Nokea
On postoperative day 7 following hepatic transplant, the patient evidences signs and symptoms of acute rejection, confirmed by histologic examination. The AGACNP knows that first-line treatment of acute rejection consists of
- A. Cyclosporine
- B. Azathioprine
- C. Methylprednisolone
- D. Sirolimus
Correct Answer: A
Rationale: The correct answer is A: Cyclosporine. Cyclosporine is a first-line treatment for acute rejection following hepatic transplant due to its immunosuppressive properties. It inhibits T-cell activation and cytokine production, suppressing the immune response against the transplanted liver. This helps in preventing further damage caused by rejection. Azathioprine (B) and Sirolimus (D) are also immunosuppressants, but Cyclosporine is preferred as the initial treatment. Methylprednisolone (C) is a corticosteroid that can be used in combination with Cyclosporine for acute rejection to provide a more potent immunosuppressive effect.
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Respiratory distress syndrome is caused by:
- A. Poor quality of surfactant
- B. Inadequate surfactant levels
- C. Rib cage underdevelopment
- D. Gradual alveolar rupture
Correct Answer: B
Rationale: The correct answer is B: Inadequate surfactant levels. Surfactant is a substance that reduces surface tension in the alveoli, preventing their collapse. In respiratory distress syndrome, premature infants have insufficient surfactant production, leading to collapsed alveoli and difficulty breathing. Choice A is incorrect because it focuses on quality rather than quantity of surfactant. Choice C is incorrect as rib cage underdevelopment is associated with congenital conditions like thoracic dystrophy, not RDS. Choice D is incorrect as gradual alveolar rupture is not a known cause of RDS.
How does iron supplementation benefit pregnancy?
- A. Increases fetal blood flow
- B. Reduces anemia
- C. Prevents miscarriages
- D. Enhances fetal bone growth
Correct Answer: B
Rationale: Iron supplementation benefits pregnancy by correcting or preventing iron deficiency anemia in the mother. Anemia can lead to various complications for the mother and baby. Iron is essential for the production of hemoglobin, which carries oxygen to tissues. Therefore, by reducing anemia, iron supplementation ensures optimal oxygen delivery to both the mother and the developing fetus. This ultimately supports healthy pregnancy outcomes.
Explanation for other choices:
A: Iron supplementation does not directly increase fetal blood flow.
C: While iron deficiency may increase the risk of miscarriage, iron supplementation alone does not prevent miscarriages.
D: Iron is not directly involved in fetal bone growth, so iron supplementation does not enhance this aspect of fetal development.
The congenital abnormality of the respiratory tract, associated with abnormal apical position, is
- A. Laryngeal stridor
- B. Diaphragmatic hernia
- C. Choanal atresia
- D. Tracheo-bronchi fistula
Correct Answer: C
Rationale: The correct answer is C: Choanal atresia. The congenital abnormality of the respiratory tract with abnormal apical position is typically associated with choanal atresia, which is a blockage or narrowing of the back of the nasal passage. This condition can lead to respiratory distress in newborns due to difficulty breathing through the nose.
Explanation:
1. Laryngeal stridor (Choice A) is a high-pitched noise during breathing and is not typically associated with abnormal apical position.
2. Diaphragmatic hernia (Choice B) is a defect in the diaphragm that allows abdominal organs to move into the chest cavity, but it is not related to abnormal apical position.
3. Tracheo-bronchi fistula (Choice D) is an abnormal connection between the trachea and bronchi, which is not associated with abnormal apical position.
In summary, choanal atresia is the correct answer because it fits the description of
With respect to tumor nomenclature, the AGACNP knows that the term carcinoma describes
- A. Malignant neoplasms of internal structure
- B. Tumors that have lost normal growth regulation
- C. A dysfunctional metaplastic adaptation
- D. Neoplasms of epithelial origin
Correct Answer: D
Rationale: The correct answer is D because the term "carcinoma" specifically refers to neoplasms of epithelial origin. Epithelial cells line the surfaces and cavities of the body, so carcinomas originate from these tissues. This term does not describe internal structure (A), loss of growth regulation (B), or metaplastic adaptation (C). Carcinomas are the most common type of cancer and can occur in various organs such as the skin, lungs, breasts, and colon.
Which one of the following is involved in the management of cord prolapse?
- A. Placing client on all fours position
- B. Application of fundal pressure
- C. Placing client on Trendelenburg position
- D. Labor augmentation using oxytocin regimen
Correct Answer: C
Rationale: The correct answer is C: Placing client on Trendelenburg position. This helps prevent compression of the cord by moving the presenting part off the cord. Placing the client on all fours (choice A) may worsen cord compression. Application of fundal pressure (choice B) is contraindicated as it can further compress the cord. Labor augmentation with oxytocin (choice D) is not indicated in cord prolapse management as it does not address the immediate risk to the fetus. Trendelenburg position is the recommended intervention to alleviate cord compression and improve fetal oxygenation.