Nokea
What is the significance of amniotic fluid analysis during pregnancy?
- A. Detect fetal infections
- B. Assess fetal lung maturity
- C. Determine fetal position
- D. Assess placental health
Correct Answer: B
Rationale: The correct answer is B: Assess fetal lung maturity. Amniotic fluid analysis measures the levels of substances like surfactant, which indicates lung maturity. This helps in determining if the fetus is ready for delivery. Other choices are incorrect because amniotic fluid analysis is not primarily used to detect fetal infections (A), determine fetal position (C), or assess placental health (D). These functions are typically achieved through other diagnostic tests or imaging techniques.
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Perception and reaction to labor pain is highly influenced by
- A. Labor preparedness and fatigue
- B. Culture and level of education
- C. Culture and age of the woman
- D. Number of deliveries and anxiety
Correct Answer: B
Rationale: The correct answer is B - Culture and level of education. Culture influences beliefs about pain and coping mechanisms. Education can affect understanding of pain and pain management techniques. Labor preparedness and fatigue (A) may impact pain perception but are not as influential. Age (C) alone does not determine pain perception. Number of deliveries and anxiety (D) can play a role but are not as significant as culture and education.
An inorganic risk factor to birth injuries includes
- A. Maternal short stature
- B. Prenatal oligohydramnios
- C. External cephalic version
- D. Fetal macrosomia
Correct Answer: D
Rationale: The correct answer is D: Fetal macrosomia. Fetal macrosomia, which refers to a baby being significantly larger than average, is an inorganic risk factor for birth injuries because it can lead to difficult delivery and increase the risk of birth trauma such as shoulder dystocia. Maternal short stature (A) is a biological risk factor, not inorganic. Prenatal oligohydramnios (B) refers to low levels of amniotic fluid and is a maternal condition, not an inorganic factor. External cephalic version (C) is a procedure to turn a breech baby and is not a risk factor for birth injuries.
S. R. is a 51-year-old male patient who is being evaluated for fatigue. Over the last few months he has noticed a marked decrease in activity tolerance. Physical examination reveals a variety of ecchymoses of unknown origin. The CBC is significant for a Hgb of 10.1 gdL, an MCV of 72 fL and a platelet count of 65,000L the remainder of the CBC is normal. Coagulation studies are normal, but bleeding time is prolonged. The AGACNP recognizes that initial management of this patient will include
- A. Avoidance of elective surgery and nonessential medications
- B. Prednisone 60 mg daily until platelets normal
- C. Monoclonal antibody therapy such as rituximab
- D. Splenectomy
Correct Answer: D
Rationale: The correct answer is D: Splenectomy. In this case, the patient presents with signs of immune thrombocytopenic purpura (ITP) with low platelet count and bleeding time prolongation. Splenectomy is the definitive treatment for ITP as the spleen is the site of platelet destruction. Avoiding elective surgery and medications (choice A) may be necessary to prevent bleeding complications but do not address the underlying issue. Prednisone (choice B) is used for acute treatment but not for long-term management. Monoclonal antibody therapy (choice C) is an option for refractory cases but not first-line therapy.
In the preoperative assessment of a patient for the likelihood of postoperative risk, ascorbic acid deficiency, anemia, and volume contraction are all risk factors for
- A. Prolonged intubation
- B. Thromboembolism
- C. Delayed wound healing
- D. Atelectasis
Correct Answer: D
Rationale: Rationale for Correct Answer (D: Atelectasis):
1. Ascorbic acid deficiency can lead to impaired collagen synthesis, affecting lung tissue integrity.
2. Anemia reduces oxygen-carrying capacity, increasing the risk of lung collapse.
3. Volume contraction can lead to decreased lung compliance, predisposing to atelectasis.
Summary of Incorrect Choices:
A: Prolonged intubation is more related to airway issues, not specifically affected by the mentioned risk factors.
B: Thromboembolism is more linked to blood clotting issues rather than the mentioned risk factors.
C: Delayed wound healing is more influenced by nutritional deficiencies and blood flow, not directly linked to lung complications like atelectasis.
Bishop’s score is based on
- A. Descent, presentation and cervical dilatation
- B. Position, attitude and cervical length
- C. Descent, cervical length and dilatation
- D. Cervical dilatation, lie and effacement
Correct Answer: A
Rationale: The correct answer is A because Bishop's score assesses the readiness of the cervix for labor by evaluating descent (station of the fetal head), presentation (fetal position), and cervical dilatation, which are key indicators of cervical ripening and effacement. Descent shows the progress of the fetus through the birth canal, presentation indicates the fetal position for delivery, and cervical dilatation reflects the opening of the cervix for labor. Choices B, C, and D are incorrect as they do not encompass all the essential components of Bishop's score, which focuses on descent, presentation, and cervical dilatation.