Nokea
The AGACNP is counseling a patient about various methods of tumor biopsy. Which of the following is not an accurate statement?
- A. Incisional biopsy is preferred to excisional biopsy when possible
- B. Core needle biopsy has a higher rate of false positive than does fine needle aspiration
- C. Fine needle aspiration does not allow grading of tumors
- D. Core needle and incisional biopsies are virtually identical in terms of false results
Correct Answer: C
Rationale: Correct Answer: C - Fine needle aspiration does not allow grading of tumors.
Rationale:
1. Fine needle aspiration (FNA) collects cells for cytology evaluation, not tissue for grading.
2. Grading requires evaluation of tissue architecture, which is not possible with FNA.
3. FNA is useful for diagnosis but not for determining tumor grade.
Summary:
A: Incorrect - Excisional biopsy is preferred over incisional biopsy to obtain the entire tumor for diagnosis and grading.
B: Incorrect - Core needle biopsy has a lower false positive rate compared to fine needle aspiration.
D: Incorrect - Core needle and incisional biopsies differ in the amount of tissue sampled and potential for false results.
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Which one of the following therapies is the MOST incorporated in the management of clients with gestational diabetes?
- A. Therapeutic diet alone
- B. Long acting insulin
- C. Oral hypoglycaemics
- D. Short acting insulin
Correct Answer: D
Rationale: The correct answer is D: Short acting insulin. In gestational diabetes, short acting insulin is preferred as it provides immediate control over blood sugar levels after meals. This is crucial in managing the condition to prevent complications for both the mother and the baby. Therapeutic diet alone (choice A) may not be sufficient to control blood sugar levels, while long-acting insulin (choice B) may not provide the rapid response needed after meals. Oral hypoglycemics (choice C) are generally avoided in pregnancy due to potential risks to the fetus. Therefore, short acting insulin is the most appropriate therapy for managing gestational diabetes effectively.
According to the American College of Surgeons (ACS) and the National Surgical Quality Improvement Program (NSQIP) guidelines for preoperative evaluation of the geriatric patient, the preoperative evaluation should include all of the following except
- A. Cognitive ability
- B. Functional status
- C. Competency assessment
- D. Frailty score
Correct Answer: A
Rationale: Step-by-step rationale:
1. Cognitive ability is important for decision-making during surgery.
2. Functional status helps assess the patient's ability to recover post-surgery.
3. Competency assessment ensures the patient can consent to surgery.
4. Frailty score predicts surgical outcomes in geriatric patients.
5. Cognitive ability is not typically assessed preoperatively in the ACS/NSQIP guidelines.
Summary:
- A: Cognitive ability is not typically part of preoperative evaluation.
- B: Functional status is important for post-surgery recovery.
- C: Competency assessment is crucial for informed consent.
- D: Frailty score helps predict surgical outcomes in geriatric patients.
How does gestational diabetes impact fetal development?
- A. Causes macrosomia
- B. Leads to congenital anomalies
- C. Reduces fetal movements
- D. Increases risk of preterm birth
Correct Answer: A
Rationale: The correct answer is A because gestational diabetes can lead to macrosomia, which is excessive fetal growth due to high blood sugar levels in the mother. This occurs as the fetus receives excess glucose from the mother, resulting in increased fat deposition and larger birth weight. Congenital anomalies (B) are not directly caused by gestational diabetes but by genetic or environmental factors. Reduced fetal movements (C) are not a typical effect of gestational diabetes. While gestational diabetes can increase the risk of preterm birth (D), the primary impact on fetal development is macrosomia.
A correct statement about an acute small for gestational age neonate is
- A. Entire body is proportionately reduced for gestational age
- B. Head is disproportionately larger than the rest of the body
- C. The body is disproportionately larger than the baby’s head
- D. The neonate appears plumpy with a scaphoid shaped abdomen
Correct Answer: A
Rationale: The correct answer is A because an acute small for gestational age neonate will have all body parts proportionately reduced in size compared to a normal gestational age baby. This is due to intrauterine growth restriction. Choice B is incorrect because the head is not disproportionately larger. Choice C is incorrect as it states the body is larger than the head, which is not the case in SGA babies. Choice D is incorrect as SGA babies typically appear thin with a scaphoid abdomen, not plumpy.
A non-pharmacological measure of pain relief in labour includes
- A. Entonox
- B. Cyclothane
- C. Homeopathy
- D. Diamorphine
Correct Answer: C
Rationale: The correct answer is C: Homeopathy. Homeopathy involves using highly diluted substances to stimulate the body's natural healing processes. In labor, homeopathy can help manage pain and support relaxation. Entonox (A) and Diamorphine (D) are pharmacological measures, while Cyclothane (B) is not a recognized pain relief option in labor. Homeopathy aligns with non-pharmacological approaches, making it the most suitable choice for pain relief in labor.