Nokea
Productive cough, dyspnoea at rest, and generalized oedema are among the features of:
- A. Folate deficiency
- B. Very severe anaemia
- C. Mild iron deficiency
- D. Severe anaemia
Correct Answer: B
Rationale: The correct answer is B: Very severe anaemia. Productive cough, dyspnoea at rest, and generalized oedema are classic symptoms of very severe anaemia due to decreased oxygen-carrying capacity of the blood. Anemia leads to tissue hypoxia, causing shortness of breath and fluid retention. Folate deficiency (A) typically presents with megaloblastic anemia, not generalized edema. Mild iron deficiency (C) may lead to fatigue and weakness but not the severe symptoms described. Severe anemia (D) is too broad; very severe anemia specifically refers to the severity of the condition.
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Inability to eat or retain feeds throughout the day prenatally is highly associated with
- A. Weight gain control
- B. Hyperemesis gravidarum
- C. Morning sickness
- D. Presence of preeclampsia
Correct Answer: B
Rationale: The correct answer is B: Hyperemesis gravidarum. This condition is characterized by severe nausea and vomiting during pregnancy, leading to inability to eat or retain feeds. It is associated with significant weight loss and dehydration. Other choices are incorrect because:
A: Weight gain control is not the primary concern when hyperemesis gravidarum is present.
C: Morning sickness typically does not cause severe inability to eat or retain feeds.
D: Preeclampsia is a separate condition characterized by high blood pressure and organ damage, not directly related to feeding difficulties.
When examining a patient with abdominal pain, the AGACNP knows that tenderness to percussion is analogous to
- A. Tympany
- B. Guarding
- C. Rebound tenderness
- D. Somatic pain
Correct Answer: A
Rationale: The correct answer is A: Tympany. Tenderness to percussion is analogous to tympany as both indicate the presence of gas-filled structures. When a patient experiences tenderness to percussion in the abdomen, it suggests that there is gas or air present in the abdomen, leading to a hollow, drum-like sound upon percussion, which is characteristic of tympany. Guarding (B) is the involuntary contraction of abdominal muscles to protect the underlying organs, not related to percussion. Rebound tenderness (C) is the pain experienced when pressure is released during palpation, not percussion. Somatic pain (D) refers to pain originating from the skin, muscles, or bones, not related to percussion findings.
Outline four (4) causes of obstructed labour:
- A. Fetal macrosomia
- B. Malpresentation
- C. Pelvic abnormalities
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D, "All of the above." Fetal macrosomia, malpresentation, and pelvic abnormalities are all known causes of obstructed labor. Fetal macrosomia refers to a large baby, which can lead to difficulty in passing through the birth canal. Malpresentation occurs when the baby is not positioned optimally for delivery, such as breech or transverse positions. Pelvic abnormalities, such as a contracted pelvis, can impede the baby's passage during labor. Therefore, selecting option D is appropriate as it encompasses all the major causes of obstructed labor. Choices A, B, and C are not individually comprehensive enough to cover all potential causes of obstructed labor.
Sara S. is a 41-year-old patient who has just had a bone marrow transplant. The AGACNP knows that which medication will be used to decrease her risk of graft-versus-host reaction?
- A. Immune globulin
- B. Cyclosporine
- C. Prophylactic antibiotics
- D. Systemic corticosteroids
Correct Answer: A
Rationale: The correct answer is A: Immune globulin. Post bone marrow transplant, immune globulin is used to decrease the risk of graft-versus-host reaction by providing passive immunity. This helps in reducing the chances of the donor's immune cells attacking the recipient's tissues. Immune globulin does not suppress the immune system like cyclosporine (B) or systemic corticosteroids (D) do, which could increase the risk of infections post-transplant. Prophylactic antibiotics (C) are used to prevent infections but do not specifically target graft-versus-host reaction.
A condition of trial of scar is
- A. Estimated fetal weight of less than 3600g
- B. Availability of a level one hospital nearby
- C. Not more than two previous caesarean section scars
- D. An adequate pelvis with true conjugate 10.5cm
Correct Answer: C
Rationale: Rationale for Correct Answer (C): A trial of scar is indicated when a woman has had no more than two previous caesarean sections. This is because the risk of uterine rupture increases with each subsequent caesarean section due to scar tissue weakening. Limiting the number of previous scars reduces this risk. Therefore, option C is correct.
Summary of Incorrect Choices:
A: Estimated fetal weight is not a determining factor for a trial of scar.
B: Availability of a level one hospital nearby is important for emergency situations but not a criteria for trial of scar.
D: Adequate pelvis with true conjugate 10.5cm is important for vaginal delivery but not a specific requirement for a trial of scar.