Nokea
Hypoplastic left heart syndrome is characterized by underdevelopment of
- A. Pulmonary veins, ventricles and aortic valve
- B. Left ventricle, atrium and pulmonary vessels
- C. Aorta arch, venacava and right atrium
- D. Left ventricle, aortic valve and arch
Correct Answer: D
Rationale: The correct answer is D because hypoplastic left heart syndrome involves underdevelopment of the left ventricle, aortic valve, and aortic arch. The left ventricle is typically small and unable to adequately pump blood to the body. The aortic valve is often malformed, leading to difficulties in blood flow from the heart to the body. Additionally, the aortic arch may be narrow or underdeveloped, further impacting blood circulation.
Choice A is incorrect as it includes the pulmonary veins, which are not typically affected in hypoplastic left heart syndrome. Choice B is incorrect as it focuses on the left atrium and pulmonary vessels, which are not the primary structures affected in this condition. Choice C is incorrect as it mentions the aorta arch, venacava, and right atrium, which are not primarily associated with hypoplastic left heart syndrome.
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Which of the following is NOT a source of pain in labour?
- A. Uterine contractions
- B. Socio-cultural norms
- C. Cervical dilatation
- D. Pelvic floor stretching
Correct Answer: B
Rationale: Step 1: Uterine contractions are a physiological process in labor causing pain due to muscle contractions.
Step 2: Cervical dilatation involves the opening of the cervix, which can cause pain and discomfort.
Step 3: Pelvic floor stretching occurs as the baby moves through the birth canal, leading to pain.
Step 4: Socio-cultural norms do not directly cause physical pain in labor, making choice B the correct answer. Other choices directly relate to physical processes causing pain.
Justin F. is seen in the emergency department with an 8-cm jagged laceration on the dorsal surface of his right forearm. He says he was working with his brother-in-law yesterday morning building a deck on the back of his home. A pile of wooden planks fell on top of him, and he sustained a variety of cuts and superficial injuries. He cleaned the wound with soap and water but didnt want to go to the emergency room because he didnt want to risk being in the waiting room for hours. He wrapped up his arm and went back to work, and then took a normal shower and went to bed last night. This morning the cut on his arm was still flapping open, and he realized he needed sutures. The appropriate management of this patient includes
- A. Proper cleansing and covering of the laceration, along with antibiotic therapy
- B. Local anesthesia, cleansing, and wound exploration for foreign bodies
- C. Local anesthesia, cleansing, and suture repair
- D. Cleansing, covering, antibiotic therapy, and tetanus prophylaxis
Correct Answer: C
Rationale: The correct answer is C: Local anesthesia, cleansing, and suture repair.
1. Local anesthesia is needed to numb the area before suturing.
2. Cleansing is necessary to prevent infection and remove debris.
3. Suture repair is required for a jagged laceration to promote proper wound healing and minimize scarring.
Other choices are incorrect:
A: Antibiotic therapy is not indicated for clean, non-infected wounds like this laceration.
B: Wound exploration for foreign bodies is not necessary in this case as the mechanism of injury is known and there is no indication of foreign bodies.
D: Tetanus prophylaxis is important but not directly related to the immediate management of the laceration.
A client is declared fit for a vaginal birth after cesarean section if
- A. Her previous C/S was due to cephalopelvic disproportion
- B. The current pregnancy is confirmed a multiple pregnancy
- C. Previous delivery was via cesarean section
- D. Previous delivery was via spontaneous vertex delivery
Correct Answer: D
Rationale: The correct answer is D because a client is declared fit for a vaginal birth after cesarean section if their previous delivery was via spontaneous vertex delivery. This indicates that the client has successfully given birth vaginally before, reducing the risk associated with a vaginal birth after cesarean section.
A, B, and C are incorrect:
A: Cephalopelvic disproportion was the reason for the previous C/S, indicating potential difficulty in vaginal delivery.
B: Confirmation of a multiple pregnancy does not impact the client's eligibility for a vaginal birth after cesarean section.
C: Previous cesarean section does not necessarily mean the client is fit for a vaginal birth after cesarean section.
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.
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.