Nokea
How can Braxton Hicks contractions be differentiated from true labor?
- A. By timing
- B. By intensity
- C. By duration
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D - All of the above. Braxton Hicks contractions can be differentiated from true labor by timing, intensity, and duration. Timing refers to the regularity of contractions, intensity relates to the strength of contractions, and duration indicates how long contractions last. By considering all three factors together, one can determine whether contractions are Braxton Hicks (practice contractions) or true labor contractions. Choices A, B, and C alone provide only partial information, which may lead to misinterpretation. Therefore, choosing all three factors collectively (D) is essential for accurate differentiation.
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Based upon an understanding of the normal relationship between gastrin levels and acid secretion, the AGACNP recognizes that which of the following combinations is almost diagnostic of gastrinoma?
- A. Hypogastrinemia and acid hyposecretion
- B. Hypergastrinemia and acid hyposecretion
- C. Hypogastrinemia and acid hypersecretion
- D. Hypergastrinemia and acid hypersecretion
Correct Answer: A
Rationale: The correct answer is A: Hypogastrinemia and acid hyposecretion. Gastrinoma is a tumor that secretes excessive gastrin, leading to hypergastrinemia and increased acid secretion. However, due to a negative feedback mechanism, chronic exposure to high gastrin levels can cause downregulation of gastrin receptors on parietal cells, leading to decreased acid secretion. Therefore, in gastrinoma, despite high gastrin levels, acid secretion may be reduced due to this negative feedback loop. Choices B, C, and D are incorrect because they do not align with the expected relationship between gastrin levels and acid secretion in gastrinoma.
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.
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.
Which of the following is not a true statement with respect to decision making for a cognitively impaired patient?
- A. Only a court can declare a patient incompetent
- B. Impaired cognition does not make a person incompetent
- C. Living wills typically are honored if a person is terminally ill
- D. A patient can give informed consent if not declared incompetent
Correct Answer: C
Rationale: The correct answer is C because living wills are typically not honored for terminally ill patients with impaired cognition. Firstly, living wills require the patient to be of sound mind to make decisions. Secondly, in the case of a cognitively impaired patient, their ability to express their wishes and understand the implications may be compromised. Therefore, healthcare providers may not be able to honor the living will accurately. Choices A, B, and D are incorrect because A) competency can be determined by healthcare professionals, B) impaired cognition can lead to incompetence, and D) informed consent requires the patient to understand the decision-making process.
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.