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How does maternal age impact pregnancy risks?
- A. Older mothers are at higher risk for preeclampsia
- B. Younger mothers are at higher risk of miscarriage
- C. Advanced age increases cesarean rates
- D. Both A and C
Correct Answer: D
Rationale: The correct answer is D because both statements A and C are true. Older mothers have a higher risk of developing preeclampsia due to age-related complications. Additionally, advanced maternal age is associated with an increased likelihood of requiring a cesarean section due to factors like decreased uterine elasticity. Statement B is incorrect as younger mothers are not at higher risk of miscarriage compared to older mothers. This is because maternal age is not a significant factor in miscarriage risk.
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A 42-year-old woman presents to the emergency department after being raped. The AGACNP examines her and realizes that the patients husband is the rapist. The patient does not want to press charges and wants to return home with her husband. The AGACNPs initial action should be to
- A. Report the physical assault to law enforcement
- B. Have the patient sign a release to go home with her husband
- C. Consult psychiatry for a psych hold
- D. Provide counseling to the patient regarding her options Downloaded by: basil7kl | basil7kl@gmail.com Distribution of this document is illegal Stuvia.com - The Marketplace to Buy and Sell your Study Material
Correct Answer: D
Rationale: The correct initial action for the AGACNP is to provide counseling to the patient regarding her options (Choice D). This is important to ensure the patient's safety, well-being, and autonomy. Counseling will allow the patient to explore her feelings, understand her options, and make an informed decision about her next steps. Reporting the physical assault to law enforcement (Choice A) should only be done with the patient's consent to respect her wishes. Having the patient sign a release to go home with her husband (Choice B) could potentially put the patient at risk of further harm. Consulting psychiatry for a psych hold (Choice C) may not be appropriate unless the patient is deemed a danger to herself or others.
Which one of the following signs is indicative of possible shoulder dystocia during delivery?
- A. Failure of internal rotation of the head
- B. Fetal head retracts against the perineum
- C. Gentle traction aids in effecting the delivery
- D. The occiput slowly restitutes towards the left side
Correct Answer: B
Rationale: The correct answer is B: Fetal head retracts against the perineum. This sign indicates possible shoulder dystocia as it suggests the baby's shoulders are impacted and unable to pass through the birth canal. The retraction of the fetal head against the perineum is a classic sign of shoulder dystocia, which requires specific maneuvers to dislodge the shoulders and facilitate delivery.
A: Failure of internal rotation of the head is not specific to shoulder dystocia.
C: Gentle traction should not be applied in cases of shoulder dystocia as it can worsen the situation.
D: The occiput restituting towards the left side is not a sign of shoulder dystocia, as it refers to the rotation of the fetal head during delivery.
Mrs. Coates is a 65-year-old female who is on postoperative day 1 following a duodenal resection for a bleeding ulcer. She had an uneventful immediate postoperative course, but throughout the course of day 1 she has complained of a mild abdominal discomfort that has progressed throughout the day. This evening the AGACNP is called to the bedside to evaluate the patient for persistent and progressive discomfort. Likely causes of her symptoms include all of the following except
- A. Colic due to return of peristalsis
- B. Leakage from the duodenal stump
- C. Gastric retention
- D. Hemorrhage
Correct Answer: C
Rationale: The correct answer is C: Gastric retention. Mrs. Coates' symptoms of persistent and progressive discomfort are not likely due to gastric retention because she underwent a duodenal resection for a bleeding ulcer, which would bypass the stomach. Therefore, gastric retention is not a possible cause.
A: Colic due to return of peristalsis is a possible cause as peristalsis returning after surgery can cause discomfort.
B: Leakage from the duodenal stump is a possible cause as it can lead to abdominal discomfort postoperatively.
D: Hemorrhage is a possible cause given her history of bleeding ulcer and surgery.
The last part to be replaced in uterine inversion is the
- A. Cervix
- B. Fundus
- C. Isthmus
- D. Body
Correct Answer: B
Rationale: The correct answer is B: Fundus. In uterine inversion, the uterus is turned inside out, with the fundus protruding through the cervix. The fundus is the last part to be replaced during the reduction process because it is the uppermost part of the uterus. The cervix, isthmus, and body are other parts of the uterus that are not the last to be replaced in uterine inversion. The cervix is the lower part, the isthmus is the narrow portion, and the body is the main part of the uterus. Hence, the fundus is the correct choice for the last part to be replaced in uterine inversion.
Which one of the following features is indicative of an abnormal labour pattern?
- A. Presence of the retraction ring
- B. Presence of the Bandl’s ring
- C. Cervical canal short and thin
- D. Vagina is warm and moist
Correct Answer: B
Rationale: The correct answer is B: Presence of the Bandl's ring. This is indicative of an abnormal labor pattern as it may suggest a uterine rupture, which is a serious complication. Bandl's ring is a constriction ring formed between the upper and lower uterine segments due to excessive uterine contractions. It can lead to fetal distress and necessitate immediate medical intervention.
A: Presence of the retraction ring is a normal phenomenon during labor, marking the boundary between the lower and upper uterine segments.
C: Cervical canal short and thin can be a normal variation in labor and does not necessarily indicate an abnormal pattern.
D: Vagina being warm and moist is a common physiological response during labor and does not provide information on the progress or abnormality of labor.