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How can maternal smoking during pregnancy affect fetal development?
- A. Causes low birth weight
- B. Increases the risk of preterm birth
- C. Affects lung development
- D. All of the above
Correct Answer: D
Rationale: Maternal smoking during pregnancy can affect fetal development in multiple ways. Smoking can cause low birth weight by restricting oxygen and nutrients to the fetus, leading to growth issues. It can also increase the risk of preterm birth due to the harmful chemicals in cigarette smoke. Furthermore, smoking can affect lung development in the fetus, leading to respiratory issues. Therefore, the correct answer is D - All of the above, as maternal smoking can have a comprehensive impact on fetal development, including low birth weight, preterm birth, and lung development issues.
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A student AGACNP just beginning his clinical rotation is observing his preceptor perform a physical survey on a patient who is brought in following a serious motor vehicle accident. The student observes that the physical examination includes rectovaginal examination, inspection of the urethral meatus, and palpation of the pelvic landmarks. The student knows the patient is being assessed for
- A. Peritoneal bleeding
- B. Retroperitoneal bleeding
- C. Paresthesia
- D. Pelvic fracture
Correct Answer: B
Rationale: The correct answer is B: Retroperitoneal bleeding. The physical survey described focuses on assessing for internal bleeding within the retroperitoneal space following a serious motor vehicle accident. The rectovaginal examination, inspection of the urethral meatus, and palpation of pelvic landmarks help evaluate for signs of pelvic fracture and internal bleeding. These assessments help identify potential sources of retroperitoneal bleeding, which can be a life-threatening complication of trauma. Peritoneal bleeding (choice A) involves bleeding within the abdominal cavity, which is less likely in this scenario. Paresthesia (choice C) refers to abnormal sensations like tingling or numbness, which are not typically assessed through physical examination in this context. Pelvic fracture (choice D) is a possible outcome of trauma but does not directly assess for retroperitoneal bleeding.
The MAIN clinical feature of puerperal psychosis is
- A. Episodic insomnia
- B. Neglect of hygiene
- C. Major depression
- D. Mild headache
Correct Answer: C
Rationale: The correct answer is C, major depression. Puerperal psychosis is a severe mental health condition that occurs in the postpartum period, characterized by symptoms such as hallucinations, delusions, and disorganized thinking. Major depression is a key clinical feature, often accompanied by mood disturbances and severe emotional distress.
Rationale:
- A: Episodic insomnia is a common symptom in various mental health disorders but not specific to puerperal psychosis.
- B: Neglect of hygiene may occur in severe cases but is not the main clinical feature of puerperal psychosis.
- D: Mild headache is not a characteristic symptom of puerperal psychosis, which is primarily marked by severe psychiatric symptoms.
Mallory-Weiss syndrome is a complication of
- A. Placenta praevia
- B. Cardiac disease
- C. Postpartum haemorrhage
- D. Hyperemesis gravidarum
Correct Answer: D
Rationale: Mallory-Weiss syndrome is caused by severe vomiting leading to tears in the esophagus. Hyperemesis gravidarum is severe nausea and vomiting during pregnancy, which can result in Mallory-Weiss syndrome. Placenta praevia, cardiac disease, and postpartum hemorrhage are not directly associated with Mallory-Weiss syndrome.
Inadequate levels of surfactant in a neonate leads to a condition referred to as
- A. Meconium aspiration syndrome
- B. Intranatal pneumonia
- C. Respiratory distress syndrome
- D. Congenital pneumothorax
Correct Answer: C
Rationale: The correct answer is C: Respiratory distress syndrome. Surfactant is essential for reducing surface tension in the alveoli, preventing their collapse. Inadequate levels of surfactant in a neonate result in respiratory distress syndrome. Meconium aspiration syndrome (A) is due to inhalation of meconium by the neonate. Intranatal pneumonia (B) is an infection acquired during birth. Congenital pneumothorax (D) is the presence of air in the pleural space, not directly related to surfactant levels.
A patient who has been in the intensive care unit for 17 days develops hyponatremic hyperosmolality. The patient weighs 132 lb (59.9 kg), is intubated, and is receiving mechanical ventilation. The serum osmolality is 320 mOsmL kg H2O. Clinical signs include tachycardia and hypotension. The adult-gerontology acute care nurse practitioners initial treatment is to
- A. reduce serum osmolality by infusing a 5% dextrose in 0.2% sodium chloride solution
- B. reduce serum sodium concentration by infusing a 0.45% sodium chloride solution
- C. replenish volume by infusing a 0.9% sodium chloride solution
- D. replenish volume by infusing a 5% dextrose in water solution.
Correct Answer: B
Rationale: The correct answer is B: reduce serum sodium concentration by infusing a 0.45% sodium chloride solution. In hyponatremic hyperosmolality, the primary goal is to correct the low serum sodium levels. A 0.45% sodium chloride solution is hypotonic, which helps to slowly correct the serum sodium concentration without causing rapid shifts in osmolality. Infusing a hypotonic solution will gradually increase the serum sodium levels, addressing the underlying issue. Choices A, C, and D are incorrect because they do not directly address the low serum sodium levels, which is essential in treating hyponatremic hyperosmolality. Infusing a 5% dextrose in 0.2% sodium chloride solution (Choice A) or a 5% dextrose in water solution (Choice D) would not correct the low sodium levels. Replenishing volume with a 0.9% sodium chloride solution (Choice C) would not directly