Nokea
There are no other abnormal findings. This suggests that Mr. Thornton
- A. Is having anterior wall ischemia
- B. Is having an anterior wall infarction
- C. Has a history of anterior wall NSTEMI
- D. Has a history of anterior wall STEMI
Correct Answer: D
Rationale: In the given scenario where there are no other abnormal findings, it suggests that Mr. Thornton is experiencing anterior wall ischemia. Ischemia occurs due to inadequate blood supply to the heart muscles, often caused by a partial blockage in the coronary arteries. The absence of abnormal findings, such as ST-segment elevation or specific changes on the electrocardiogram (ECG), indicates that the issue is more likely ischemia rather than infarction. Infarction, whether NSTEMI or STEMI, would typically be associated with specific ECG changes and significant abnormalities beyond just the absence of findings. In the absence of these features, the more likely diagnosis is anterior wall ischemia.
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The AGACNP is evaluating a patient who reportedly fell down a flight of steps. Her history is significant for several emergency room visits, but she denies any significant medical conditions. Some documentation in her chart indicates that she may have been subjected to physical abuse. Today she presents with a periorbital ecchymosis of the left eye and swelling in the left side of the face. Her neurologic examination is within normal limits. Which head imaging study would be most useful in assessing for findings consistent with a history of abuse?
- A. Radiographs
- B. CT scan without contrast
- C. MRI
- D. PET scan
Correct Answer: A
Rationale: An MRI (Magnetic Resonance Imaging) would be the most useful head imaging study in assessing for findings consistent with a history of abuse in this patient. MRI is superior to CT in detecting subtle changes in the brain, such as small hemorrhages, edema, or shearing injuries, which may be present in cases of physical abuse. In cases of suspected abuse, it is important to evaluate for both acute and chronic changes that may not be clearly visible on other imaging modalities. While CT scans can detect acute hemorrhages or fractures, they may miss more subtle findings that can be seen on MRI. Therefore, an MRI would provide a more comprehensive evaluation of the brain and surrounding structures in this case.
The gradual rewarming process in the management of hypothermia neonatorum is aimed at
- A. Providing energy
- B. Providing comfort
- C. Preventing shock
- D. Preventing burns
Correct Answer: C
Rationale: The primary goal of gradual rewarming is to prevent shock and stabilize the neonate's condition.
How can maternal nutrition affect fetal development?
- A. Ensures proper growth
- B. Prevents birth defects
- C. Reduces the risk of preterm birth
- D. All of the above
Correct Answer: D
Rationale: Maternal nutrition supports fetal growth, prevents birth defects, and reduces preterm birth risks.
Mr. Jefferson is a 59-year-old male who presents to the emergency department complaining of severe abdominal pain. His medical history is significant for dyslipidemia, and he takes 40 mgof simvastatin daily. He admits to drinking 6 to 10 bottles of beer nightly and to smoking 1 packs of cigarettes a day. He denies any history of chest pain or cardiovascular disease. He was in his usual state of good health until a couple of hours ago, when he developed this acute onset of severe pain in the upper abdomen. He says that he tried to wait it out at home but it was so bad he finally came in. His vital signs are as follows temperature 99.1F, pulse 129 bpm, respirations 22 breaths per minute, and blood pressure 13784 mm Hg. The abdomen is diffusely tender to palpation with some guarding but no rebound tenderness. The AGACNP anticipates that which of the following laboratory tests will be abnormal?
- A. A complete blood count and RBC differential
- B. Liver function enzymes
- C. Serum amylase, lipase, and glucose
- D. A basic metabolic panel
Correct Answer: A
Rationale: Given the patient's presentation of acute onset severe abdominal pain, the AGACNP anticipates abnormalities in serum amylase and lipase levels, as this can indicate pancreatitis. The presence of symptoms such as severe upper abdominal pain, along with the patient's risk factors such as heavy alcohol consumption, smoking, and dyslipidemia, increase suspicion for acute pancreatitis. Additionally, the evaluation of serum glucose levels is important to assess for potential hyperglycemia, which can be seen in acute pancreatitis. Liver function enzymes and basic metabolic panel may also be abnormal in the setting of pancreatitis; however, the most specific and sensitive tests for diagnosing acute pancreatitis are serum amylase and lipase levels.
Mrs. Coates is a 65-year-old female who is on postoperative day 1 following a duodenal resection for a bleeding ulcer. She had an uneventful immediate postoperative course, but throughout the course of day 1 she has complained of a mild abdominal discomfort that has progressed throughout the day. This evening the AGACNP is called to the bedside to evaluate the patient for persistent and progressive discomfort. Likely causes of her symptoms include all of the following except
- A. Colic due to return of peristalsis
- B. Leakage from the duodenal stump
- C. Gastric retention
- D. Hemorrhage
Correct Answer: D
Rationale: In the scenario described, Mrs. Coates is a 65-year-old female who is on the first day postoperatively following a duodenal resection for a bleeding ulcer. Given her surgical history and the progression of her abdominal discomfort, the likely causes to consider are complications related to the surgery. Options B, C, and D are all potential postoperative complications following a duodenal resection: