Nokea
In obstructed labor, edema of the vulva presents early due to
- A. Prolonged effort of the mother to push the baby
- B. Pressure applied on cervix by the presenting part
- C. An ill-fitting presenting part pressing on the cervix
- D. Large presenting diameters stretching the vulva
Correct Answer: B
Rationale: The correct answer is B because pressure applied on the cervix by the presenting part in obstructed labor leads to edema of the vulva. This pressure causes obstruction of blood and lymphatic flow in the area, resulting in swelling and edema. Prolonged effort by the mother (choice A) would not directly cause vulvar edema. An ill-fitting presenting part (choice C) may contribute to obstruction but does not explain the mechanism of edema. Large presenting diameters (choice D) stretching the vulva would not directly cause edema without pressure on the cervix.
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While participating in sports, it is not uncommon for people to be subjected to sudden rotational injuries that result in the abrupt rotation of the cerebral cortex around the more fixed midbrain structures. This can interrupt input and outflow from the reticular activating system and result in what clinical phenomenon?
- A. Epidural hematoma
- B. Uncal herniation
- C. Concussion
- D. Contrecoup injury
Correct Answer: C
Rationale: Step 1: Sudden rotational injuries can disrupt brain function.
Step 2: Abrupt rotation of the cerebral cortex can affect the reticular activating system.
Step 3: Disruption of the reticular activating system can lead to altered consciousness.
Step 4: Altered consciousness is a hallmark of a concussion.
Therefore, the correct answer is C: Concussion. Other choices are incorrect because an epidural hematoma involves bleeding between the skull and dura (A), uncal herniation involves brain shifting through tentorium (B), and contrecoup injury occurs opposite the site of impact (D).
Aims of exchange transfusion procedure includes:
- A. Cure of haemolysis and restoration of hemoglobin level
- B. Cure of hypoxia and removal of all toxic materials
- C. Stabilization of baby’s immune system and liver functions
- D. Control of haemolysis and restoration of hemoglobin level
Correct Answer: D
Rationale: The correct answer is D because the main aims of an exchange transfusion procedure are to control haemolysis (process of breaking down red blood cells) and restore hemoglobin levels. This procedure involves removing the baby's blood and replacing it with donor blood to prevent complications from severe jaundice or other conditions. Choice A is incorrect because exchange transfusion does not necessarily cure haemolysis, but it helps control it. Choice B is incorrect as the procedure focuses on managing specific issues rather than removing all toxic materials. Choice C is incorrect because it does not directly address the primary goals of an exchange transfusion.
V. is a 75-year-old male patient who, during a recent wellness evaluation, was found to have a new onset grade IIVI crescendo-decrescendo cardiac murmur at the 2nd intercostal space, right sternal border. He is symptom free and reports no limitations to his usual daily activity. He specifically denies activity intolerance or near syncope, and he is very active physically. Echocardiography reveals a mild aortic calcification. The AGACNP knows that ongoing management for R. V. must include
- A. Annual or biannual serial echocardiography
- B. Modification of activity level
- C. Baseline cardiac catheterization
- D. Statin therapy
Correct Answer: C
Rationale: The correct answer is C: Baseline cardiac catheterization. Given the presence of a new onset grade IIVI crescendo-decrescendo cardiac murmur, a baseline cardiac catheterization is necessary to assess the severity and etiology of the murmur. This procedure will provide crucial information on the structure and function of the heart, helping to determine the appropriate management plan.
A: Annual or biannual serial echocardiography is not necessary as the patient is currently asymptomatic and echocardiography has already revealed mild aortic calcification.
B: Modification of activity level is not the immediate priority as the patient is very active physically and not reporting any limitations to daily activities.
D: Statin therapy is not indicated based solely on the presence of a new murmur without further assessment of cardiac function through cardiac catheterization.
A neonate of a smear-negative mother just before birth receives BCG as usual.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: A
Rationale: The correct answer is A: TRUE. This is because BCG vaccination for newborns is recommended even if the mother is smear-negative for tuberculosis, as it helps protect the newborn from severe forms of TB. Smear status of the mother does not impact the need for BCG vaccination in the neonate. Choice B is incorrect as it falsely implies that BCG should not be given in this scenario. Choices C and D are not applicable as they do not provide any information.
What are the risks of untreated gestational hypertension?
- A. Preeclampsia
- B. Placental abruption
- C. Preterm labor
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D, All of the above. Untreated gestational hypertension can lead to serious complications such as preeclampsia, characterized by high blood pressure and organ damage, placental abruption which is the separation of the placenta from the uterine wall, and preterm labor, resulting in premature birth. Each of these complications poses significant risks to both the mother and the baby, highlighting the importance of managing gestational hypertension. Therefore, all the choices A, B, and C are consequences of untreated gestational hypertension.