Nokea
Which of the following birth trauma results from damage of cervical nerve roots C8 & T1?
- A. Erb’s palsy
- B. Radial palsy
- C. Brachial palsy
- D. Facial palsy
Correct Answer: A
Rationale: Erb’s palsy results from damage to the C8 and T1 cervical nerve roots.
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When evaluating a patient with acute pancreatitis, which of the following physical or diagnostic findings is an ominous finding that indicates a seriously illpotentially moribund patient?
- A. Severe epigastric pain with radiation to the back
- B. Abdominal guarding and rigidity
- C. Grey Turner sign
- D. Obturator sign
Correct Answer: C
Rationale: The Grey Turner sign is characterized by bruising in the flanks and is a rare finding associated with acute pancreatitis. It indicates retroperitoneal bleeding and is considered an ominous finding that suggests a severe and potentially moribund state in patients with acute pancreatitis. The presence of the Grey Turner sign should prompt immediate intervention and close monitoring in a hospital setting. The other options, severe epigastric pain with radiation to the back, abdominal guarding and rigidity, and obturator sign, are indicative of pancreatitis but do not carry the same ominous implication as the Grey Turner sign.
R. R. is a 61-year-old male patient who presents with a chief complaint of fever and urinary symptoms. He was in his usual state of good health when for no apparent reason he developed pain in his back and perineal region, as well as fever and chills. He presents as septic. He had urinary hesitancy and decreased stream but now reports that he has not passed urine in more than 12 hours. Palpation of the lower abdomen is consistent with bladder distention. The AGACNP knows that which of the following is contraindicated in this circumstance?
- A. Digital prostate examination
- B. Urinary catheterization
- C. Fluoroquinolone antibiotics
- D. Drainage of prostate abscess
Correct Answer: D
Rationale: In a patient with suspected prostatic abscess and urinary retention, urinary catheterization is contraindicated due to the risk of spreading infection and causing potential complications such as septicemia or worsening of the abscess. The introduction of a catheter can disrupt the abscess capsule, leading to dissemination of the infection. Therefore, other methods of decompression and treatment should be considered, such as drainage of the abscess or other appropriate interventions guided by a healthcare provider.
Post-partum haemorrhage is likely to lead to acute renal failure due to
- A. Sheehan’s syndrome
- B. Disseminated intravascular coagulation
- C. Hypovolaemia leading to tubules necrosis
- D. Asherman’s syndrome
Correct Answer: C
Rationale: Hypovolaemia from excessive bleeding can lead to renal failure.
Precipitate labor is an unusually rapid labor
- A. That is concluded in less than three hours
- B. Where the external cervical os fails to dilate despite good uterine contractions
- C. That is concluded in more than three hours
- D. Where the external cervical os fails to dilate due to poor uterine contractions.
Correct Answer: A
Rationale: Precipitate labor is defined as labor lasting less than three hours.
Mrs. Coates is a 65-year-old female who is on postoperative day 1 following a duodenal resection for a bleeding ulcer. She had an uneventful immediate postoperative course, but throughout the course of day 1 she has complained of a mild abdominal discomfort that has progressed throughout the day. This evening the AGACNP is called to the bedside to evaluate the patient for persistent and progressive discomfort. Likely causes of her symptoms include all of the following except
- A. Colic due to return of peristalsis
- B. Leakage from the duodenal stump
- C. Gastric retention
- D. Hemorrhage
Correct Answer: D
Rationale: In the scenario described, Mrs. Coates is a 65-year-old female who is on the first day postoperatively following a duodenal resection for a bleeding ulcer. Given her surgical history and the progression of her abdominal discomfort, the likely causes to consider are complications related to the surgery. Options B, C, and D are all potential postoperative complications following a duodenal resection: