Nokea
The most common cause of immediate postpartum haemorrhage is uterine atony, not trauma to the genital tract.
- A. TRUE
- B. FALSE
- C. Sometimes True
- D. Unclear
Correct Answer: A
Rationale: The correct answer is A: TRUE. Uterine atony is the most common cause of immediate postpartum hemorrhage due to inadequate uterine contraction to control bleeding. This is supported by research and clinical evidence. Trauma to the genital tract is a less common cause and usually leads to delayed hemorrhage. Choice B is incorrect as uterine atony is a well-documented primary cause. Choice C is incorrect as uterine atony is consistently the leading cause. Choice D is incorrect as the cause of immediate postpartum hemorrhage is clear, with uterine atony being the most common culprit.
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An early sign of a ruptured uterus includes
- A. Maternal dehydration
- B. Maternal pyrexia >38˚C
- C. Maternal oliguria
- D. Failure of cervix to dilate
Correct Answer: D
Rationale: The correct answer is D. A ruptured uterus can lead to fetal distress and necessitate a cesarean section. Failure of the cervix to dilate is indicative of a potential uterine rupture, as the uterus may not be able to contract effectively due to the rupture. Maternal dehydration (A), pyrexia (B), and oliguria (C) are not specific signs of a ruptured uterus and may be present in various other conditions. Therefore, failure of the cervix to dilate is the most relevant early sign in this scenario.
Which one of the following is an endogenous cause of puerperal sepsis?
- A. Chlamydia trachomatis
- B. Escherichia coli
- C. Clostridium tetani
- D. Pseudomonas aeruginosa
Correct Answer: B
Rationale: The correct answer is B: Escherichia coli. Puerperal sepsis is often caused by endogenous bacteria from the mother's own flora. E. coli is a common endogenous bacteria found in the gastrointestinal tract and can cause infection during childbirth. Chlamydia trachomatis is a sexually transmitted infection, not typically associated with puerperal sepsis. Clostridium tetani causes tetanus, not puerperal sepsis. Pseudomonas aeruginosa is an environmental pathogen, not typically an endogenous cause of puerperal sepsis.
While reviewing the head CT scan of a patient following a motor vehicle accident, the AGACNP appreciates a crescent-shaped fluid collection. This most likely represents
- A. Acute subdural hematoma
- B. Acute epidural hematoma
- C. Acute uncal herniation
- D. Acute brainstem compression
Correct Answer: B
Rationale: The correct answer is B: Acute epidural hematoma. A crescent-shaped fluid collection seen on a head CT scan following trauma is indicative of an epidural hematoma, which typically occurs due to an arterial bleed between the dura mater and the skull. This collection appears biconvex due to the restriction of the hematoma by the dura mater and is often associated with a lucid interval followed by rapid deterioration.
Explanation for Incorrect Choices:
A: Acute subdural hematoma typically presents as a crescent-shaped collection but is located between the dura mater and arachnoid mater, not between the dura mater and skull as seen in epidural hematomas.
C: Acute uncal herniation involves displacement of the uncus of the temporal lobe, leading to compression of the brainstem, but it does not manifest as a crescent-shaped fluid collection.
D: Acute brainstem compression does not typically present as a distinct crescent-shaped
Homeopathy, music therapy, and hydrotherapy are among the
- A. Systemic methods of pain relief
- B. Regional analgesia methods of pain relief
- C. Inhalational analgesia method of pain relief
- D. Non-pharmacological methods of pain relief
Correct Answer: D
Rationale: The correct answer is D: Non-pharmacological methods of pain relief. Homeopathy, music therapy, and hydrotherapy are all non-pharmacological approaches that do not involve the use of medication to manage pain. They focus on alternative techniques to alleviate pain, such as using natural remedies, music, or water-based therapies. These methods aim to address pain through holistic approaches that do not rely on traditional pharmaceutical interventions.
A: Systemic methods of pain relief typically involve medications that affect the entire body, such as opioids.
B: Regional analgesia methods target specific areas for pain relief, like nerve blocks.
C: Inhalational analgesia involves administering pain relief medications through inhalation, such as nitrous oxide.
In summary, the other choices are incorrect because they do not accurately describe the non-pharmacological nature of homeopathy, music therapy, and hydrotherapy in managing pain.
On postoperative day 7 following hepatic transplant, the patient evidences signs and symptoms of acute rejection, confirmed by histologic examination. The AGACNP knows that first-line treatment of acute rejection consists of
- A. Cyclosporine
- B. Azathioprine
- C. Methylprednisolone
- D. Sirolimus
Correct Answer: A
Rationale: The correct answer is A: Cyclosporine. Cyclosporine is a first-line treatment for acute rejection following hepatic transplant due to its immunosuppressive properties. It inhibits T-cell activation and cytokine production, suppressing the immune response against the transplanted liver. This helps in preventing further damage caused by rejection. Azathioprine (B) and Sirolimus (D) are also immunosuppressants, but Cyclosporine is preferred as the initial treatment. Methylprednisolone (C) is a corticosteroid that can be used in combination with Cyclosporine for acute rejection to provide a more potent immunosuppressive effect.