Nokea
Mr. Mettenberger is being discharged following his hospitalization for reexpansion of his second spontaneous pneumothorax this year. He has stopped smoking and does not appear to have any overt risk factors. While doing his discharge teaching, the AGACNP advises Mr. Mettenberger that his current risk for another pneumothorax is
- A. < 10%
- B. 25-50%
- C. 50-75%
- D. > 90
Correct Answer: D
Rationale: The correct answer is D (>90%). Mr. Mettenberger had a reexpansion of his second spontaneous pneumothorax this year, indicating a high recurrence risk. Spontaneous pneumothorax recurrence rates are high, especially in young males. Factors such as smoking history, gender, and prior occurrences contribute to increased risk. Mr. Mettenberger's cessation of smoking reduces but does not eliminate the risk. Choices A, B, and C are too low, given his history and current situation. Choice D is the most appropriate due to the high likelihood of recurrence based on his medical history and risk factors.
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Which one of the following statements is correct about secondary post-partum haemorrhage?
- A. Mostly occurs between the 8th-14th day post-partum
- B. Results due to bleeding immediately after delivery
- C. Can extend up to the first 46 days following delivery
- D. Is diagnosed by presence of persistent lochia serosa
Correct Answer: C
Rationale: The correct answer is C because secondary post-partum hemorrhage can occur up to 6 weeks (46 days) after delivery, typically due to delayed complications like retained placental fragments or infection. Choice A is incorrect because most secondary post-partum hemorrhage occurs after the first week. Choice B is incorrect as it describes primary post-partum hemorrhage, which occurs within 24 hours of delivery. Choice D is incorrect since lochia serosa is a normal discharge present in the early post-partum period and is not specific to diagnosing secondary post-partum hemorrhage.
Clinical diagnosis of polyhydramnios is based on an amount of amniotic fluid exceeding
- A. 1500 ml
- B. 3000 ml
- C. 1900 ml
- D. 2500 ml
Correct Answer: B
Rationale: The correct answer is B (3000 ml) because polyhydramnios is defined as an excessive amount of amniotic fluid, typically exceeding 2000-2500 ml. A level of 3000 ml is commonly used as a cutoff point for clinical diagnosis. Choices A, C, and D are incorrect because they fall below the threshold typically considered diagnostic for polyhydramnios. Answer A (1500 ml) is too low, while choices C (1900 ml) and D (2500 ml) are below or at the lower end of the range typically associated with polyhydramnios. Therefore, the most appropriate threshold for diagnosing polyhydramnios is when the amount of amniotic fluid exceeds 3000 ml.
A clinical feature that is indicative of transient tachypnea of the newborn is
- A. Rapid respirations of up to 120/minute
- B. There’s marked recession of the rib cage
- C. Mostly common following a normal delivery
- D. Diminished respirations of less than 40/minute
Correct Answer: A
Rationale: Step 1: Transient tachypnea of the newborn is characterized by rapid respirations due to delayed reabsorption of fetal lung fluid.
Step 2: Rapid respirations of up to 120/minute is a common clinical feature seen in newborns with transient tachypnea.
Step 3: This rapid breathing pattern distinguishes it from other conditions.
Step 4: Marked recession of the rib cage is more indicative of respiratory distress syndrome.
Step 5: Transient tachypnea can occur in both normal and cesarean deliveries, so choice C is incorrect.
Step 6: Diminished respirations of less than 40/minute would not be expected in transient tachypnea.
Summary: Choice A is correct because rapid respirations are a key clinical feature of transient tachypnea, while the other choices do not align with its characteristic presentation.
Predisposing factors to uterine rupture include
- A. Nulliparity, neglected obstructed labor
- B. Breech presentation, multiple pregnancy
- C. Neglected obstructed labor, high parity
- D. Obstetric maneuvers, breech presentation
Correct Answer: C
Rationale: The correct answer is C because neglected obstructed labor and high parity are well-established predisposing factors to uterine rupture. Neglected obstructed labor can cause prolonged pressure on the uterus, leading to weakening and potential rupture. High parity (having given birth multiple times) can also increase the risk of uterine rupture due to repeated stretching and strain on the uterine muscles.
A, B, and D are incorrect because nulliparity (never given birth), breech presentation, multiple pregnancy, and obstetric maneuvers are not as strongly associated with uterine rupture as neglected obstructed labor and high parity. These factors may increase the risk of other complications during childbirth but are not primary predisposing factors for uterine rupture.
A characteristic of monozygotic twins includes
- A. Always of the same sex
- B. Share a similar fingerprint pattern
- C. Have different blood groups
- D. Superfetation is a common finding
Correct Answer: A
Rationale: The correct answer is A: Always of the same sex. Monozygotic twins develop from a single fertilized egg, so they have the same genetic material, making them always the same sex. This is due to the fact that the sex of an individual is determined by the chromosomes inherited from the parents. This is a fundamental principle of genetics. Choices B, C, and D are incorrect because monozygotic twins can have different fingerprints, blood groups, and superfetation (conception that occurs during an existing pregnancy) is not common in monozygotic twins.