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: 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.
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Flexion-distraction injuries of the thoracolumbar spine are most commonly caused by
- A. Blunt trauma
- B. Rotational injury
- C. Seat belts
- D. Gunshot wounds
Correct Answer: B
Rationale: The correct answer is B: Rotational injury. Flexion-distraction injuries of the thoracolumbar spine are often caused by rotational forces that occur during accidents such as motor vehicle collisions or falls. These forces lead to the spine being twisted, causing separation of the vertebrae. Blunt trauma (A) can cause various spinal injuries but is not specific to flexion-distraction injuries. Seat belts (C) are designed to prevent spinal injuries by restraining the body during a collision. Gunshot wounds (D) can cause spinal cord injuries but are not commonly associated with flexion-distraction injuries of the thoracolumbar spine.
Which of the following statements is true with respect to adrenal tumors that produce gender symptoms?
- A. Feminizing adrenal tumors are almost always carcinomas
- B. Feminizing adrenal tumors are the most common type of adrenal tumor
- C. Virilizing tumors in women are most often localized to the adrenal cortex
- D. Virilizing adrenal tumors are more likely to be malignant in children
Correct Answer: B
Rationale: Step 1: Feminizing adrenal tumors are not always carcinomas, so A is incorrect.
Step 2: Virilizing tumors in women can originate from adrenal or extra-adrenal sites, so C is incorrect.
Step 3: Virilizing adrenal tumors are usually benign, especially in children, so D is incorrect.
Step 4: B is correct as feminizing adrenal tumors are rare but are the most common type of adrenal tumor causing gender symptoms.
TB in pregnancy predisposes a mother to premature labour due to
- A. Poor maternal appetite
- B. Severe anaemia experienced
- C. Adverse reactions of anti-TB drugs
- D. The fever experienced
Correct Answer: D
Rationale: The correct answer is D. TB in pregnancy can lead to premature labor due to the fever experienced. Fever increases the risk of premature labor by triggering uterine contractions. Poor maternal appetite (A) and severe anemia (B) may impact the mother's health but are not directly linked to premature labor. Adverse reactions of anti-TB drugs (C) could potentially affect the mother's health but are not a direct cause of premature labor.
Diagnosis of occipito-posterior position:
- A. External examination and ultrasound
- B. Physical exam with pelvic exam findings
- C. Regular contractions and maternal discomfort
- D. Both A and B
Correct Answer: D
Rationale: Step-by-step rationale:
1. External examination can reveal the position of the baby's head.
2. Ultrasound can confirm the baby's position accurately.
3. Physical exam and pelvic exam findings can provide additional information.
4. Combining both methods (A and B) ensures a comprehensive assessment for accurate diagnosis.
Summary:
- Choice A alone may not provide sufficient information.
- Choice B alone may not be as accurate as combined with ultrasound.
- Choice C is not specific to diagnosing occipito-posterior position.
- Choice D is correct as it combines external examination, ultrasound, and physical exam for accurate diagnosis.
Causes of puerperal pyrexia are entirely obstetrically related.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: Step 1: Puerperal pyrexia refers to fever occurring after childbirth.
Step 2: Causes can be obstetric (infection) or non-obstetric (e.g., urinary tract infection).
Step 3: Non-obstetric causes are also common postpartum.
Step 4: Therefore, puerperal pyrexia is not entirely obstetrically related.
Step 5: Hence, the correct answer is B (FALSE).