Nokea
Inability to eat or retain feeds throughout the day prenatally is highly associated with
- A. Weight gain control
- B. Hyperemesis gravidarum
- C. Morning sickness
- D. Presence of preeclampsia
Correct Answer: B
Rationale: The correct answer is B: Hyperemesis gravidarum. This condition is characterized by severe nausea and vomiting during pregnancy, leading to inability to eat or retain feeds. It is associated with significant weight loss and dehydration. Other choices are incorrect because:
A: Weight gain control is not the primary concern when hyperemesis gravidarum is present.
C: Morning sickness typically does not cause severe inability to eat or retain feeds.
D: Preeclampsia is a separate condition characterized by high blood pressure and organ damage, not directly related to feeding difficulties.
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The MAIN aim of encouraging plenty of fluids to a postnatal client with urinary tract trauma is to
- A. Keep client well hydrated
- B. Maintain proper fluid balance
- C. Facilitate proper healing
- D. Control growth of organisms
Correct Answer: A
Rationale: The correct answer is A: Keep client well hydrated. Encouraging plenty of fluids helps prevent dehydration, maintain adequate urine output, and promote flushing of the urinary tract to prevent infections, all crucial for postnatal clients with urinary tract trauma. Proper hydration also supports overall health and aids in the healing process.
B: Maintain proper fluid balance - While important, the main aim is to keep the client well hydrated to support healing.
C: Facilitate proper healing - Proper hydration does facilitate healing, but the primary aim is to keep the client well hydrated.
D: Control growth of organisms - While hydration can help in preventing infections, the main aim is to keep the client well hydrated.
What is the significance of skin-to-skin contact after birth?
- A. Stabilizes baby’s temperature
- B. Promotes bonding
- C. Regulates baby’s heartbeat
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because skin-to-skin contact after birth offers multiple benefits. Firstly, it helps stabilize the baby's temperature by utilizing the parent's body heat. Secondly, it promotes bonding between the parent and baby through physical closeness and touch. Finally, it can regulate the baby's heartbeat by providing a calming and reassuring environment. Therefore, all of the above choices are correct in highlighting the significance of skin-to-skin contact after birth.
During induction of labor with syntocinon, drops increase is stopped prematurely on
- A. Achieving three moderate contractions
- B. Realizing normal maternal observations
- C. Achieving progressive cervical dilatation
- D. Observing normal fetal-related observations
Correct Answer: C
Rationale: Step-by-step rationale for choice C:
1. Progressive cervical dilatation indicates effective labor progress.
2. Stopping the syntocinon drops prematurely allows natural labor progression.
3. Prematurely stopping drops before reaching full dilation may hinder labor.
4. Achieving cervical dilatation is a crucial indicator for successful labor.
Summary:
A: Contractions should be strong, not just moderate.
B: Maternal observations alone do not determine labor progress.
D: Fetal-related observations are important but not the primary indicator for stopping drops.
K. T. presents for a routine wellness examination, and the review of systems is significant only for a markedly decreased capacity for intake and a vague sense of nausea after eating. K. T. denies any other symptoms the remainder of the GI review of systems is negative. His medical history is significant for complicated peptic ulcer disease that finally required resection for a perforated ulcer. The AGACNP advises the patient that
- A. He will need endoscopy to evaluate the problem
- B. Chronic gastroparesis is a known complication of ulcer surgery
- C. Medication is unlikely to help, and he may need another surgery
- D. His symptoms occur in 5 to 10% of people after ulcer surgery
Correct Answer: C
Rationale: Rationale for Correct Answer (C):
1. The patient's symptoms of decreased capacity for intake and nausea after eating suggest gastroparesis, a common complication post-ulcer surgery.
2. Given the history of complicated peptic ulcer disease and prior surgery, medication may be ineffective, necessitating potential reoperation.
3. The AGACNP advises that another surgery may be needed, indicating that medication alone may not suffice to address the issue.
Summary of Incorrect Choices:
A: Endoscopy is not necessary at this point as the symptoms are likely indicative of a functional issue rather than a structural problem.
B: While gastroparesis can occur post-ulcer surgery, the patient's symptoms are more suggestive of gastroparesis rather than chronic gastroparesis as a known complication.
D: The frequency of occurrence of symptoms after ulcer surgery is not relevant to the current management of the patient's symptoms.
Based upon an understanding of the normal relationship between gastrin levels and acid secretion, the AGACNP recognizes that which of the following combinations is almost diagnostic of gastrinoma?
- A. Hypogastrinemia and acid hyposecretion
- B. Hypergastrinemia and acid hyposecretion
- C. Hypogastrinemia and acid hypersecretion
- D. Hypergastrinemia and acid hypersecretion
Correct Answer: A
Rationale: The correct answer is A: Hypogastrinemia and acid hyposecretion. Gastrinoma is a tumor that secretes excessive gastrin, leading to hypergastrinemia and increased acid secretion. However, due to a negative feedback mechanism, chronic exposure to high gastrin levels can cause downregulation of gastrin receptors on parietal cells, leading to decreased acid secretion. Therefore, in gastrinoma, despite high gastrin levels, acid secretion may be reduced due to this negative feedback loop. Choices B, C, and D are incorrect because they do not align with the expected relationship between gastrin levels and acid secretion in gastrinoma.