Nokea
Which of the following is an indication for forceps delivery?
- A. Cephalopelvic disproportion
- B. Occipito posterior position
- C. Breech presentation
- D. Placenta abruption
Correct Answer: B
Rationale: The correct answer is B: Occipito posterior position. Forceps delivery may be indicated in this situation to help rotate the baby's head and facilitate delivery. Occipito posterior position can lead to prolonged labor and fetal distress, making forceps delivery necessary for a safe delivery.
Incorrect choices:
A: Cephalopelvic disproportion is not an indication for forceps delivery as it refers to mismatch between the size of the baby's head and the mother's pelvis.
C: Breech presentation typically requires a different approach such as cesarean section rather than forceps delivery.
D: Placenta abruption, a medical emergency, would not be managed with forceps delivery but rather require immediate intervention to prevent harm to both the mother and baby.
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V. is a 75-year-old male patient who, during a recent wellness evaluation, was found to have a new onset grade IIVI crescendo-decrescendo cardiac murmur at the 2nd intercostal space, right sternal border. He is symptom free and reports no limitations to his usual daily activity. He specifically denies activity intolerance or near syncope, and he is very active physically. Echocardiography reveals a mild aortic calcification. The AGACNP knows that ongoing management for R. V. must include
- A. Annual or biannual serial echocardiography
- B. Modification of activity level
- C. Baseline cardiac catheterization
- D. Statin therapy
Correct Answer: C
Rationale: The correct answer is C: Baseline cardiac catheterization. Given the presence of a new onset grade IIVI crescendo-decrescendo cardiac murmur, a baseline cardiac catheterization is necessary to assess the severity and etiology of the murmur. This procedure will provide crucial information on the structure and function of the heart, helping to determine the appropriate management plan.
A: Annual or biannual serial echocardiography is not necessary as the patient is currently asymptomatic and echocardiography has already revealed mild aortic calcification.
B: Modification of activity level is not the immediate priority as the patient is very active physically and not reporting any limitations to daily activities.
D: Statin therapy is not indicated based solely on the presence of a new murmur without further assessment of cardiac function through cardiac catheterization.
A general principle in surgical oncology is that the best approach to curative surgery in a fixed tumor requires
- A. En bloc resection
- B. Adjuvant therapies
- C. Neoadjuvant therapies
- D. Elective lymph node dissection
Correct Answer: D
Rationale: The correct answer is D: Elective lymph node dissection. This is because elective lymph node dissection helps to remove potentially cancerous lymph nodes, aiding in staging and ensuring complete tumor removal, thus improving the chances of curative surgery. En bloc resection (A) is important but may not always be feasible in fixed tumors. Adjuvant therapies (B) are used after surgery, not as the primary approach. Neoadjuvant therapies (C) are given before surgery to shrink tumors, not specifically for fixed tumors.
A neonate of a smear-negative mother just before birth receives BCG as usual.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: A
Rationale: The correct answer is A because BCG vaccination is recommended for newborns regardless of maternal smear status to prevent tuberculosis. The neonate is at risk of TB exposure postnatally and needs protection. Maternal smear status does not affect the indication for BCG in the newborn. Choice B is incorrect because withholding BCG in this case would leave the neonate vulnerable to TB. Choices C and D are not applicable as they do not provide any information.
The progression of coronary artery plaque formation can lead to a variety of pathologic conditions. When subtotal plaque disruption occurs resulting in vasoconstriction, platelet activation, and embolization, it most commonly causes which clinical phenomenon?
- A. Endothelial cell dysfunction
- B. Prinzmetal’s angina
- C. Transmural myocardial infarction
- D. Non-ST elevation myocardial infarction
Correct Answer: C
Rationale: The correct answer is C: Transmural myocardial infarction. Subtotal plaque disruption leads to vasoconstriction, platelet activation, and embolization, causing complete occlusion of a coronary artery. This results in ischemia of the entire thickness of the myocardial wall, leading to transmural myocardial infarction. Endothelial cell dysfunction (A) is an early event in atherosclerosis but does not directly result from subtotal plaque disruption. Prinzmetal's angina (B) is caused by transient coronary artery spasm rather than plaque disruption. Non-ST elevation myocardial infarction (D) involves incomplete blockage of a coronary artery and typically does not result from subtotal plaque disruption.
Postdatism is pregnancy equal to or more than
- A. 280 days
- B. 294 days
- C. 290 days
- D. 287 days
Correct Answer: B
Rationale: Postdatism refers to a pregnancy that extends beyond the normal gestation period of 280 days. The correct answer is B (294 days) as it is more than the standard 280-day term. Choice A (280 days) is the normal term, not postdatism. Choices C (290 days) and D (287 days) are also below the 294-day mark, making them incorrect for defining postdatism.