Nokea
The AGACNP knows that when evaluating a patient with suspected acute pyelonephritis, which of the following is not a common feature?
- A. Pyuria
- B. Fever
- C. CVA tenderness
- D. Gross hematuria
Correct Answer: D
Rationale: While pyuria, fever, and CVA tenderness are common features of acute pyelonephritis, gross hematuria is less commonly associated with this condition. In acute pyelonephritis, the inflammatory process primarily affects the renal parenchyma and pelvis, leading to symptoms such as fever, chills, flank pain, pyuria (presence of pus in the urine), and CVA tenderness (tenderness over the costovertebral angle). Hematuria in acute pyelonephritis is more likely to be microscopic rather than gross.
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The AGACNP knows that which of the following must be evaluated as a cause of her abdominal pain?
- A. HELLP syndrome
- B. Placental abruption
- C. Spontaneous hepatic rupture
- D. Preterm labor
Correct Answer: C
Rationale: Abdominal pain in pregnancy can be caused by various conditions, but spontaneous hepatic rupture is a rare but life-threatening cause that must be ruled out. Spontaneous hepatic rupture, also known as liver rupture, can occur in pregnancy, though it is extremely rare. It is associated with severe abdominal pain, hypovolemic shock, and can lead to significant maternal and fetal morbidity and mortality. Therefore, the AGACNP should evaluate this possibility when assessing a pregnant patient with abdominal pain to provide timely and appropriate management.HELLP syndrome, placental abruption, and preterm labor are important considerations in the differential diagnosis of abdominal pain in pregnancy but are not specific to the life-threatening nature of spontaneous hepatic rupture.
The priority management of uncomplicated malaria during the second trimester includes administration of
- A. Oral quinine
- B. Parenteral quinine
- C. Artemether lumefantrine
- D. Sulphadoxine pyrimethamine
Correct Answer: C
Rationale: Artemether lumefantrine is recommended for uncomplicated malaria in pregnancy.
When resuscitating an asphyxiated baby, the purpose of ensuring adequate ventilation prior to administration of sodium bicarbonate is because
- A. The drug decreases carbon dioxide tension
- B. The drug increases carbon dioxide tension
- C. The drug is effective in the correction of metabolic acidosis
- D. The drug is effective in the correction of metabolic alkalosis
Correct Answer: C
Rationale: Sodium bicarbonate is used to correct metabolic acidosis, not to influence carbon dioxide levels directly.
Based on vaginal examination findings, indicators of abnormal labor are
- A. Bandl’s ring and oedematous vulva
- B. Oedematous cervix and fetal hypoxia
- C. Maternal distress and severe moulding
- D. Hot, dry vagina and arrest in descent
Correct Answer: D
Rationale: A hot, dry vagina and lack of descent suggest abnormal labor patterns.
Jake is a 32-year-old patient who is recovering from major abdominal surgery and organ resection following a catastrophic motor vehicle accident. Due to the nature of his injuries, a large portion of his jejunum had to be resected. In planning for his recovery and nutritional needs, the AGACNP considers that
- A. He will probably be able to transition to oral nutrition but will have lifetime issues with diarrhea
- B. His procedure has put him at significant risk for B12 absorption problems
- C. Most jejunum absorption functions will be assumed by the ileum
- D. Enteral nutrition will need to be delayed for 3 to 6 months to facilitate adaptation
Correct Answer: B
Rationale: The jejunum is the primary site for absorption of nutrients, including vitamin B12. Resection of a large portion of the jejunum can lead to malabsorption of vitamin B12, as this nutrient is primarily absorbed in the distal ileum but also partially absorbed in the jejunum. Thus, Jake is at significant risk for B12 absorption problems following his surgery, and close monitoring and potential supplementation may be needed to address this issue.