Nokea
Predisposing factors to vitamin K deficiency bleeding include
- A. Postdatism, prematurity
- B. Asphyxia, congenital abnormalities
- C. Prematurity, hypoxia
- D. Hypoxia, congenital abnormalities
Correct Answer: A
Rationale: Postdatism and prematurity are significant risk factors for vitamin K deficiency bleeding.
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The AGACNP is receiving report from the recovery room on a patient who just had surgical resection for pheochromocytoma. He knows that which class of drugs should be available immediately to manage hypertensive crisis, a possible consequence of physical manipulation of the adrenal medulla?
- A. Alpha-adrenergic antagonists
- B. Beta-adrenergic antagonists
- C. Intravenous vasodilators
- D. Arteriolar dilators
Correct Answer: C
Rationale: Surgical manipulation of the adrenal medulla during resection of a pheochromocytoma can result in the release of catecholamines leading to a hypertensive crisis. Alpha-adrenergic antagonists, such as phenoxybenzamine or prazosin, are the drugs of choice for managing hypertensive crisis in this situation. These medications block the alpha-adrenergic receptors, leading to vasodilation and lowering of blood pressure. Beta-adrenergic antagonists are contraindicated in this scenario due to the risk of unopposed alpha-adrenergic stimulation that could worsen the hypertension. Intravenous vasodilators and arteriolar dilators may be used as adjunctive therapy but alpha-adrenergic antagonists are the primary agents for managing hypertensive crisis in this context.
Complications of unrepaired cleft lip and palate include
- A. Pneumonia and retarded growth
- B. Mental retardation and blindness
- C. Failure to thrive and deafness
- D. Impaired speech and convulsions
Correct Answer: D
Rationale: Failure to thrive and impaired speech are common complications due to feeding and developmental issues with cleft lip and palate.
In marginal cephalopelvic disproportion,
- A. All the patients will need an operative delivery.
- B. Half of the patients will need an operative delivery.
- C. The problem is always overcome during labor.
- D. The pelvis is too small for the fetus to pass through.
Correct Answer: C
Rationale: Marginal cephalopelvic disproportion can often be managed in labor without the need for a cesarean.
The AGACNP knows that when managing a patient with acute cardiogenic shock after myocardial infarction, all of the following pharmacologic agents may be used except
- A. Opioids
- B. Diuretics
- C. Beta-adrenergic antagonists
- D. Anticholinergics
Correct Answer: A
Rationale: Anticholinergics are not typically used in the management of acute cardiogenic shock after myocardial infarction. Anticholinergic medications may worsen tachycardia and exacerbate myocardial ischemia by increasing heart rate and myocardial oxygen demand. Therefore, the AGACNP should avoid using anticholinergics in this patient population.
The neonatal birth injury that results due to bleeding between the epicranial aponeurosis and the periosteum is
- A. Caput succedaneum
- B. Intracranial hemorrhage
- C. Subgaleal hemorrhage
- D. Aponeurotic hemorrhage
Correct Answer: A
Rationale: Caput succedaneum is caused by bleeding between the epicranial aponeurosis and the periosteum.