Nokea
Vitamin K prevents hemorrhagic disease of the neonate by
- A. Activating the white blood cells
- B. Activating the dormant clotting factors
- C. Adopting a fibrinogen sparing mechanism
- D. Altering the red blood cells count
Correct Answer: B
Rationale: Vitamin K activates dormant clotting factors, preventing hemorrhagic disease in neonates.
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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 term persistent occipito-posterior position indicates that the occiput
- A. Fails to rotate forward
- B. Escapes under the symphysis pubis
- C. Rotates forward always
- D. Reaches the pelvic floor first
Correct Answer: A
Rationale: Persistent occipito-posterior position means the occiput fails to rotate forward.
Match the conditions in column A with their correct description in column B
- A. Torticollis
- B. Damage to the sternomastoid muscles
- C. Erb’s palsy
- D. Damage to the upper brachial plexus
Correct Answer: A
Rationale: Torticollis is caused by damage to the sternomastoid muscles, while Erb’s palsy affects the upper brachial plexus.
Laryngeal stridor as a congenital abnormality is caused by
- A. Choanal atresia
- B. Laryngomalacia
- C. Diaphragmatic hernia
- D. Hirschsprung’s disease
Correct Answer: B
Rationale: Laryngeal stridor is caused by laryngomalacia, where the soft tissue above the vocal cords collapses inward.
Lester R. is a 58-year-old male who is being evaluated for nocturia. He reports that he has to get up 2 to 3 times nightly to void. Additional assessment reveals urinary urgency and appreciable post-void dribbling. A digital rectal examination reveals a normal-sized prostate with no appreciable hypertrophy. The best approach to this patient includes
- A. Administration of the American Urological Association (AUA) Symptom Scale
- B. Laboratory assessment to include a PSA
- C. Ordering a prostate ultrasound
- D. Assessment of nonprostate causes of nocturia
Correct Answer: C
Rationale: In this case, the best approach to the patient includes assessment of nonprostate causes of nocturia. Despite the lack of significant prostate hypertrophy on digital rectal examination, the patient is experiencing bothersome lower urinary tract symptoms such as nocturia, urinary urgency, and post-void dribbling. These symptoms suggest the need to consider alternative causes beyond prostate enlargement. Factors such as overactive bladder, urinary tract infections, diabetes, sleep apnea, medications, or other systemic conditions could be contributing to the patient's symptoms. Therefore, a comprehensive evaluation to identify potential nonprostate causes of the patient's nocturia is warranted before considering more invasive prostate-specific tests like PSA, ultrasound, or symptom scales.