Nokea
Obstructed labor MAINLY results due to
- A. Maternal exhaustion
- B. Cephalopelvic disproportion
- C. Microsomic fetus
- D. Fetal exsanguination
Correct Answer: B
Rationale: The correct answer is B: Cephalopelvic disproportion. This condition occurs when the baby's head is too large to pass through the mother's pelvis during labor. This leads to obstructed labor, causing complications for both the mother and the baby. Maternal exhaustion (A) may occur as a result of prolonged labor but is not the primary cause of obstructed labor. Microsomic fetus (C) refers to a small baby and would not typically cause obstructed labor. Fetal exsanguination (D) is the loss of blood from the fetus and is not a common cause of obstructed labor. Cephalopelvic disproportion is the most common reason for obstructed labor as it directly affects the passage of the baby through the birth canal.
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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.
TB in pregnancy predisposes a mother to premature labour due to
- A. Poor maternal appetite
- B. Severe anaemia experienced
- C. Adverse reactions of anti-TB drugs
- D. The fever experienced
Correct Answer: D
Rationale: The correct answer is D. TB in pregnancy can lead to premature labor due to the fever experienced. Fever increases the risk of premature labor by triggering uterine contractions. Poor maternal appetite (A) and severe anemia (B) may impact the mother's health but are not directly linked to premature labor. Adverse reactions of anti-TB drugs (C) could potentially affect the mother's health but are not a direct cause of premature labor.
According to the American College of Cardiology Foundation and the American Heart Association (ACCFAHA), the recommendation regarding antiplatelet therapy in patients with cardiovascular disease preoperatively is that
- A. Antiplatelet therapy should be held for 10 days preoperatively
- B. Cardiac consultation is required before an operation in patients who are on antiplatelet therapy
- C. Medications should be continued unless concerns about hemostasis are significant
- D. Antiplatelet therapy should be initiated in all high-risk cardiac procedures
Correct Answer: B
Rationale: Step-by-step rationale for why choice B is correct:
1. The ACCF/AHA recommends cardiac consultation before an operation for patients on antiplatelet therapy to assess the risk of bleeding versus thrombotic events.
2. Cardiac consultation helps determine the necessity of continuing, modifying, or stopping antiplatelet therapy.
3. This individualized approach ensures optimal perioperative management based on the patient's cardiovascular risk profile.
4. Choice A is incorrect as stopping antiplatelet therapy for 10 days can increase the risk of thrombotic events.
5. Choice C is incorrect as it oversimplifies the decision-making process without considering the patient's specific risks.
6. Choice D is incorrect because initiating antiplatelet therapy in all high-risk cardiac procedures may not be necessary for every patient.
Mr. Costigan is a 50-year-old male patient who recently had a screening colonoscopy because it was recommended by his primary care provider as a screening measure. He received a report that noted inflammatory polyps. He is concerned because one of his friends had polyps that turned into cancer. While advising Mr. Costigan, the AGACNP tells him that
- A. The polyps are considered precancerous, but if he has a colonoscopy every 3 to 5 years, any new polyps can be removed before they become malignant
- B. The primary danger is when there is a family history of colon cancer; he should discuss with his mother and father the presence of any colon cancer in the family
- C. There is no chance that these polyps could become cancerous, and their presence does not require any additional action or concern on his part
- D. He would be best served at this point to discuss with an oncologist the risks and benefits of aggressive versus conservative treatment.
Correct Answer: B
Rationale: Step 1: Family history of colon cancer is a significant risk factor for developing colon cancer.
Step 2: By discussing with his parents, Mr. Costigan can determine if there is a family history of colon cancer.
Step 3: Knowing this information can help assess his own risk and guide appropriate screening and preventive measures.
Step 4: The primary danger for Mr. Costigan lies in potential genetic predisposition rather than the presence of inflammatory polyps.
Step 5: Therefore, discussing with family members about any history of colon cancer is crucial for his overall risk assessment and management.
Summary:
- Choice A is incorrect as the frequency of colonoscopy should be individualized based on the patient's risk factors.
- Choice C is incorrect as all polyps have the potential to become cancerous, especially inflammatory polyps.
- Choice D is incorrect as consulting an oncologist at this stage is premature without first assessing family history.
Mother-to-child transmission of TB organisms never occurs during labor.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: Step 1: TB can be transmitted from an infected mother to her child during labor.
Step 2: The TB bacteria can be present in the mother's respiratory secretions.
Step 3: During labor, the baby can inhale these bacteria and contract TB.
Step 4: Therefore, the statement that mother-to-child transmission of TB organisms never occurs during labor is FALSE.
Summary: Option B is correct because it accurately reflects the possibility of mother-to-child transmission of TB during labor. Option A is incorrect as it contradicts the factual information. Options C and D are not applicable as they provide no information.