Nokea
What are the risks of cesarean sections?
- A. Infection
- B. Blood loss
- C. Prolonged recovery
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because all the choices (A, B, and C) are risks associated with cesarean sections. Infection can occur at the incision site, blood loss is a common concern during surgery, and cesarean sections typically have a longer recovery time compared to vaginal delivery. Therefore, all of these risks are potential complications of undergoing a cesarean section. The other choices (A, B, and C) are incorrect individually because they only represent a subset of the risks associated with cesarean sections, while choice D encompasses all potential risks.
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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: D
Rationale: Step-by-step rationale for why D is correct:
1. Arteriolar dilators such as sodium nitroprusside are used to manage hypertensive crisis by rapidly reducing blood pressure.
2. Pheochromocytoma surgery can result in catecholamine release, causing severe hypertension.
3. Arteriolar dilators act directly on blood vessels to lower blood pressure quickly.
4. Alpha-adrenergic antagonists (A) can worsen hypotension, beta-adrenergic antagonists (B) can lead to unopposed alpha-adrenergic effects, and intravenous vasodilators (C) may not act rapidly enough.
Specific management for incomplete uterine rupture:
- A. Immediate cesarean, monitoring for signs of shock, fluid resuscitation
- B. Observation with pain relief, assisted vaginal delivery
- C. Immediate caesarean, control bleeding, fluid management
- D. Continuous monitoring, natural birth
Correct Answer: A
Rationale: The correct answer is A because immediate cesarean is crucial to prevent further complications and ensure the safety of the mother and baby. Monitoring for signs of shock is essential to detect any deterioration in the mother's condition. Fluid resuscitation helps stabilize the mother's hemodynamic status. Option B is incorrect as observation alone may delay necessary interventions. Option C is partially correct as immediate cesarean is necessary but does not address monitoring for shock and fluid resuscitation. Option D is incorrect as continuous monitoring alone is insufficient to manage incomplete uterine rupture.
The MAIN clinical feature of puerperal psychosis is
- A. Episodic insomnia
- B. Neglect of hygiene
- C. Major depression
- D. Mild headache
Correct Answer: C
Rationale: The correct answer is C, major depression. Puerperal psychosis is a severe mental health condition that occurs in the postpartum period, characterized by symptoms such as hallucinations, delusions, and disorganized thinking. Major depression is a key clinical feature, often accompanied by mood disturbances and severe emotional distress.
Rationale:
- A: Episodic insomnia is a common symptom in various mental health disorders but not specific to puerperal psychosis.
- B: Neglect of hygiene may occur in severe cases but is not the main clinical feature of puerperal psychosis.
- D: Mild headache is not a characteristic symptom of puerperal psychosis, which is primarily marked by severe psychiatric symptoms.
The appropriate time to perform external cephalic version in a breech presentation is at
- A. 36 gestational weeks
- B. 38 gestational weeks
- C. 42 gestational weeks
- D. 40 gestational weeks
Correct Answer: A
Rationale: Rationale for correct answer (A): At 36 weeks, the baby has enough room to move, reducing risks of complications during external cephalic version. Earlier intervention also allows for possible repeat attempts if needed. This timing aligns with guidelines for optimal success rates.
Summary of other choices:
B: 38 weeks may be too late as the baby may have less space to turn.
C: 42 weeks is post-term and poses risks for both the baby and the mother.
D: 40 weeks is close to full term and may not allow for adequate time for successful version.
When examining a patient with abdominal pain, the AGACNP knows that tenderness to percussion is analogous to
- A. Tympany
- B. Guarding
- C. Rebound tenderness
- D. Somatic pain
Correct Answer: C
Rationale: The correct answer is C: Rebound tenderness. Tenderness to percussion is similar to rebound tenderness because both involve assessing pain upon release of pressure. Rebound tenderness specifically evaluates pain when the examiner quickly removes pressure, indicating peritoneal inflammation. Tympany (A) refers to a drum-like sound upon percussion, not pain. Guarding (B) is involuntary muscle contractions in response to palpation, not percussion. Somatic pain (D) is localized pain arising from skin, muscles, or bones, not related to percussion tenderness.