Nokea
Prior to application of traction in forceps delivery, it’s MOST important to note
- A. When the contraction ends
- B. When the client feels the contraction
- C. When the contraction begins
- D. When the fetal heart rate drops
Correct Answer: C
Rationale: It is important to apply traction during contractions to help with the delivery process.
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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.
When a patient is hospitalized with a possible stroke, the AGACNP recognizes that the stroke most likely resulted from a subarachnoid hemorrhage when the patients family reports that the patient
- A. Has a history of atrial fibrillation
- B. Was unable to be aroused in the morning
- C. Had been complaining of a headache before losing consciousness
- D. Has had several brief episodes of mental confusion and right arm and leg weakness
Correct Answer: A
Rationale: The key clinical manifestation indicating a possible subarachnoid hemorrhage in this scenario is that the patient had been complaining of a headache before losing consciousness. Subarachnoid hemorrhage is a type of stroke that results from bleeding into the space between the arachnoid membrane and the pia mater surrounding the brain. Severe headache, often described as the worst headache of one's life, is a classic symptom of subarachnoid hemorrhage. The sudden onset of a severe headache before loss of consciousness raises the suspicion for this type of stroke. Other symptoms such as mental confusion and weakness may also be present, but the headache is a crucial indicator in this case.
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.
Vasa praevia occurs when there is a
- A. Velamentous insertion of the cord
- B. Succenturiate insertion of the cord
- C. Tripartite cord
- D. Bipartite cord
Correct Answer: A
Rationale: Vasa praevia occurs with a velamentous insertion of the umbilical cord.
The AGACNP is treating a patient with ascites. After a regimen of 200 mg of spironolactone daily, the patient demonstrates a weight loss of 0.75 kgday. The best approach to this patients management is to
- A. Continue the current regimen
- B. D/C the spironolactone and begin a loop diuretic
- C. Add a loop diuretic to the spironolactone
- D. Proceed to large-volume paracentesis Which of the following is a true statement with respect to the use of corticosteroids in posttransplant patients?
Correct Answer: B
Rationale: The best approach to managing the patient with ascites who has responded to spironolactone with weight loss is to add a loop diuretic to the current regimen. Spironolactone is an aldosterone antagonist that primarily works on the distal convoluted tubule, while loop diuretics, such as furosemide, act on the thick ascending limb of the loop of Henle. Combining these two diuretics can result in a synergistic effect, increasing diuresis and reducing fluid retention in patients with ascites. This combination therapy is often used in patients who do not respond adequately to spironolactone alone, and it is considered a common strategy in the management of ascites due to cirrhosis. Therefore, adding a loop diuretic to the spironolactone regimen is the most appropriate next step to optimize diuresis and fluid management in this patient.