Nokea
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: B
Rationale: The correct answer is B: Cyclosporine. Cyclosporine is an immunosuppressant medication commonly used post-bone marrow transplant to prevent graft-versus-host disease. It works by inhibiting T-cell activation and proliferation, reducing the risk of the donor's immune cells attacking the recipient's tissues. Immune globulin (A) is used for passive immunization, not prevention of graft-versus-host reaction. Prophylactic antibiotics (C) are used to prevent infections post-transplant, not graft-versus-host disease. Systemic corticosteroids (D) may be used to treat graft-versus-host disease but are not the first-line prophylactic medication.
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Based upon an understanding of the normal relationship between gastrin levels and acid secretion, the AGACNP recognizes that which of the following combinations is almost diagnostic of gastrinoma?
- A. Hypogastrinemia and acid hyposecretion
- B. Hypergastrinemia and acid hyposecretion
- C. Hypogastrinemia and acid hypersecretion
- D. Hypergastrinemia and acid hypersecretion
Correct Answer: D
Rationale: The correct answer is D: Hypergastrinemia and acid hypersecretion. Gastrinoma is a tumor that secretes excessive gastrin, leading to elevated gastrin levels. High gastrin levels stimulate acid secretion in the stomach, resulting in acid hypersecretion. Therefore, the combination of hypergastrinemia and acid hypersecretion is almost diagnostic of gastrinoma.
A: Hypogastrinemia and acid hyposecretion is incorrect because gastrinoma leads to increased gastrin levels and subsequent acid hypersecretion.
B: Hypergastrinemia and acid hyposecretion is incorrect because gastrinoma is associated with acid hypersecretion, not hyposecretion.
C: Hypogastrinemia and acid hypersecretion is incorrect because gastrinoma causes elevated gastrin levels and acid hypersecretion, not hypogastrinemia.
In summary, the correct answer D aligns with the pathophysiology of gastrinoma, while the
The appropriate time to perform external cephalic version in a breech presentation is at
- A. 36 gestational weeks
- B. 38 gestational weeks
- C. 42 gestational weeks
- D. 40 gestational weeks
Correct Answer: A
Rationale: Rationale for correct answer (A): At 36 weeks, the baby has enough room to move, reducing risks of complications during external cephalic version. Earlier intervention also allows for possible repeat attempts if needed. This timing aligns with guidelines for optimal success rates.
Summary of other choices:
B: 38 weeks may be too late as the baby may have less space to turn.
C: 42 weeks is post-term and poses risks for both the baby and the mother.
D: 40 weeks is close to full term and may not allow for adequate time for successful version.
The correct statement about shoulder dystocia is
- A. It’s an impaction of the anterior shoulder after delivery of the head
- B. It’s an impaction of the posterior shoulder after delivery of the head
- C. Shoulder dystocia occurs due to compound presentation of the fetus
- D. Shoulder dystocia is not an emergency, it usually resolves on its own
Correct Answer: A
Rationale: The correct statement about shoulder dystocia is A: It’s an impaction of the anterior shoulder after delivery of the head. This is accurate as shoulder dystocia occurs when the anterior shoulder becomes impacted behind the maternal pubic symphysis. This can lead to difficulty delivering the shoulders after the head is delivered. B is incorrect as shoulder dystocia involves the anterior shoulder, not the posterior. C is incorrect as shoulder dystocia is not related to compound presentation. D is incorrect as shoulder dystocia is an obstetric emergency that requires prompt intervention to prevent complications for both the mother and the baby.
How does maternal obesity affect pregnancy outcomes?
- A. Increases risk of gestational diabetes
- B. Causes miscarriage
- C. Leads to anemia
- D. Reduces chance of preterm labor
Correct Answer: A
Rationale: The correct answer is A: Increases risk of gestational diabetes. Maternal obesity can lead to insulin resistance, increasing the likelihood of developing gestational diabetes during pregnancy. This condition can have negative effects on both the mother and the baby.
B: Miscarriage is not directly linked to maternal obesity but can be influenced by other factors.
C: Maternal obesity is not a direct cause of anemia during pregnancy. Anemia is usually related to iron deficiency or other factors.
D: Maternal obesity is actually associated with an increased risk of preterm labor, not a reduced chance. This is due to various complications such as hypertension and preeclampsia.
The comprehensive serologic assessment of a patient with Cushings syndrome is likely to produce which constellation of findings?
- A. Low potassium, high glucose, high white blood cell count
- B. High sodium, polycythemia, low BUN
- C. Low sodium, low potassium, high BUN
- D. High sodium, high chloride, high RBCs
Correct Answer: A
Rationale: The correct answer is A because in Cushing's syndrome, there is excess cortisol production leading to hyperglycemia (high glucose) and hypokalemia (low potassium). The high white blood cell count is due to the immunosuppressive effects of cortisol. Option B is incorrect as polycythemia is not typically seen in Cushing's syndrome. Option C is incorrect as low sodium and low potassium are not common findings in Cushing's syndrome. Option D is incorrect as high sodium, high chloride, and high RBCs are not typical features of Cushing's syndrome.