Nokea
The AGACNP knows that treatment for this likely will include
- A. Observation
- B. Hyperextension casting
- C. Jewett brace
- D. Surgical intervention
Correct Answer: B
Rationale: The correct answer is B: Hyperextension casting. The AGACNP knows that this treatment is appropriate for a condition that requires immobilization and support while allowing controlled movement. Hyperextension casting provides stability and support while promoting healing. Observation (A) would not provide adequate treatment for a condition requiring immobilization. Jewett brace (C) is typically used for spinal fractures, not for conditions that require hyperextension casting. Surgical intervention (D) would be considered if conservative measures like casting have failed.
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The CORRECT statement with regards to face to pubis delivery is
- A. It results due to a 135˚ anterior rotation of the occiput
- B. It results due to a persistent occipito posterior position
- C. It results due to a 45˚ anterior rotation of the occiput
- D. It results due to a 45˚ anterior rotation of the sinciput
Correct Answer: C
Rationale: Rationale:
Face to pubis delivery occurs when the fetal face presents towards the mother's pubic bone during birth. Choice C is correct because a 45˚ anterior rotation of the occiput is needed for this positioning. This allows the fetal face to be directed towards the mother's pubis for a successful face to pubis delivery. Choices A and D are incorrect as they mention incorrect angles of rotation. Choice B is incorrect as a persistent occipito posterior position would result in a face to sacrum delivery, not face to pubis.
Why is it important to monitor blood pressure regularly in pregnant women?
- A. To prevent anemia
- B. To detect preeclampsia
- C. To avoid preterm labor
- D. To prevent gestational diabetes
Correct Answer: B
Rationale: It is important to monitor blood pressure in pregnant women to detect preeclampsia, a serious condition that can lead to complications for both the mother and the baby. Preeclampsia is characterized by high blood pressure and protein in the urine, and early detection is crucial for timely intervention. Regular monitoring allows healthcare providers to identify and manage preeclampsia promptly, reducing the risk of severe complications such as eclampsia and organ damage. Anemia, preterm labor, and gestational diabetes are important aspects of prenatal care but are not directly related to the need for regular blood pressure monitoring in pregnant women.
The complication that is associated with hyperemesis gravidarum is
- A. Wernicke’s encephalopathy
- B. Sheehan’s syndrome
- C. Maurice encephalitis
- D. Antepartum bleeding
Correct Answer: A
Rationale: The correct answer is A: Wernicke's encephalopathy. Hyperemesis gravidarum is severe nausea and vomiting during pregnancy. Wernicke's encephalopathy is a neurological complication due to thiamine deficiency, which can occur in severe cases of vomiting, leading to impaired brain function. Sheehan's syndrome is a complication of postpartum pituitary necrosis. Maurice encephalitis is a fictional term not related to this context. Antepartum bleeding is not a typical complication of hyperemesis gravidarum. Therefore, the correct answer is A due to the potential neurological impact of severe vomiting on thiamine levels.
During neonatal resuscitation, dry wiping is aimed at
- A. Preventing hypothermia and facilitating tactile stimulation
- B. Preventing hemorrhage and clearing of the airway
- C. Preventing infection and facilitating tactile stimulation
- D. Improving the appearance and preventing infection
Correct Answer: A
Rationale: The correct answer is A: Preventing hypothermia and facilitating tactile stimulation. Dry wiping during neonatal resuscitation helps prevent hypothermia by removing wetness from the baby's skin. It also facilitates tactile stimulation, which can help stimulate the baby's breathing.
Summary:
B: Preventing hemorrhage and clearing of the airway - Dry wiping does not prevent hemorrhage or clear the airway directly.
C: Preventing infection and facilitating tactile stimulation - While dry wiping can help prevent infection, its primary aim during neonatal resuscitation is to prevent hypothermia.
D: Improving the appearance and preventing infection - Dry wiping is not done for cosmetic reasons; its main purpose is to prevent hypothermia.
Janet is a 54-year-old female who is in the ICU following hepatic resection due to metastatic disease. She is expected to move to a general medical floor today. Morning labs are as follows serum bilirubin approximately 2 gdL, albumin 3.1 gdL, and prothrombin time 20 seconds. AST and ALT are 85 and 99 respectively. The appropriate response would be to
- A. Cancel the transfer and keep her in the ICU
- B. Infuse albumin and fresh frozen plasma
- C. Repeat the labs the next day
- D. Prepare for reoperation
Correct Answer: D
Rationale: The correct answer is D: Prepare for reoperation. Given the patient's elevated AST and ALT levels after hepatic resection, along with abnormal prothrombin time and low albumin, there is concern for liver dysfunction. This indicates a potential complication post-surgery, such as hepatic insufficiency or failure, necessitating reoperation for further evaluation and management. Cancelling the transfer (A) would delay necessary intervention. Infusing albumin and fresh frozen plasma (B) would address only the symptoms but not the underlying cause. Repeating labs the next day (C) would not address the urgency of the situation.