The earliest onset of cephalohematoma is
- A. Six hours postnatally
- B. Twelve hours postnatally
- C. Eighteen hours postnatally
- D. Immediately after birth
Correct Answer: A
Rationale: The correct answer is A: Six hours postnatally. Cephalohematoma is a collection of blood between a baby's skull and the periosteum. It typically appears several hours after birth due to trauma during delivery, causing bleeding under the periosteum. This allows time for the blood to accumulate and form a distinct swelling, making the onset around six hours postnatally. Choices B, C, and D are incorrect as they do not align with the typical timeline for the development of cephalohematoma.
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The AGACNP is counseling a patient about various methods of tumor biopsy. Which of the following is not an accurate statement?
- A. Incisional biopsy is preferred to excisional biopsy when possible
- B. Core needle biopsy has a higher rate of false positive than does fine needle aspiration
- C. Fine needle aspiration does not allow grading of tumors
- D. Core needle and incisional biopsies are virtually identical in terms of false results
Correct Answer: C
Rationale: Correct Answer: C - Fine needle aspiration does not allow grading of tumors.
Rationale:
1. Fine needle aspiration (FNA) collects cells for cytology evaluation, not tissue for grading.
2. Grading requires evaluation of tissue architecture, which is not possible with FNA.
3. FNA is useful for diagnosis but not for determining tumor grade.
Summary:
A: Incorrect - Excisional biopsy is preferred over incisional biopsy to obtain the entire tumor for diagnosis and grading.
B: Incorrect - Core needle biopsy has a lower false positive rate compared to fine needle aspiration.
D: Incorrect - Core needle and incisional biopsies differ in the amount of tissue sampled and potential for false results.
The PRIORITY action to take when nursing a neonate on phototherapy is to
- A. Turn the neonate every six hours routinely
- B. Encourage mother to discontinue breastfeeding
- C. Notify physician if the skin turns bronze-colored
- D. Check the neonate’s vital signs every 2-4 hourly
Correct Answer: D
Rationale: The correct answer is D: Check the neonate’s vital signs every 2-4 hourly. This is the priority action because neonates undergoing phototherapy are at risk for dehydration and temperature instability. Monitoring vital signs regularly helps to detect any signs of dehydration, such as decreased urine output or increased heart rate, and ensures timely intervention.
Explanation for other choices:
A: Turning the neonate every six hours routinely is important for preventing pressure ulcers but is not the priority when compared to monitoring vital signs for potential complications.
B: Encouraging the mother to discontinue breastfeeding is incorrect as breastmilk provides essential nutrients and hydration, which are important for neonates, even during phototherapy.
C: Notifying the physician if the skin turns bronze-colored is important to address a potential adverse reaction to phototherapy but does not take precedence over monitoring vital signs for immediate concerns.
In mild preeclampsia, the mother has no complaints.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: The correct answer is B: FALSE. In mild preeclampsia, the mother may have symptoms such as mild hypertension, proteinuria, and swelling. This contradicts the statement that the mother has no complaints. Choice A is incorrect because it inaccurately states that the mother has no complaints. Choices C and D are not applicable as they do not provide any relevant information to address the question.
Cord presentation is when the
- A. Umbilical cord lies in front of the presenting part after the membranes have ruptured.
- B. Umbilical cord lies in front of the presenting part before membranes have ruptured
- C. Umbilical cord is tied around the fetal neck.
- D. Umbilical cord has prematurely been detached.
Correct Answer: A
Rationale: The correct answer is A because cord presentation occurs when the umbilical cord lies in front of the presenting part after the membranes have ruptured. This can lead to compression of the cord during labor, affecting fetal oxygenation. Option B is incorrect as it describes cord prolapse, where the cord lies in front of the presenting part before membrane rupture. Option C describes nuchal cord, where the cord is wrapped around the fetal neck. Option D describes cord abruption, where the cord detaches prematurely from the placenta.
A correct statement about an acute small for gestational age neonate is
- A. Entire body is proportionately reduced for gestational age
- B. Head is disproportionately larger than the rest of the body
- C. The body is disproportionately larger than the baby’s head
- D. The neonate appears plumpy with a scaphoid shaped abdomen
Correct Answer: A
Rationale: The correct answer is A because an acute small for gestational age neonate will have all body parts proportionately reduced in size compared to a normal gestational age baby. This is due to intrauterine growth restriction. Choice B is incorrect because the head is not disproportionately larger. Choice C is incorrect as it states the body is larger than the head, which is not the case in SGA babies. Choice D is incorrect as SGA babies typically appear thin with a scaphoid abdomen, not plumpy.