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Specific management for incomplete uterine rupture:
- A. Immediate cesarean, monitoring for signs of shock, fluid resuscitation
- B. Observation with pain relief, assisted vaginal delivery
- C. Immediate caesarean, control bleeding, fluid management
- D. Continuous monitoring, natural birth
Correct Answer: A
Rationale: The correct answer is A because immediate cesarean is crucial to prevent further complications and ensure the safety of the mother and baby. Monitoring for signs of shock is essential to detect any deterioration in the mother's condition. Fluid resuscitation helps stabilize the mother's hemodynamic status. Option B is incorrect as observation alone may delay necessary interventions. Option C is partially correct as immediate cesarean is necessary but does not address monitoring for shock and fluid resuscitation. Option D is incorrect as continuous monitoring alone is insufficient to manage incomplete uterine rupture.
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Prenatally, malaria parasites hide at the
- A. Bone marrow
- B. Placental bed
- C. Fetal circulation
- D. Uterine muscle
Correct Answer: B
Rationale: The correct answer is B: Placental bed. Malaria parasites hide in the placental bed during pregnancy to avoid detection by the immune system. This location provides a safe haven for the parasites to survive and replicate without being cleared by the mother's immune response. The placental bed offers a rich blood supply and a favorable environment for the parasites to thrive.
Incorrect choices:
A: Bone marrow - Malaria parasites do not typically hide in the bone marrow during pregnancy.
C: Fetal circulation - Malaria parasites do not hide in the fetal circulation; they primarily reside in the placental bed.
D: Uterine muscle - Malaria parasites do not hide in the uterine muscle; the placental bed is the main site of sequestration during pregnancy.
Clinical diagnosis of polyhydramnios is based on an amount of amniotic fluid exceeding
- A. 1500 ml
- B. 3000 ml
- C. 1900 ml
- D. 2500 ml
Correct Answer: B
Rationale: The correct answer is B: 3000 ml. Polyhydramnios is diagnosed when the amniotic fluid volume exceeds 2000-3000 ml. This amount is considered excessive and can indicate various maternal or fetal health conditions. Choice A (1500 ml) is too low to qualify as polyhydramnios. Choice C (1900 ml) falls within the normal range of amniotic fluid volume. Choice D (2500 ml) is close to the threshold but may not always be considered excessive. Therefore, the correct diagnosis of polyhydramnios is based on an amniotic fluid volume exceeding 3000 ml.
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
A major predisposing factor to cardiac disease in pregnancy includes
- A. Rheumatic heart disease
- B. Notable peripheral oedema
- C. Easy fatiguability
- D. Basal crepitation
Correct Answer: A
Rationale: The correct answer is A: Rheumatic heart disease. This is because rheumatic heart disease is a known risk factor for cardiac complications during pregnancy due to the strain pregnancy places on the heart. Choice B, notable peripheral edema, is a symptom of heart failure but not a predisposing factor. Choice C, easy fatiguability, is a non-specific symptom and not a direct predisposing factor. Choice D, basal crepitation, is a sign of possible lung pathology and not directly related to cardiac disease in pregnancy. Therefore, the correct answer is A as it directly relates to an increased risk of cardiac issues during pregnancy.
Mr. Mettenberger is being discharged following his hospitalization for reexpansion of his second spontaneous pneumothorax this year. He has stopped smoking and does not appear to have any overt risk factors. While doing his discharge teaching, the AGACNP advises Mr. Mettenberger that his current risk for another pneumothorax is
- A. < 10%
- B. 25-50%
- C. 50-75%
- D. > 90
Correct Answer: D
Rationale: The correct answer is D (>90%). Mr. Mettenberger had a reexpansion of his second spontaneous pneumothorax this year, indicating a high recurrence risk. Spontaneous pneumothorax recurrence rates are high, especially in young males. Factors such as smoking history, gender, and prior occurrences contribute to increased risk. Mr. Mettenberger's cessation of smoking reduces but does not eliminate the risk. Choices A, B, and C are too low, given his history and current situation. Choice D is the most appropriate due to the high likelihood of recurrence based on his medical history and risk factors.