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Neoadjuvant chemotherapy treatment for cancer is given to facilitate surgical resection. When the outcomes of cancer therapies are evaluated, the terms complete response and partial response often are used. Partial response means that
- A. 50% of the patients treated with a given regimen demonstrate remission
- B. 50% of the patients treated survive to the 5-year point
- C. The tumor mass has reduced by > 50%
- D. In 50% of cases, the tumor converts from unresectable to resectable
Correct Answer: C
Rationale: The correct answer is C because partial response in cancer therapy typically refers to a reduction in tumor size by more than 50%. This reduction indicates some positive effect of the treatment on the tumor.
Choice A is incorrect because partial response is not solely based on the percentage of patients demonstrating remission, it is about the tumor response.
Choice B is incorrect because survival at 5 years is related to overall survival rate, not specifically to the tumor response.
Choice D is incorrect because the conversion from unresectable to resectable is more related to the operability of the tumor, rather than the response to chemotherapy.
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The MAIN clinical feature of puerperal psychosis is
- A. Episodic insomnia
- B. Neglect of hygiene
- C. Major depression
- D. Mild headache
Correct Answer: C
Rationale: The correct answer is C, major depression. Puerperal psychosis is a severe mental health condition that occurs in the postpartum period, characterized by symptoms such as hallucinations, delusions, and disorganized thinking. Major depression is a key clinical feature, often accompanied by mood disturbances and severe emotional distress.
Rationale:
- A: Episodic insomnia is a common symptom in various mental health disorders but not specific to puerperal psychosis.
- B: Neglect of hygiene may occur in severe cases but is not the main clinical feature of puerperal psychosis.
- D: Mild headache is not a characteristic symptom of puerperal psychosis, which is primarily marked by severe psychiatric symptoms.
In the majority of cases, the first clinical manifestation of physiologic stress ulcer is
- A. Epigastric pain
- B. Change in mental status
- C. Fever
- D. Hemorrhage
Correct Answer: C
Rationale: The correct answer is C: Fever. Physiologic stress ulcers are often associated with systemic stress response, leading to an increase in body temperature. Fever is an early sign of stress-related ulcers before other symptoms like epigastric pain or hemorrhage manifest. Change in mental status is more indicative of neurological issues rather than stress ulcers. Epigastric pain typically occurs after the ulcer has progressed, and hemorrhage is a severe complication of untreated stress ulcers.
A student AGACNP just beginning his clinical rotation is observing his preceptor perform a physical survey on a patient who is brought in following a serious motor vehicle accident. The student observes that the physical examination includes rectovaginal examination, inspection of the urethral meatus, and palpation of the pelvic landmarks. The student knows the patient is being assessed for
- A. Peritoneal bleeding
- B. Retroperitoneal bleeding
- C. Paresthesia
- D. Pelvic fracture
Correct Answer: B
Rationale: The correct answer is B: Retroperitoneal bleeding. The physical survey described focuses on assessing for internal bleeding within the retroperitoneal space following a serious motor vehicle accident. The rectovaginal examination, inspection of the urethral meatus, and palpation of pelvic landmarks help evaluate for signs of pelvic fracture and internal bleeding. These assessments help identify potential sources of retroperitoneal bleeding, which can be a life-threatening complication of trauma. Peritoneal bleeding (choice A) involves bleeding within the abdominal cavity, which is less likely in this scenario. Paresthesia (choice C) refers to abnormal sensations like tingling or numbness, which are not typically assessed through physical examination in this context. Pelvic fracture (choice D) is a possible outcome of trauma but does not directly assess for retroperitoneal bleeding.
Breech presentation: a) What is meant by “breech presentation”?
- A. Head-first presentation
- B. Bottom or feet-first presentation
- C. Oblique lie
- D. Transverse lie
Correct Answer: B
Rationale: Breech presentation refers to the bottom or feet-first position of the baby in the uterus. This is the correct answer (B) because it accurately defines breech presentation. Choice A (head-first presentation) is incorrect as it describes the typical vertex presentation. Choices C (oblique lie) and D (transverse lie) are also incorrect as they refer to other abnormal fetal positions that are different from breech presentation.
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.