Nokea
On vaginal examination, the findings characteristic of brow presentation include
- A. Presenting diameter is submento-vertical 11.5cm, head partially extended
- B. Back difficult to palpate, fetal heart heard on the same side as the limbs
- C. Presenting diameter is mento-vertical 13.5cm, head partially extended
- D. Presenting diameter is mento-vertical 13.5cm, head completely extended
Correct Answer: A
Rationale: The characteristic presenting diameter in brow presentation is submento-vertical, with the head partially extended.
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When resuscitating an asphyxiated baby, the purpose of ensuring adequate ventilation prior to administration of sodium bicarbonate is because
- A. The drug decreases carbon dioxide tension
- B. The drug increases carbon dioxide tension
- C. The drug is effective in the correction of metabolic acidosis
- D. The drug is effective in the correction of metabolic alkalosis
Correct Answer: C
Rationale: Sodium bicarbonate is used to correct metabolic acidosis, not to influence carbon dioxide levels directly.
The priority management of uncomplicated malaria during the second trimester includes administration of
- A. Oral quinine
- B. Parenteral quinine
- C. Artemether lumefantrine
- D. Sulphadoxine pyrimethamine
Correct Answer: C
Rationale: Artemether lumefantrine is recommended for uncomplicated malaria in pregnancy.
Justin F. is seen in the emergency department with an 8-cm jagged laceration on the dorsal surface of his right forearm. He says he was working with his brother-in-law yesterday morning building a deck on the back of his home. A pile of wooden planks fell on top of him, and he sustained a variety of cuts and superficial injuries. He cleaned the wound with soap and water but didnt want to go to the emergency room because he didnt want to risk being in the waiting room for hours. He wrapped up his arm and went back to work, and then took a normal shower and went to bed last night. This morning the cut on his arm was still flapping open, and he realized he needed sutures. The appropriate management of this patient includes
- A. Proper cleansing and covering of the laceration, along with antibiotic therapy
- B. Local anesthesia, cleansing, and wound exploration for foreign bodies
- C. Local anesthesia, cleansing, and suture repair
- D. Cleansing, covering, antibiotic therapy, and tetanus prophylaxis
Correct Answer: D
Rationale: In this scenario, the patient presents with a jagged laceration on his forearm that is still open and requires sutures. The appropriate management for this patient involves local anesthesia to reduce pain, thorough cleansing of the wound to prevent infection, and wound exploration to assess for any foreign bodies that may be present. Suturing the wound is necessary to promote proper healing and reduce the risk of complications. Antibiotic therapy may be indicated if signs of infection are present, but it is not mentioned in the scenario as a primary management step. Tetanus prophylaxis should also be considered given the mechanism of injury involving a dirty object.
The AGACNP is going over preoperative information and instructions with a patient who is having a major transverse abdominal procedure tomorrow morning. The patient is very nervous and is asking a lot of questions. The AGACNP prescribes a sleeping agent because he knows that anxiety and sleeplessness may
- A. Lead to hypoxia due to hyperventilation
- B. Increase the physiologic stress response postoperatively
- C. Contribute to risk of delirium and prolonged length of stay
- D. Decreasep.o. intake and produce nutritional risk
Correct Answer: C
Rationale: Anxiety and sleeplessness can contribute to the risk of delirium and prolonged length of stay for the patient undergoing a major transverse abdominal procedure. Delirium is a common complication seen in patients who are anxious and sleep-deprived, especially postoperatively. It is important to address these issues preoperatively to help prevent delirium and ensure a smoother recovery process for the patient. By prescribing a sleeping agent, the AGACNP aims to reduce anxiety and promote a good night's sleep, which can ultimately decrease the risk of delirium and lead to better outcomes for the patient.
A client is declared fit for vaginal birth after cesarean section if
- A. Her previous C/S was due to cephalopelvic disproportion
- B. The current pregnancy is confirmed as a multiple pregnancy
- C. Previous delivery was via cesarean section
- D. Previous delivery was via spontaneous vertex delivery
Correct Answer: D
Rationale: Vaginal birth after cesarean section is possible if the previous delivery was via spontaneous vertex delivery