Nokea
In mild preeclampsia, the mother has no complaints.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: The correct answer is B: FALSE. In mild preeclampsia, the mother may have symptoms such as mild hypertension, proteinuria, and sometimes mild edema. This indicates that the mother does have complaints, albeit they may be mild. The other choices (A, C, D) are incorrect because in mild preeclampsia, the mother does have complaints, so option A is not true. Options C and D are not applicable as they do not provide any information.
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The earliest onset of cephalohematoma is
- A. Six hours postnatally
- B. Twelve hours postnatally
- C. Eighteen hours postnatally
- D. Immediately after birth
Correct Answer: A
Rationale: The correct answer is A: Six hours postnatally. Cephalohematoma is a collection of blood between a baby's skull and the periosteum. It typically appears several hours after birth due to trauma during delivery, causing bleeding under the periosteum. This allows time for the blood to accumulate and form a distinct swelling, making the onset around six hours postnatally. Choices B, C, and D are incorrect as they do not align with the typical timeline for the development of cephalohematoma.
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 M. R. is a 52-year-old female who presents complaining of significant abdominal pain, which she rates as 8 to 9 on a 1 to 10 scale. The pain has been going on for a matter of hours, and she is afraid it won’t go away on its own. She denies any nausea or vomiting, and she cannot remember precisely when her last bowel movement occurred; probably it was a few days ago. She reports that she is ―always‖ constipated. On physical examination, she is tachycardic but otherwise has normal vital signs; her abdomen is tensely rigid, but no point tenderness to palpation is appreciated. The entire abdomen percusses as tympanic—there is no distinct dullness over the upper quadrants. Bowel sounds are present but hypoactive and intermittent. There is rebound tenderness to palpation. The AGACNP suspects:
Correct Answer: D
Rationale: The correct answer is D: Provide counseling to the patient regarding her options. The AGACNP's initial action should prioritize the patient's well-being and autonomy. Counseling allows the patient to understand her options, including legal, medical, and emotional support. Reporting to law enforcement (A) without the patient's consent violates her autonomy. Having the patient sign a release to go home with her husband (B) disregards the potential danger and trauma she may face. Consulting psychiatry for a psych hold (C) may not address the immediate emotional and physical needs of the patient.
McEwen sign is associated with
- A. Hydrocephalus
- B. Myelomeningocele
- C. Microcephaly
- D. Encephalocele
Correct Answer: B
Rationale: The correct answer is B: Myelomeningocele. McEwen sign refers to the characteristic scalloping of the frontal bones due to pressure from the expanding brain in individuals with myelomeningocele. This sign is specific to myelomeningocele and is not associated with hydrocephalus (A), microcephaly (C), or encephalocele (D), which have different clinical manifestations and imaging findings. Myelomeningocele is a neural tube defect where the spinal cord and its coverings protrude through an opening in the spine, leading to neurological deficits and associated signs like McEwen sign.
Complications of occipito-posterior position:
- A. Prolonged labor, fetal distress, back pain
- B. Postpartum hemorrhage, uterine rupture, fetal death
- C. Cesarean delivery, low birth weight, infection
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A because occipito-posterior position can lead to prolonged labor due to poor fetal positioning, causing maternal back pain. This can result in fetal distress as the baby may have difficulty descending through the birth canal. Postpartum hemorrhage, uterine rupture, fetal death (choices B and C) are not typically associated with occipito-posterior position. Therefore, choice A is the most appropriate answer.
A patient being monitored post-heart transplant suffers a bradyarrhythmia. The AGACNP knows that which of the following medications is not indicated as part of emergency intervention for bradycardic abnormalities in a posttransplant patient?
- A. Isoproterenol 0.2 to 0.6 mg IV bolus
- B. External pacemaking
- C. Atropine 0.5 mg IV
- D. Epinephrine 1 mg IV
Correct Answer: A
Rationale: The correct answer is A: Isoproterenol 0.2 to 0.6 mg IV bolus. Isoproterenol is a non-selective beta-adrenergic agonist that can worsen graft rejection in heart transplant patients. The appropriate intervention for bradyarrhythmia in posttransplant patients is external pacemaking or pharmacological agents like atropine or epinephrine. Isoproterenol should be avoided due to its potential to stimulate the immune system and increase the risk of rejection. It is crucial to choose interventions that address the bradycardia without compromising the patient's transplant graft.