Nokea
The commonest causative organism of pyelonephritis is
- A. Streptococcus faecalis
- B. Proteus vulgaris
- C. Staphylococcus pyogene
- D. Escherichia coli
Correct Answer: D
Rationale: The correct answer is D: Escherichia coli. E. coli is the most common causative organism of pyelonephritis due to its prevalence in the gastrointestinal tract. It has specific virulence factors that enable it to ascend the urinary tract and cause infection. Streptococcus faecalis, Proteus vulgaris, and Staphylococcus pyogene are less commonly associated with pyelonephritis compared to E. coli.
You may also like to solve these questions
Intraperitoneal uterine rupture involves
- A. A tear of endometrium, myometrium & peritoneum
- B. A tear of the endometrium, myometrium & basal layer
- C. A tear of the endometrium, capsular layer & myometrium
- D. A tear of the endometrium, spongy layer & myometrium only
Correct Answer: A
Rationale: The correct answer is A because intraperitoneal uterine rupture involves a tear that goes through all layers of the uterus - endometrium, myometrium, and peritoneum. This type of rupture extends beyond the muscular layer of the uterus and into the peritoneal cavity. Choices B, C, and D are incorrect as they do not include the peritoneum, which is a key component of intraperitoneal uterine rupture. Therefore, choice A is the correct answer as it accurately describes the layers involved in this type of rupture.
Jennifer is an RN applicant for a staff nurse position in the surgical ICU. She has had a screening PPD and comes back in 48 hours to have it read. There is a 12-mm induration at the site of injection. A chest radiograph is negative. The AGACNP knows that the next step in Jennifers evaluation and management should include
- A. No further care, because the chest radiograph is negative
- B. Quantiferon serum assay for exposure
- C. Consideration of prophylactic therapy
- D. Beginning therapy for pulmonary TB pending sputum cultures
Correct Answer: C
Rationale: The correct answer is C: Consideration of prophylactic therapy. A 12-mm induration in a healthcare worker is considered positive for PPD. In the absence of active TB on chest radiograph, the next step is to consider prophylactic therapy to prevent the development of active TB. This is based on the guidelines for the management of latent TB infection. Choice A is incorrect as a positive PPD warrants further evaluation regardless of the chest radiograph result. Choice B, the Quantiferon assay, is not the next step after a positive PPD and negative chest radiograph. Choice D, beginning therapy for pulmonary TB pending sputum cultures, is not indicated in this scenario as there is no evidence of active TB.
Complications of occipito-posterior position:
- A. Prolonged labor, fetal distress, back pain
- B. Postpartum hemorrhage, uterine rupture, fetal death
- C. Cesarean delivery, low birth weight, infection
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A because occipito-posterior position can lead to prolonged labor due to poor fetal positioning, causing maternal back pain. This can result in fetal distress as the baby may have difficulty descending through the birth canal. Postpartum hemorrhage, uterine rupture, fetal death (choices B and C) are not typically associated with occipito-posterior position. Therefore, choice A is the most appropriate answer.
There are no other abnormal findings. This suggests that Mr. Thornton
- A. Is having anterior wall ischemia
- B. Is having an anterior wall infarction
- C. Has a history of anterior wall NSTEMI
- D. Has a history of anterior wall STEMI
Correct Answer: B
Rationale: The correct answer is B because the absence of any other abnormal findings suggests that Mr. Thornton is currently experiencing an anterior wall infarction. This is indicated by the localized area of myocardial necrosis due to prolonged ischemia. Option A is incorrect because ischemia would typically present with reversible changes rather than necrosis. Option C is incorrect as NSTEMI would show some abnormal findings. Option D is incorrect as STEMI would show more significant ECG changes and enzyme elevation. In summary, the absence of other abnormalities points towards an acute event like an anterior wall infarction.
Vaginal delivery is possible in
- A. Brow presentation
- B. Face presentation
- C. Shoulder presentation
- D. Unstable lie
Correct Answer: B
Rationale: The correct answer is B: Face presentation. Vaginal delivery is possible in face presentation as the baby's head is extended, allowing for descent through the birth canal. Brow presentation (A) and shoulder presentation (C) may require cesarean delivery due to the atypical presentation of the baby. Unstable lie (D) refers to the baby being in a transverse position, which also necessitates a cesarean section. Face presentation is the only option where vaginal delivery may be possible due to the extended position of the baby's head.