Nokea
The main feature in the initial stage of shock is
- A. Cyanosis
- B. Tachycardia
- C. Sweat beads
- D. Hypotension
Correct Answer: B
Rationale: The correct answer is B: Tachycardia. In the initial stage of shock, the body tries to compensate for decreased perfusion by increasing heart rate to maintain blood flow to vital organs. Cyanosis (A) is a late sign of shock due to inadequate oxygenation. Sweat beads (C) are a non-specific response and not a defining feature of shock. Hypotension (D) typically occurs in the later stages of shock as the body's compensatory mechanisms start to fail. Tachycardia is the earliest and most consistent sign of shock, reflecting the body's attempt to maintain cardiac output.
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The recommended number of chest compressions for neonatal resuscitation is
- A. 60 compressions coordinated with 30 breaths per minute
- B. 3 compressions coordinated with 1 breath per minute
- C. 1 compression coordinated with 3 breaths per minute
- D. 90 compressions coordinated with 30 breaths per minute
Correct Answer: A
Rationale: The correct answer is A: 60 compressions coordinated with 30 breaths per minute. In neonatal resuscitation, the recommended compression-to-ventilation ratio is 3:1. This means 3 compressions are given followed by 1 breath. With a target compression rate of 120 per minute, this translates to 60 compressions coordinated with 30 breaths per minute. Each compression should be at a depth of about one-third the anterior-posterior diameter of the chest. This ratio and rate are crucial for maintaining adequate circulation and oxygenation during neonatal resuscitation.
Choice B: 3 compressions coordinated with 1 breath per minute is too slow and would not provide enough support for the neonate's circulation.
Choice C: 1 compression coordinated with 3 breaths per minute would not provide sufficient compressions to maintain circulation.
Choice D: 90 compressions coordinated with 30 breaths per minute would result in an incorrect compression-to-vent
Mr. Costigan is a 50-year-old male patient who recently had a screening colonoscopy because it was recommended by his primary care provider as a screening measure. He received a report that noted inflammatory polyps. He is concerned because one of his friends had polyps that turned into cancer. While advising Mr. Costigan, the AGACNP tells him that
- A. The polyps are considered precancerous, but if he has a colonoscopy every 3 to 5 years, any new polyps can be removed before they become malignant
- B. The primary danger is when there is a family history of colon cancer; he should discuss with his mother and father the presence of any colon cancer in the family
- C. There is no chance that these polyps could become cancerous, and their presence does not require any additional action or concern on his part
- D. He would be best served at this point to discuss with an oncologist the risks and benefits of aggressive versus conservative treatment.
Correct Answer: B
Rationale: Step 1: Family history of colon cancer is a significant risk factor for developing colon cancer.
Step 2: By discussing with his parents, Mr. Costigan can determine if there is a family history of colon cancer.
Step 3: Knowing this information can help assess his own risk and guide appropriate screening and preventive measures.
Step 4: The primary danger for Mr. Costigan lies in potential genetic predisposition rather than the presence of inflammatory polyps.
Step 5: Therefore, discussing with family members about any history of colon cancer is crucial for his overall risk assessment and management.
Summary:
- Choice A is incorrect as the frequency of colonoscopy should be individualized based on the patient's risk factors.
- Choice C is incorrect as all polyps have the potential to become cancerous, especially inflammatory polyps.
- Choice D is incorrect as consulting an oncologist at this stage is premature without first assessing family history.
When counseling a patient about treatment modalities for achalasia, the AGACNP advised that which of the following is the treatment of choice?
- A. Calcium channel antagonists
- B. Intrasphincter botulinum injection
- C. Pneumatic dilation
- D. Myotomy and partial fundoplication
Correct Answer: A
Rationale: Rationale for choice A: Calcium channel antagonists are the treatment of choice for achalasia as they help relax the lower esophageal sphincter, improving swallowing. This is a non-invasive option that can provide symptom relief for many patients.
Summary for other choices:
B: Intrasphincter botulinum injection is a temporary solution and not considered the treatment of choice.
C: Pneumatic dilation is another option for achalasia but is typically used if calcium channel antagonists are ineffective.
D: Myotomy and partial fundoplication is a more invasive surgical option and usually considered if other treatments fail.
Mother-to-child transmission of TB organisms never occurs during labor.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: Step 1: TB can be transmitted through respiratory droplets, not just during labor.
Step 2: Mother with active TB can transmit the bacteria to the child during childbirth.
Step 3: Therefore, the statement that mother-to-child transmission never occurs during labor is false.
Summary: Choice B is correct because TB transmission can occur during labor, making Choice A incorrect. Choices C and D are irrelevant.
A client is declared fit for a vaginal birth after cesarean section if
- A. Her previous C/S was due to cephalopelvic disproportion
- B. The current pregnancy is confirmed a multiple pregnancy
- C. Previous delivery was via cesarean section
- D. Previous delivery was via spontaneous vertex delivery
Correct Answer: D
Rationale: The correct answer is D because a client is declared fit for a vaginal birth after cesarean section if their previous delivery was via spontaneous vertex delivery. This indicates that the client has successfully given birth vaginally before, reducing the risk associated with a vaginal birth after cesarean section.
A, B, and C are incorrect:
A: Cephalopelvic disproportion was the reason for the previous C/S, indicating potential difficulty in vaginal delivery.
B: Confirmation of a multiple pregnancy does not impact the client's eligibility for a vaginal birth after cesarean section.
C: Previous cesarean section does not necessarily mean the client is fit for a vaginal birth after cesarean section.