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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 characteristic of monozygotic twins is that
- A. They are always of the same sex
- B. They share a similar fingerprint pattern
- C. They have different blood groups
- D. Superfetation is a common finding
Correct Answer: A
Rationale: The correct answer is A because monozygotic twins, also known as identical twins, develop from a single fertilized egg and share the same genetic material. This results in them always being of the same sex. Choice B is incorrect because fingerprint patterns are not solely determined by genetics. Choice C is incorrect because monozygotic twins will have the same blood group since they share the same DNA. Choice D is incorrect because superfetation, the fertilization of multiple eggs at different times during the same pregnancy, is not common in monozygotic twins.
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.
Janet is a 54-year-old female who is in the ICU following hepatic resection due to metastatic disease. She is expected to move to a general medical floor today. Morning labs are as follows serum bilirubin approximately 2 gdL, albumin 3.1 gdL, and prothrombin time 20 seconds. AST and ALT are 85 and 99 respectively. The appropriate response would be to
- A. Cancel the transfer and keep her in the ICU
- B. Infuse albumin and fresh frozen plasma
- C. Repeat the labs the next day
- D. Prepare for reoperation
Correct Answer: B
Rationale: The correct answer is B: Infuse albumin and fresh frozen plasma. Given Janet's post-hepatic resection status and abnormal lab values indicating liver dysfunction (elevated bilirubin, low albumin, prolonged prothrombin time, elevated AST and ALT), she is at risk for coagulopathy and hypoalbuminemia. Infusing albumin can help improve her oncotic pressure and fluid balance, while fresh frozen plasma can replenish clotting factors to address the prolonged prothrombin time. This intervention aims to stabilize her condition before transferring to the general medical floor.
Canceling the transfer (Choice A) is not necessary if appropriate interventions can be taken. Repeating labs the next day (Choice C) delays potentially needed treatments. Preparing for reoperation (Choice D) is not indicated based on the information provided.
Which one of the following clinical features denotes cardiac disease grade III?
- A. Patient is comfortable even at rest
- B. Patient is asymptomatic initially
- C. Marked limitation of physical activity
- D. Absolute limitation of physical activity
Correct Answer: C
Rationale: The correct answer is C: Marked limitation of physical activity. In cardiac disease grading, grade III signifies marked limitation of physical activity. This indicates that the patient experiences symptoms with less than ordinary physical activity, such as shortness of breath or chest pain. This grade reflects significant impairment in daily activities due to cardiac issues.
A: Patient is comfortable even at rest - This describes grade I, where patients are comfortable at rest.
B: Patient is asymptomatic initially - This describes pre-symptomatic stages before any limitations in physical activity.
D: Absolute limitation of physical activity - This is more severe and indicative of grade IV, where any physical activity causes discomfort or symptoms.
A medical/obstetric predisposing factor to puerperal sepsis includes
- A. Delivery by unskilled birth attendants
- B. Emergency cesarean section
- C. Poor personal hygiene
- D. Delay in care seeking
Correct Answer: B
Rationale: The correct answer is B: Emergency cesarean section. Emergency cesarean sections can increase the risk of puerperal sepsis due to the urgency of the procedure, which may lead to inadequate sterilization or contamination. Other choices are less directly associated with puerperal sepsis: A may increase the risk of infection, but not specifically puerperal sepsis. C relates to general hygiene practices and D focuses on delays in seeking care, which may affect treatment outcomes but are not direct predisposing factors to puerperal sepsis.