Nokea
The Brain Trauma Foundation recommends intracranial pressure monitoring for all of the following patients except those with
- A. GCS of 3 to 8 and abnormal head CT
- B. GCS of 3 to 8 and hypotension
- C. GCS of 3 to 8 and > 40 years old
- D. GCS of 3 to 8 and bradycardia
Correct Answer: B
Rationale: The correct answer is B (GCS of 3 to 8 and hypotension) because hypotension is not a specific indication for intracranial pressure (ICP) monitoring according to the Brain Trauma Foundation guidelines. The rationale is that hypotension is a systemic issue affecting overall perfusion, whereas ICP monitoring is specifically for assessing intracranial dynamics.
A, C, and D are incorrect choices because they all involve conditions that could potentially indicate increased intracranial pressure and the need for monitoring. A) Abnormal head CT indicates structural brain injury, C) age > 40 is a risk factor for poor outcomes after traumatic brain injury, and D) bradycardia can be a sign of increased ICP affecting brainstem function. Therefore, these conditions warrant ICP monitoring according to guidelines.
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Surgical induction of labor refers to the use of
- A. Cytotec and mechanical cervical dilatation
- B. Sweeping of membranes and amniotomy
- C. Mechanical cervical dilatation and buscopan
- D. Artificial rupture of membranes and syntocinon
Correct Answer: B
Rationale: The correct answer is B: Sweeping of membranes and amniotomy.
1. Sweeping of membranes involves manually separating the amniotic sac from the lower part of the uterus, stimulating the release of prostaglandins to induce labor.
2. Amniotomy is the artificial rupture of membranes, which can accelerate labor by releasing amniotic fluid and initiating contractions.
3. These methods are commonly used for surgical induction of labor due to their effectiveness and minimal invasiveness compared to other options.
Incorrect choices:
A: Cytotec is a medication used for labor induction, but mechanical cervical dilatation is not a standard surgical method.
C: Buscopan is used for relaxation of smooth muscle and not commonly used for labor induction.
D: Syntocinon is a synthetic form of oxytocin used to induce or augment labor, but it is not typically used in surgical induction methods.
Which one of the following statements is correct about secondary post-partum haemorrhage?
- A. Mostly occurs between the 8th-14th day post-partum
- B. Results due to bleeding immediately after delivery
- C. Can extend up to the first 46 days following delivery
- D. Is diagnosed by presence of persistent lochia serosa
Correct Answer: C
Rationale: The correct answer is C because secondary post-partum hemorrhage can occur up to 6 weeks (46 days) after delivery, typically due to delayed complications like retained placental fragments or infection. Choice A is incorrect because most secondary post-partum hemorrhage occurs after the first week. Choice B is incorrect as it describes primary post-partum hemorrhage, which occurs within 24 hours of delivery. Choice D is incorrect since lochia serosa is a normal discharge present in the early post-partum period and is not specific to diagnosing secondary post-partum hemorrhage.
A characteristic of monozygotic twins includes
- A. Always of the same sex
- B. Share a similar fingerprint pattern
- C. Have different blood groups
- D. Superfetation is a common finding
Correct Answer: A
Rationale: The correct answer is A: Always of the same sex. Monozygotic twins develop from a single fertilized egg, so they have the same genetic material, making them always the same sex. This is due to the fact that the sex of an individual is determined by the chromosomes inherited from the parents. This is a fundamental principle of genetics. Choices B, C, and D are incorrect because monozygotic twins can have different fingerprints, blood groups, and superfetation (conception that occurs during an existing pregnancy) is not common in monozygotic twins.
K. T. presents for a routine wellness examination, and the review of systems is significant only for a markedly decreased capacity for intake and a vague sense of nausea after eating. K. T. denies any other symptoms the remainder of the GI review of systems is negative. His medical history is significant for complicated peptic ulcer disease that finally required resection for a perforated ulcer. The AGACNP advises the patient that
- A. He will need endoscopy to evaluate the problem
- B. Chronic gastroparesis is a known complication of ulcer surgery
- C. Medication is unlikely to help, and he may need another surgery
- D. His symptoms occur in 5 to 10% of people after ulcer surgery
Correct Answer: D
Rationale: The correct answer is D: His symptoms occur in 5 to 10% of people after ulcer surgery. This is the correct answer because the patient's symptoms of decreased capacity for intake and nausea after eating are common post-operative complications following ulcer surgery. By stating this fact to the patient, the AGACNP is providing reassurance that these symptoms are not unusual.
Explanation for why the other choices are incorrect:
A: Endoscopy is not necessary at this point since the symptoms described by the patient are known post-operative complications and do not indicate an urgent need for endoscopy.
B: While gastroparesis can be a complication of ulcer surgery, there is no information in the case to suggest that the patient has chronic gastroparesis.
C: Jumping to the conclusion that medication is unlikely to help and another surgery may be needed is premature and not supported by the information provided in the case.
How does maternal obesity affect pregnancy outcomes?
- A. Increases risk of gestational diabetes
- B. Causes miscarriage
- C. Leads to anemia
- D. Reduces chance of preterm labor
Correct Answer: A
Rationale: The correct answer is A: Increases risk of gestational diabetes. Maternal obesity can lead to insulin resistance, increasing the likelihood of developing gestational diabetes during pregnancy. This condition can have negative effects on both the mother and the baby.
B: Miscarriage is not directly linked to maternal obesity but can be influenced by other factors.
C: Maternal obesity is not a direct cause of anemia during pregnancy. Anemia is usually related to iron deficiency or other factors.
D: Maternal obesity is actually associated with an increased risk of preterm labor, not a reduced chance. This is due to various complications such as hypertension and preeclampsia.