
The comprehensive serologic assessment of a patient with Cushings syndrome is likely to produce which constellation of findings?
- A. Low potassium, high glucose, high white blood cell count
- B. High sodium, polycythemia, low BUN
- C. Low sodium, low potassium, high BUN
- D. High sodium, high chloride, high RBCs
Correct Answer: C
Rationale: The correct answer is C. In Cushing's syndrome, there is excess cortisol production leading to sodium retention, potassium loss, and increased protein breakdown. Low sodium and potassium levels along with high BUN are commonly seen in patients with Cushing's syndrome.
A: Low potassium and high glucose are possible findings, but high white blood cell count is not typically associated with Cushing's syndrome.
B: High sodium and polycythemia are not typical findings in Cushing's syndrome, and low BUN is not consistent with the protein breakdown seen in this condition.
D: High sodium and high chloride levels can be seen, but high RBCs are not typically associated with Cushing's syndrome.
The factor indicative of an abnormal labour pattern on vaginal examination is
- A. The vagina is warm and moist
- B. Cervical canal is long and thick
- C. Cervical canal is short and thin
- D. The vagina is hot and dry
Correct Answer: C
Rationale: Step 1: In normal labor, the cervix undergoes effacement and dilation.
Step 2: A short and thin cervical canal indicates progression towards labor.
Step 3: Long and thick cervical canal suggests a delay in labor progress.
Step 4: Choice C, short and thin cervical canal, is indicative of abnormal labor.
Summary: A, B, and D do not reflect changes in the cervix seen in labor, making them incorrect choices.