Nokea
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.
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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.
Dwarfism is associated with
- A. Polydactylism
- B. Achondroplasia
- C. Syndactylism
- D. Talipes
Correct Answer: B
Rationale: Dwarfism is typically associated with achondroplasia, a genetic disorder affecting bone growth.
The AGACNP recognizes that which of the following diagnostic studies is essential in all cases of acute abdomen?
- A. Abdominal radiograph
- B. Contrast radiography
- C. Chest radiography
- D. Ultrasonography
Correct Answer: C
Rationale: Ultrasonography is considered essential in all cases of acute abdomen because it is a valuable tool in evaluating various abdominal organs non-invasively. It can quickly identify common causes of acute abdomen such as cholecystitis, pancreatitis, appendicitis, and other intra-abdominal pathologies. Ultrasonography also has the advantage of being radiation-free and can be performed rapidly at the bedside, making it a preferred initial diagnostic modality in the evaluation of acute abdominal pain. Abdominal radiograph, contrast radiography, and chest radiography may have limited utility in the evaluation of acute abdomen compared to ultrasonography.
Persistent nausea and vomiting related to pregnancy is indicative of
- A. Morning sickness
- B. Multiple gestation
- C. Hyperemesis gravidarum
- D. Hypertensive disorders
Correct Answer: C
Rationale: Persistent nausea and vomiting is a hallmark of hyperemesis gravidarum.
Justin F. is seen in the emergency department with an 8-cm jagged laceration on the dorsal surface of his right forearm. He says he was working with his brother-in-law yesterday morning building a deck on the back of his home. A pile of wooden planks fell on top of him, and he sustained a variety of cuts and superficial injuries. He cleaned the wound with soap and water but didnt want to go to the emergency room because he didnt want to risk being in the waiting room for hours. He wrapped up his arm and went back to work, and then took a normal shower and went to bed last night. This morning the cut on his arm was still flapping open, and he realized he needed sutures. The appropriate management of this patient includes
- A. Proper cleansing and covering of the laceration, along with antibiotic therapy
- B. Local anesthesia, cleansing, and wound exploration for foreign bodies
- C. Local anesthesia, cleansing, and suture repair
- D. Cleansing, covering, antibiotic therapy, and tetanus prophylaxis
Correct Answer: D
Rationale: In this scenario, the patient presents with a jagged laceration on his forearm that is still open and requires sutures. The appropriate management for this patient involves local anesthesia to reduce pain, thorough cleansing of the wound to prevent infection, and wound exploration to assess for any foreign bodies that may be present. Suturing the wound is necessary to promote proper healing and reduce the risk of complications. Antibiotic therapy may be indicated if signs of infection are present, but it is not mentioned in the scenario as a primary management step. Tetanus prophylaxis should also be considered given the mechanism of injury involving a dirty object.