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Ms. Kweke’s possible complications (obstructed labour):
- A. Hemorrhage, uterine rupture
- B. Fetal distress, infection
- C. Preterm birth, asphyxia
- D. Both A and B
Correct Answer: D
Rationale: Rationale:
1. Obstructed labor can lead to prolonged pressure on the uterus, causing hemorrhage and uterine rupture (A).
2. Prolonged labor can result in fetal distress due to reduced oxygen supply and potential infection (B).
3. Therefore, both complications mentioned in A and B can occur in obstructed labor.
Summary:
A: Incorrect - Preterm birth and asphyxia are not directly related to obstructed labor.
B: Incorrect - Only fetal distress and infection are commonly associated with obstructed labor.
C: Incorrect - Both A and B are possible complications of obstructed labor, making D the correct choice.
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Five (5) major factors predisposed to uterine rupture:
- A. Previous C-section, uterine scars, fetal macrosomia, trauma, prolonged labor
- B. Malpresentation, premature rupture of membranes, obesity, malnutrition, anemia
- C. Uterine fibroids, excessive weight gain, smoking, poor prenatal care
- D. All of the above
Correct Answer: A
Rationale: Rationale for Correct Answer (A):
1. Previous C-section and uterine scars weaken the uterine wall.
2. Fetal macrosomia (large baby) increases pressure on the uterus.
3. Trauma can cause direct injury to the uterus.
4. Prolonged labor can lead to uterine overdistension and fatigue, increasing rupture risk.
Summary of Incorrect Choices:
B: Malpresentation, premature rupture of membranes, obesity, malnutrition, anemia are not direct factors for uterine rupture.
C: Uterine fibroids, excessive weight gain, smoking, poor prenatal care can contribute to complications but not primary causes of uterine rupture.
D: Not all factors in choices B and C are predisposing factors for uterine rupture, making this choice incorrect.
Presence of severe epigastric pain in preeclampsia is associated with hyperacidity.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: The correct answer is B: FALSE. In preeclampsia, epigastric pain is typically associated with liver and/or HELLP syndrome, not hyperacidity. Hyperacidity is more commonly seen in conditions like gastritis or peptic ulcers. Therefore, severe epigastric pain in preeclampsia is not related to hyperacidity. Other choices are not applicable as they do not provide relevant information to the question.
Jake is a 32-year-old patient who is recovering from major abdominal surgery and organ resection following a catastrophic motor vehicle accident. Due to the nature of his injuries, a large portion of his jejunum had to be resected. In planning for his recovery and nutritional needs, the AGACNP considers that
- A. He will probably be able to transition to oral nutrition but will have lifetime issues with diarrhea
- B. His procedure has put him at significant risk for B12 absorption problems
- C. Most jejunum absorption functions will be assumed by the ileum
- D. Enteral nutrition will need to be delayed for 3 to 6 months to facilitate adaptation
Correct Answer: B
Rationale: The correct answer is B: His procedure has put him at significant risk for B12 absorption problems.
Rationale:
1. Jejunum is primarily responsible for nutrient absorption, including B12.
2. Resection of a large portion of the jejunum can lead to malabsorption of B12.
3. B12 is essential for neurological function and red blood cell production.
4. Patients with significant jejunum resection are at high risk for B12 deficiency.
5. Monitoring B12 levels and potentially requiring supplementation is crucial for patients like Jake.
Summary of other choices:
A: Incorrect. Lifetime issues with diarrhea are not necessarily expected following jejunum resection.
C: Incorrect. The ileum may assume some functions of the jejunum but cannot fully compensate.
D: Incorrect. Enteral nutrition should not be delayed for months as it is essential for Jake's recovery and nutritional needs.
The AGACNP recognizes that which of the following diagnostic studies is essential in all cases of acute abdomen?
- A. Abdominal radiograph
- B. Contrast radiography
- C. Chest radiography
- D. Ultrasonography
Correct Answer: C
Rationale: The correct answer is C: Chest radiography. In cases of acute abdomen, a chest radiograph is essential to rule out conditions like pneumothorax, pleural effusion, or pneumonia which may present with similar symptoms. This helps in identifying potential causes of abdominal pain outside the abdomen. Abdominal radiograph (A) may not provide enough information for diagnosis. Contrast radiography (B) and ultrasonography (D) are not universally essential for all cases of acute abdomen and may not be appropriate in certain situations.
An oedematous swelling on the newborn’s scalp is indicative of
- A. Caput succedaneum
- B. Subgaleal hemorrhage
- C. Intracranial injury
- D. Neonatal cephalhematoma
Correct Answer: A
Rationale: The correct answer is A: Caput succedaneum. This swelling is a result of pressure during birth and typically resolves on its own. Subgaleal hemorrhage involves bleeding into the potential space between the periosteum and skull, presenting as a boggy mass. Intracranial injury refers to damage within the skull, often due to trauma. Neonatal cephalhematoma is a subperiosteal collection of blood, causing a localized swelling. Caput succedaneum is the most likely diagnosis based on the description provided.