Nokea
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.
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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.
A student AGACNP just beginning his clinical rotation is observing his preceptor perform a physical survey on a patient who is brought in following a serious motor vehicle accident. The student observes that the physical examination includes rectovaginal examination, inspection of the urethral meatus, and palpation of the pelvic landmarks. The student knows the patient is being assessed for
- A. Peritoneal bleeding
- B. Retroperitoneal bleeding
- C. Paresthesia
- D. Pelvic fracture
Correct Answer: A
Rationale: The correct answer is A: Peritoneal bleeding. In a patient with a serious motor vehicle accident, a physical examination that includes rectovaginal examination, inspection of the urethral meatus, and palpation of pelvic landmarks is aimed at assessing for signs of internal bleeding, particularly peritoneal bleeding. Rectovaginal examination can detect blood in the rectouterine pouch, inspection of the urethral meatus can reveal blood at the urethral opening, and palpation of pelvic landmarks can identify tenderness or instability associated with internal bleeding. These findings would be indicative of potential peritoneal bleeding requiring urgent evaluation and management.
Summary of other choices:
B: Retroperitoneal bleeding - While physical examination findings may include signs such as flank ecchymosis or tenderness, the specific examinations mentioned are not typically performed to assess retroperitoneal bleeding.
C: Paresthesia - Paresthesia refers to abnormal sensations like tingling or numbness and
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: A
Rationale: The correct answer is A: Hypogastrinemia and acid hyposecretion. Gastrinoma is a tumor that secretes excessive gastrin, leading to hypergastrinemia and increased acid secretion. However, due to a negative feedback mechanism, chronic exposure to high gastrin levels can cause downregulation of gastrin receptors on parietal cells, leading to decreased acid secretion. Therefore, in gastrinoma, despite high gastrin levels, acid secretion may be reduced due to this negative feedback loop. Choices B, C, and D are incorrect because they do not align with the expected relationship between gastrin levels and acid secretion in gastrinoma.
How can Braxton Hicks contractions be differentiated from true labor?
- A. By timing
- B. By intensity
- C. By duration
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D - All of the above. Braxton Hicks contractions can be differentiated from true labor by timing, intensity, and duration. Timing refers to the regularity of contractions, intensity relates to the strength of contractions, and duration indicates how long contractions last. By considering all three factors together, one can determine whether contractions are Braxton Hicks (practice contractions) or true labor contractions. Choices A, B, and C alone provide only partial information, which may lead to misinterpretation. Therefore, choosing all three factors collectively (D) is essential for accurate differentiation.
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.