Nokea
In which form of hypospadias should circumcision be deferred in order to preserve the prepuce for later surgical repair?
- A. Ventral displacement
- B. Proximal displacement
- C. Midscrotal hypospadias
- D. Meatus proximal to the corona
Correct Answer: A
Rationale: The correct answer is A: Ventral displacement. In ventral displacement hypospadias, the urethral opening is located on the underside of the penis, making it necessary to defer circumcision to preserve the prepuce for later surgical repair. Preserving the prepuce in this case is important for reconstructive surgery to correct the hypospadias. Choices B, C, and D do not require deferring circumcision as the location of the urethral opening does not impact the need for prepuce preservation for future surgical repair.
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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.
The AGACNP knows that treatment for this likely will include
- A. Observation
- B. Hyperextension casting
- C. Jewett brace
- D. Surgical intervention
Correct Answer: A
Rationale: The correct answer is A: Observation. As an AGACNP, observation is crucial for monitoring the progression of the condition before considering any invasive treatments. Hyperextension casting (B) and Jewett brace (C) are more specific interventions for spinal conditions and not typically indicated for this scenario. Surgical intervention (D) is typically considered only if conservative treatments fail, making it a last resort option. Therefore, observation allows for a conservative approach to assess the patient's response to initial management before considering more aggressive interventions.
Vaginal delivery is possible in
- A. Brow presentation
- B. Face presentation
- C. Shoulder presentation
- D. Unstable lie
Correct Answer: B
Rationale: The correct answer is B: Face presentation. Vaginal delivery is possible in face presentation as the fetus is in a position where the face is presenting first, allowing for delivery. In this presentation, the chin is usually tucked onto the chest, making it easier for the baby's head to pass through the birth canal.
A: Brow presentation is incorrect because it indicates the baby's head is extended slightly, making it more difficult for vaginal delivery.
C: Shoulder presentation is incorrect as it can lead to a shoulder dystocia, making vaginal delivery dangerous and difficult.
D: Unstable lie is incorrect because it refers to the baby being in a transverse position, making vaginal delivery impossible without intervention.
Clinical features of facial palsy are
- A. Inability to feed and excessive cry
- B. Reduced facial movement and irritability
- C. Excessively dry eyeball and feeding difficulties
- D. Eyes permanently open and no facial movement
Correct Answer: B
Rationale: The correct answer is B because reduced facial movement is a key clinical feature of facial palsy. This can lead to difficulty in making facial expressions, closing the eye on the affected side, and drooping of the mouth. Irritability may also occur due to discomfort or difficulty in communication.
Choice A is incorrect because inability to feed and excessive cry are not typical features of facial palsy. Choice C is incorrect as excessively dry eyeball and feeding difficulties are not commonly associated with facial palsy. Choice D is incorrect as eyes being permanently open and no facial movement are not characteristic of facial palsy.
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.