Nokea
Presence of severe epigastric pain in preeclampsia is associated with hyperacidity.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: The correct answer is B: FALSE. In preeclampsia, epigastric pain is typically associated with liver and/or HELLP syndrome, not hyperacidity. Hyperacidity is more commonly seen in conditions like gastritis or peptic ulcers. Therefore, severe epigastric pain in preeclampsia is not related to hyperacidity. Other choices are not applicable as they do not provide relevant information to the question.
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Ms. Kweke’s possible complications (obstructed labour):
- A. Hemorrhage, uterine rupture
- B. Fetal distress, infection
- C. Preterm birth, asphyxia
- D. Both A and B
Correct Answer: D
Rationale: Rationale:
1. Obstructed labor can lead to prolonged pressure on the uterus, causing hemorrhage and uterine rupture (A).
2. Prolonged labor can result in fetal distress due to reduced oxygen supply and potential infection (B).
3. Therefore, both complications mentioned in A and B can occur in obstructed labor.
Summary:
A: Incorrect - Preterm birth and asphyxia are not directly related to obstructed labor.
B: Incorrect - Only fetal distress and infection are commonly associated with obstructed labor.
C: Incorrect - Both A and B are possible complications of obstructed labor, making D the correct choice.
Which of the following can lead to placenta praevia?
- A. Grandmultiparity
- B. Preeclampsia
- C. Placenta fenestrate
- D. Placenta increta
Correct Answer: A
Rationale: Placenta praevia is more common in women with a history of multiple pregnancies (Grandmultiparity), as repeated stretching of the uterine wall can lead to abnormal placental implantation. Preeclampsia is a separate condition associated with hypertension in pregnancy. Placenta fenestrate and placenta increta are specific placental abnormalities but do not directly cause placenta praevia.
While reviewing the head CT scan of a patient following a motor vehicle accident, the AGACNP appreciates a crescent-shaped fluid collection. This most likely represents
- A. Acute subdural hematoma
- B. Acute epidural hematoma
- C. Acute uncal herniation
- D. Acute brainstem compression
Correct Answer: B
Rationale: The correct answer is B: Acute epidural hematoma. A crescent-shaped fluid collection seen on a head CT scan following trauma is indicative of an epidural hematoma, which typically occurs due to an arterial bleed between the dura mater and the skull. This collection appears biconvex due to the restriction of the hematoma by the dura mater and is often associated with a lucid interval followed by rapid deterioration.
Explanation for Incorrect Choices:
A: Acute subdural hematoma typically presents as a crescent-shaped collection but is located between the dura mater and arachnoid mater, not between the dura mater and skull as seen in epidural hematomas.
C: Acute uncal herniation involves displacement of the uncus of the temporal lobe, leading to compression of the brainstem, but it does not manifest as a crescent-shaped fluid collection.
D: Acute brainstem compression does not typically present as a distinct crescent-shaped
Jasmine is a 31-year-old female who presents with neck pain. She has a long history of injection drug use and admits to injecting opiates into her neck. Physical examination reveals diffuse tracking and scarring. Today Jasmine has a distinct inability to turn her neck without pain, throat pain, and a temperature of 102.1F. She appears ill and has foul breath. In order to evaluate for a deep neck space infection, the AGACNP orders
- A. Anteroposterior neck radiography
- B. CT scan of the neck
- C. White blood cell (WBC) differential
- D. Aspiration and culture of fluid
Correct Answer: D
Rationale: The correct answer is D: Aspiration and culture of fluid. Given Jasmine's history of injection drug use, neck pain, inability to turn her neck, elevated temperature, and foul breath, there is a high suspicion of a deep neck space infection. Aspiration and culture of fluid from the affected area will help identify the causative organism and guide appropriate antibiotic therapy. This procedure is essential for definitive diagnosis and management of deep neck infections.
A: Anteroposterior neck radiography is not the most appropriate initial diagnostic test for evaluating deep neck space infections as it may not provide detailed information on the extent or nature of the infection.
B: CT scan of the neck may provide valuable information regarding the extent of the infection, but aspiration and culture of fluid are crucial for identifying the causative organism.
C: White blood cell (WBC) differential may show signs of inflammation, but it does not provide specific information on the causative organism of the infection.
An early sign of a ruptured uterus includes
- A. Maternal dehydration
- B. Maternal pyrexia >38˚C
- C. Maternal oliguria
- D. Failure of cervix to dilate
Correct Answer: D
Rationale: The correct answer is D. A ruptured uterus can lead to fetal distress and necessitate a cesarean section. Failure of the cervix to dilate is indicative of a potential uterine rupture, as the uterus may not be able to contract effectively due to the rupture. Maternal dehydration (A), pyrexia (B), and oliguria (C) are not specific signs of a ruptured uterus and may be present in various other conditions. Therefore, failure of the cervix to dilate is the most relevant early sign in this scenario.