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The drug of choice in the management of eclampsia is
- A. Phenobarbitone
- B. Calcium gluconate
- C. Magnesium sulphate
- D. Sodium bicarbonate
Correct Answer: C
Rationale: The correct answer is C: Magnesium sulphate. In eclampsia, magnesium sulphate is the drug of choice because it helps prevent seizures by reducing neuromuscular irritability and blocking peripheral neuromuscular transmission. It also has vasodilatory effects, improving uteroplacental blood flow. Phenobarbitone (A) is not recommended due to its sedative effects. Calcium gluconate (B) is used to treat hyperkalemia, not eclampsia. Sodium bicarbonate (D) is used for metabolic acidosis, not eclampsia. In summary, magnesium sulphate is preferred for its efficacy in preventing and managing seizures in eclampsia.
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Mrs. Jenner is a 41-year-old female who is being evaluated for persistent nausea. She had an abdominal CT scan that reported three hepatic hemangiomas ranging from 3 to 5 cm. The AGACNP knows that the appropriate response to this report is to
- A. Arrange for large-bore needle biopsy
- B. Order hepatic ultrasound annually to follow progression
- C. Consult surgery for resection
- D. Document the finding in the patient’s chart
Correct Answer: B
Rationale: The correct answer is B. Ordering hepatic ultrasound annually to follow progression is the appropriate response for hepatic hemangiomas. Biopsy is not recommended due to the risk of bleeding. Surgery is usually not required unless there are complications. Documenting the finding is important but does not address the need for monitoring. Ultrasound allows for non-invasive monitoring of the hemangiomas over time to assess for growth or complications, guiding further management if needed.
Based upon an understanding of the normal relationship between gastrin levels and acid secretion, the AGACNP recognizes that which of the following combinations is almost diagnostic of gastrinoma?
- A. Hypogastrinemia and acid hyposecretion
- B. Hypergastrinemia and acid hyposecretion
- C. Hypogastrinemia and acid hypersecretion
- D. Hypergastrinemia and acid hypersecretion
Correct Answer: D
Rationale: The correct answer is D: Hypergastrinemia and acid hypersecretion. Gastrinoma is a tumor that secretes excessive gastrin, leading to elevated gastrin levels. High gastrin levels stimulate acid secretion in the stomach, resulting in acid hypersecretion. Therefore, the combination of hypergastrinemia and acid hypersecretion is almost diagnostic of gastrinoma.
A: Hypogastrinemia and acid hyposecretion is incorrect because gastrinoma leads to increased gastrin levels and subsequent acid hypersecretion.
B: Hypergastrinemia and acid hyposecretion is incorrect because gastrinoma is associated with acid hypersecretion, not hyposecretion.
C: Hypogastrinemia and acid hypersecretion is incorrect because gastrinoma causes elevated gastrin levels and acid hypersecretion, not hypogastrinemia.
In summary, the correct answer D aligns with the pathophysiology of gastrinoma, while the
Cholesteatoma is a condition characterized by a collection of desquamated keratin leading to bony erosion in the ossicular chain and inner ear. The goal of surgery in cholesteatoma is
- A. Production of a dry ear
- B. Preservation of sensorineural hearing
- C. Debridement of infection
- D. Restoration of the tympanic membrane
Correct Answer: B
Rationale: The correct answer is B: Preservation of sensorineural hearing. In cholesteatoma, surgery aims to remove the lesion and prevent further damage to the ossicles and inner ear structures. Preserving sensorineural hearing is crucial to maintain auditory function post-surgery. A: Production of a dry ear is important to prevent recurrence, but not the primary goal. C: Debridement of infection is necessary, but the main aim is to address the cholesteatoma itself. D: Restoration of the tympanic membrane may be needed but is not the primary objective in cholesteatoma surgery.
Clinical diagnosis of polyhydramnios is based on an amount of amniotic fluid exceeding
- A. 1500 ml
- B. 3000 ml
- C. 1900 ml
- D. 2500 ml
Correct Answer: B
Rationale: The correct answer is B (3000 ml) because polyhydramnios is defined as an excessive amount of amniotic fluid, typically exceeding 2000-2500 ml. A level of 3000 ml is commonly used as a cutoff point for clinical diagnosis. Choices A, C, and D are incorrect because they fall below the threshold typically considered diagnostic for polyhydramnios. Answer A (1500 ml) is too low, while choices C (1900 ml) and D (2500 ml) are below or at the lower end of the range typically associated with polyhydramnios. Therefore, the most appropriate threshold for diagnosing polyhydramnios is when the amount of amniotic fluid exceeds 3000 ml.
Stuvia.com - The Marketplace to Buy and Sell your Study Material T. O. is a 44-year-old female patient who presents for evaluation of sudden, severe upper abdominal pain. She is clear about the onset, which was profound and occurred approximately one hour ago. She denies that the onset had any relationship to food or eating, and she denies nausea or vomiting. On examination, she is lying on her right side with her hips and knees flexed to draw her knees to her chest. Vital signs are stable, but examination reveals involuntary guarding. The abdomen is painful and tympanic to percussion in all quadrants. CBC reveals a white blood cell count of 15,600L. The AGACNP suspects
- A. Dissecting aortic aneurysm
- B. Acute pancreatitis
- C. Perforated peptic ulcer
- D. Mallory-Weiss tear
Correct Answer: B
Rationale: The correct answer is B: Acute pancreatitis. The patient's sudden, severe upper abdominal pain, unaffected by food intake, along with guarding and elevated white blood cell count, are indicative of acute pancreatitis. The patient's positioning (knees to chest) suggests relief from pain, which is characteristic of pancreatitis. A dissecting aortic aneurysm (choice A) typically presents with tearing chest or back pain. Perforated peptic ulcer (choice C) would present with a history of chronic ulcer symptoms. Mallory-Weiss tear (choice D) presents with a history of recent vomiting. Therefore, based on the patient's presentation and findings, acute pancreatitis is the most likely diagnosis.