Nokea
The neonatal birth injury that results due to bleeding between the epicranial aponeurosis and the periosteum is
- A. Caput succedaneum
- B. Intracranial hemorrhage
- C. Subgaleal hemorrhage
- D. Aponeurotic hemorrhage
Correct Answer: A
Rationale: Caput succedaneum is caused by bleeding between the epicranial aponeurosis and the periosteum.
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Signs of obstructed labour per vaginally include
- A. Dry vagina, Oedema of the cervix, Caput succedaneum
- B. Plenty amniotic fluid, Hot/dry vagina, meconium stained liquor
- C. Meconium stained liquor, Hot/dry vagina, Diluted urine
- D. Caput succedaneum, Oedema of the cervix, plenty amniotic fluid
Correct Answer: A
Rationale: Signs of obstructed labor include a dry vagina, oedema of the cervix, and caput succedaneum.
When resuscitating an asphyxiated baby, the purpose of ensuring adequate ventilation prior to administration of sodium bicarbonate is because
- A. The drug decreases carbon dioxide tension
- B. The drug increases carbon dioxide tension
- C. The drug is effective in the correction of metabolic acidosis
- D. The drug is effective in the correction of metabolic alkalosis
Correct Answer: C
Rationale: Sodium bicarbonate is used to correct metabolic acidosis, not to influence carbon dioxide levels directly.
Jake is a 32-year-old patient who is recovering from major abdominal surgery and organ resection following a catastrophic motor vehicle accident. Due to the nature of his injuries, a large portion of his jejunum had to be resected. In planning for his recovery and nutritional needs, the AGACNP considers that
- A. He will probably be able to transition to oral nutrition but will have lifetime issues with diarrhea
- B. His procedure has put him at significant risk for B12 absorption problems
- C. Most jejunum absorption functions will be assumed by the ileum
- D. Enteral nutrition will need to be delayed for 3 to 6 months to facilitate adaptation
Correct Answer: B
Rationale: The jejunum is the primary site for absorption of nutrients, including vitamin B12. Resection of a large portion of the jejunum can lead to malabsorption of vitamin B12, as this nutrient is primarily absorbed in the distal ileum but also partially absorbed in the jejunum. Thus, Jake is at significant risk for B12 absorption problems following his surgery, and close monitoring and potential supplementation may be needed to address this issue.
The term persistent occipito-posterior position indicates that the occiput
- A. Escapes under the symphysis pubis
- B. Rotates forward always
- C. Reaches the pelvic floor first
- D. Fails to rotate forward
Correct Answer: D
Rationale: Persistent occipito-posterior position means the occiput fails to rotate forward.
The AGACNP is receiving report from the recovery room on a patient who just had surgical resection for pheochromocytoma. He knows that which class of drugs should be available immediately to manage hypertensive crisis, a possible consequence of physical manipulation of the adrenal medulla?
- A. Alpha-adrenergic antagonists
- B. Beta-adrenergic antagonists
- C. Intravenous vasodilators
- D. Arteriolar dilators
Correct Answer: C
Rationale: Surgical manipulation of the adrenal medulla during resection of a pheochromocytoma can result in the release of catecholamines leading to a hypertensive crisis. Alpha-adrenergic antagonists, such as phenoxybenzamine or prazosin, are the drugs of choice for managing hypertensive crisis in this situation. These medications block the alpha-adrenergic receptors, leading to vasodilation and lowering of blood pressure. Beta-adrenergic antagonists are contraindicated in this scenario due to the risk of unopposed alpha-adrenergic stimulation that could worsen the hypertension. Intravenous vasodilators and arteriolar dilators may be used as adjunctive therapy but alpha-adrenergic antagonists are the primary agents for managing hypertensive crisis in this context.