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What are the complications associated with a high-risk pregnancy?
- A. Preterm birth
- B. Gestational diabetes
- C. Preeclampsia
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. High-risk pregnancies are associated with various complications, including preterm birth, gestational diabetes, and preeclampsia. Preterm birth can lead to developmental issues for the baby. Gestational diabetes affects the mother's and baby's health. Preeclampsia can result in high blood pressure and organ damage. Choosing D as the correct answer encompasses all these complications, highlighting the comprehensive nature of risks in high-risk pregnancies. Choices A, B, and C alone do not cover all the potential complications, making them individually incorrect.
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A patient who has been in the intensive care unit for 17 days develops hyponatremic hyperosmolality. The patient weighs 132 lb (59.9 kg), is intubated, and is receiving mechanical ventilation. The serum osmolality is 320 mOsmL kg H2O. Clinical signs include tachycardia and hypotension. The adult-gerontology acute care nurse practitioners initial treatment is to
- A. reduce serum osmolality by infusing a 5% dextrose in 0.2% sodium chloride solution
- B. reduce serum sodium concentration by infusing a 0.45% sodium chloride solution
- C. replenish volume by infusing a 0.9% sodium chloride solution
- D. replenish volume by infusing a 5% dextrose in water solution.
Correct Answer: B
Rationale: The correct answer is B: reduce serum sodium concentration by infusing a 0.45% sodium chloride solution. In hyponatremic hyperosmolality, the primary goal is to correct the low serum sodium levels. A 0.45% sodium chloride solution is hypotonic, which helps to slowly correct the serum sodium concentration without causing rapid shifts in osmolality. Infusing a hypotonic solution will gradually increase the serum sodium levels, addressing the underlying issue. Choices A, C, and D are incorrect because they do not directly address the low serum sodium levels, which is essential in treating hyponatremic hyperosmolality. Infusing a 5% dextrose in 0.2% sodium chloride solution (Choice A) or a 5% dextrose in water solution (Choice D) would not correct the low sodium levels. Replenishing volume with a 0.9% sodium chloride solution (Choice C) would not directly
In the majority of cases, the first clinical manifestation of physiologic stress ulcer is
- A. Epigastric pain
- B. Change in mental status
- C. Fever
- D. Hemorrhage
Correct Answer: C
Rationale: The correct answer is C: Fever. Physiologic stress ulcers are often associated with systemic stress response, leading to an increase in body temperature. Fever is an early sign of stress-related ulcers before other symptoms like epigastric pain or hemorrhage manifest. Change in mental status is more indicative of neurological issues rather than stress ulcers. Epigastric pain typically occurs after the ulcer has progressed, and hemorrhage is a severe complication of untreated stress ulcers.
A clinical feature that is suggestive of hypothermia neonatorum is
- A. Bradycardia
- B. Hyperglycemia
- C. Hypoventilation
- D. Hyperventilation
Correct Answer: A
Rationale: The correct answer is A: Bradycardia. Hypothermia neonatorum is characterized by low body temperature in newborns, which can lead to bradycardia as the heart rate decreases in response to the cold stress. Bradycardia is a common physiological response to hypothermia as the body tries to conserve energy and maintain vital functions. Hyperglycemia, hypoventilation, and hyperventilation are not specific clinical features of hypothermia neonatorum. Hyperglycemia is more commonly associated with conditions like diabetes, hypoventilation could be a sign of respiratory distress, and hyperventilation is usually seen in response to metabolic acidosis or anxiety.
Breech presentation: a) What is meant by “breech presentation”?
- A. Head-first presentation
- B. Bottom or feet-first presentation
- C. Oblique lie
- D. Transverse lie
Correct Answer: B
Rationale: Breech presentation refers to the bottom or feet-first position of the baby in the uterus. This is the correct answer (B) because it accurately defines breech presentation. Choice A (head-first presentation) is incorrect as it describes the typical vertex presentation. Choices C (oblique lie) and D (transverse lie) are also incorrect as they refer to other abnormal fetal positions that are different from breech presentation.
Cholesteatoma is a condition characterized by a collection of desquamated keratin leading to bony erosion in the ossicular chain and inner ear. The goal of surgery in cholesteatoma is
- A. Production of a dry ear
- B. Preservation of sensorineural hearing
- C. Debridement of infection
- D. Restoration of the tympanic membrane
Correct Answer: B
Rationale: The correct answer is B: Preservation of sensorineural hearing. In cholesteatoma, surgery aims to remove the lesion and prevent further damage to the ossicles and inner ear structures. Preserving sensorineural hearing is crucial to maintain auditory function post-surgery. A: Production of a dry ear is important to prevent recurrence, but not the primary goal. C: Debridement of infection is necessary, but the main aim is to address the cholesteatoma itself. D: Restoration of the tympanic membrane may be needed but is not the primary objective in cholesteatoma surgery.