Nokea
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.
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When a hand/foot lies alongside the presenting part, the presentation is said to be
- A. Footling
- B. Transverse
- C. Compound
- D. Cephalic
Correct Answer: C
Rationale: The correct answer is C: Compound. When a hand or foot lies alongside the presenting part during childbirth, it is called a compound presentation. This can be a complication as it increases the risk of the presenting part not fitting through the birth canal properly.
A: Footling presentation occurs when the baby's foot or feet are the first to emerge from the birth canal.
B: Transverse presentation is when the baby is lying sideways in the uterus.
D: Cephalic presentation is the ideal position for vaginal delivery, with the baby's head down and ready to be born.
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.
Positive fasting blood sugar and oral glucose tolerance test, as well as being symptomatic, is diagnostic of
- A. Potential diabetes mellitus
- B. Gestational diabetes mellitus
- C. Clinical diabetes mellitus
- D. Chemical diabetes mellitus
Correct Answer: B
Rationale: The correct answer is B, Gestational diabetes mellitus. This condition is diagnosed when a pregnant woman exhibits symptoms of diabetes and has elevated fasting blood sugar and abnormal oral glucose tolerance test results. This specific combination of symptoms and test results during pregnancy points towards gestational diabetes mellitus.
A: Potential diabetes mellitus - Incorrect. The symptoms combined with abnormal test results suggest an active condition, not potential.
C: Clinical diabetes mellitus - Incorrect. While the symptoms and test results indicate diabetes, the context of pregnancy suggests gestational diabetes.
D: Chemical diabetes mellitus - Incorrect. This term is not commonly used in medical practice and does not specifically address the condition in the given scenario.
Presence of a turtle’s sign is clearly indicative of
- A. Prolonged labor
- B. Occipito-posterior position
- C. Shoulder dystocia
- D. Shoulder presentation
Correct Answer: C
Rationale: The presence of a turtle sign during delivery is indicative of shoulder dystocia. This occurs when the baby's shoulders get stuck behind the mother's pelvic bones during delivery, leading to difficulty in delivering the baby's shoulders. The turtle sign refers to the retraction of the baby's head back into the birth canal after delivery of the head, resembling a turtle retracting into its shell. This sign is a clear indicator of shoulder dystocia. Choices A, B, and D are incorrect because prolonged labor, occipito-posterior position, and shoulder presentation do not specifically involve the retraction of the baby's head like in shoulder dystocia.
A mother with a cord prolapse is given oxygen at a rate of 4 liters/minute in order to
- A. Relieve maternal distress
- B. Promote her relative rest
- C. Improve fetal oxygenation
- D. Achieve the effect of tocolysis
Correct Answer: C
Rationale: The correct answer is C: Improve fetal oxygenation. Oxygen at 4 liters/minute is given to increase oxygen levels which can help improve oxygenation to the fetus during a cord prolapse scenario. This can be crucial in preventing fetal distress and hypoxia.
Explanation for Incorrect Choices:
A: Relieve maternal distress - Oxygen is primarily given in this scenario to benefit the fetus, not to relieve maternal distress.
B: Promote her relative rest - Oxygen is not administered to promote rest, but to address the immediate concern of fetal oxygenation.
D: Achieve the effect of tocolysis - Oxygen does not have a role in tocolysis, which is the inhibition of uterine contractions.