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Which of the following can lead to placenta praevia?
- A. Grandmultiparity
- B. Preeclampsia
- C. Placenta fenestrate
- D. Placenta increta
Correct Answer: A
Rationale: Placenta praevia is more common in women with a history of multiple pregnancies (Grandmultiparity), as repeated stretching of the uterine wall can lead to abnormal placental implantation. Preeclampsia is a separate condition associated with hypertension in pregnancy. Placenta fenestrate and placenta increta are specific placental abnormalities but do not directly cause placenta praevia.
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Excessive bleeding from the genital tract after the first 24 hours, but within the puerperium period, is referred to as
- A. Primary postpartum haemorrhage
- B. Tertiary postpartum haemorrhage
- C. Secondary postpartum haemorrhage
- D. Incidental postpartum haemorrhage
Correct Answer: C
Rationale: The correct answer is C: Secondary postpartum haemorrhage. This term refers to excessive bleeding from the genital tract after the first 24 hours but within the puerperium period (6 weeks postpartum).
A: Primary postpartum haemorrhage occurs within the first 24 hours after delivery.
B: Tertiary postpartum haemorrhage occurs more than 6 weeks postpartum.
D: Incidental postpartum haemorrhage is not a recognized medical term for postpartum bleeding.
Homeopathy, music therapy, and hydrotherapy are among the
- A. Systemic methods of pain relief
- B. Regional analgesia methods of pain relief
- C. Inhalational analgesia method of pain relief
- D. Non-pharmacological methods of pain relief
Correct Answer: D
Rationale: The correct answer is D: Non-pharmacological methods of pain relief. Homeopathy, music therapy, and hydrotherapy are all non-pharmacological approaches that do not involve the use of medication to manage pain. They focus on alternative techniques to alleviate pain, such as using natural remedies, music, or water-based therapies. These methods aim to address pain through holistic approaches that do not rely on traditional pharmaceutical interventions.
A: Systemic methods of pain relief typically involve medications that affect the entire body, such as opioids.
B: Regional analgesia methods target specific areas for pain relief, like nerve blocks.
C: Inhalational analgesia involves administering pain relief medications through inhalation, such as nitrous oxide.
In summary, the other choices are incorrect because they do not accurately describe the non-pharmacological nature of homeopathy, music therapy, and hydrotherapy in managing pain.
K. W. is a 50-year-old woman who presents for surgical resection of the liver for treatment of metastatic colon cancer. Preoperatively, the surgeon tells her that he is planning to remove 50 to 75 of her liver. The patient is concerned that she will not be able to recover normal liver function with that much removed. The AGACNP counsels her that
- A. Such a high-volume resection is utilized only in people with markedly compromised hepatic function
- B. Major regeneration occurs within 10 days, and the process is complete by 5 weeks
- C. Liver function will probably recover to 50% baseline, but that is enough for normal function
- D. Up to 95% of the liver can be removed without any apparent consequence to the patient
Correct Answer: A
Rationale: The correct answer is A because high-volume liver resection is typically performed in individuals with significantly compromised hepatic function to ensure adequate liver remnant. Removing 50 to 75% of the liver in a patient with metastatic colon cancer may be necessary for tumor clearance but carries risks due to potential impairment of liver function postoperatively. Choices B and C provide inaccurate information regarding the timeline and extent of liver regeneration following resection. Choice D is incorrect as removing up to 95% of the liver would lead to severe consequences, such as liver failure. Hence, option A is the most appropriate advice given the patient's situation.
Justin F. is seen in the emergency department with an 8-cm jagged laceration on the dorsal surface of his right forearm. He says he was working with his brother-in-law yesterday morning building a deck on the back of his home. A pile of wooden planks fell on top of him, and he sustained a variety of cuts and superficial injuries. He cleaned the wound with soap and water but didnt want to go to the emergency room because he didnt want to risk being in the waiting room for hours. He wrapped up his arm and went back to work, and then took a normal shower and went to bed last night. This morning the cut on his arm was still flapping open, and he realized he needed sutures. The appropriate management of this patient includes
- A. Proper cleansing and covering of the laceration, along with antibiotic therapy
- B. Local anesthesia, cleansing, and wound exploration for foreign bodies
- C. Local anesthesia, cleansing, and suture repair
- D. Cleansing, covering, antibiotic therapy, and tetanus prophylaxis
Correct Answer: C
Rationale: The correct answer is C: Local anesthesia, cleansing, and suture repair.
1. Local anesthesia is needed to minimize pain during the procedure.
2. Cleansing is crucial to remove contaminants and reduce the risk of infection.
3. Suture repair is necessary for a jagged laceration of this size to promote proper wound healing and minimize scarring.
Summary of other choices:
A: Antibiotic therapy is not routinely needed for clean lacerations, and covering alone may not provide adequate wound closure.
B: While wound exploration for foreign bodies is important, it is not the immediate priority for this patient with an open, flapping laceration.
D: While cleansing, covering, and tetanus prophylaxis are important, antibiotic therapy is not routinely needed for clean lacerations.
What are the key indicators for cesarean section during labor?
- A. Fetal distress
- B. Failure to progress
- C. Breech presentation
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D, as all three choices are key indicators for cesarean section during labor. Fetal distress indicates the baby is not tolerating labor well. Failure to progress may lead to complications for the mother or baby. Breech presentation increases the risk of complications during vaginal delivery. Therefore, all three indicators warrant consideration for a cesarean section to ensure the safety of both the mother and the baby.