Nokea
The fetal head retracting against the perineum is a
- A. Gaskin sign
- B. Turtle sign
- C. Klumpke sign
- D. Chignon sign
Correct Answer: B
Rationale: The correct answer is B: Turtle sign. This sign refers to the fetal head retracting against the perineum during delivery. It indicates shoulder dystocia, a complication where the baby's shoulders get stuck after the head is delivered. This can lead to serious complications for both the baby and the mother if not managed promptly.
A: Gaskin sign is incorrect as it refers to a position where the mother is on her hands and knees during labor.
C: Klumpke sign is incorrect as it is a neurological condition affecting the lower arm and hand.
D: Chignon sign is incorrect as it is not a recognized medical term related to childbirth.
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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: A
Rationale: Rationale:
A needle biopsy is appropriate for definitive diagnosis of hepatic hemangiomas, ruling out other liver lesions. It helps determine if they are benign or malignant. This will guide further management decisions.
Summary:
B: Annual ultrasound is unnecessary for benign hemangiomas.
C: Surgery is not indicated for asymptomatic hepatic hemangiomas.
D: Documenting the finding is important but not the appropriate next step in management.
In the majority of cases, the first clinical manifestation of physiologic stress ulcer is
- A. Epigastric pain
- B. Change in mental status
- C. Fever
- D. Hemorrhage
Correct Answer: C
Rationale: The correct answer is C: Fever. The first clinical manifestation of physiologic stress ulcer is often a fever due to the body's response to stress. This is because stress can trigger an inflammatory response, leading to an increase in body temperature. Epigastric pain (choice A) is more commonly associated with peptic ulcers. Change in mental status (choice B) is not a typical early symptom of physiologic stress ulcer. Hemorrhage (choice D) is a severe complication that can occur later in the course of the disease, but it is not typically the first clinical manifestation.
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: A
Rationale: The correct answer is A because the Brain Trauma Foundation recommends intracranial pressure monitoring for patients with traumatic brain injury and a GCS of 3 to 8, regardless of the head CT findings. Intracranial pressure monitoring helps in the management of elevated intracranial pressure, which can be life-threatening. Abnormal head CT findings may indicate the need for immediate intervention, but intracranial pressure monitoring is still recommended for all patients in this GCS range to guide treatment decisions. Choices B, C, and D are incorrect because hypotension, age > 40 years old, and bradycardia are not factors that would exclude a patient from needing intracranial pressure monitoring in the presence of a GCS of 3 to 8.
When examining a patient with abdominal pain, the AGACNP knows that tenderness to percussion is analogous to
- A. Tympany
- B. Guarding
- C. Rebound tenderness
- D. Somatic pain
Correct Answer: A
Rationale: The correct answer is A: Tympany. Tenderness to percussion is analogous to tympany as both indicate the presence of gas-filled structures. When a patient experiences tenderness to percussion in the abdomen, it suggests that there is gas or air present in the abdomen, leading to a hollow, drum-like sound upon percussion, which is characteristic of tympany. Guarding (B) is the involuntary contraction of abdominal muscles to protect the underlying organs, not related to percussion. Rebound tenderness (C) is the pain experienced when pressure is released during palpation, not percussion. Somatic pain (D) refers to pain originating from the skin, muscles, or bones, not related to percussion findings.
Complete placenta praevia is also referred to as
- A. Type 4
- B. Type 1
- C. Type 2
- D. Type 3
Correct Answer: A
Rationale: Placenta praevia is classified into four types based on the degree of coverage of the cervix by the placenta. Complete placenta praevia, where the internal os is completely covered by the placenta, is referred to as Type 4. This is the correct answer as it accurately describes the specific condition. Choices B, C, and D are incorrect as they do not correspond to the classification system for placenta praevia.