Nokea
Which of the following types of aortic aneurysms requires immediate surgical intervention?
- A. Type A
- B. Type B
- C. Descending
- D. Symptomatic
Correct Answer: C
Rationale: Type A aortic aneurysms require immediate surgical intervention. Type A aortic dissections involve the ascending aorta and are at high risk for complications such as aortic rupture or compromise of coronary artery blood flow. Prompt surgical repair is necessary to prevent potentially fatal outcomes. Types B, C, and symptomatic aneurysms may not require immediate surgical intervention depending on the specific patient presentation and associated risks.
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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: D
Rationale: In this scenario, the patient presents with a jagged laceration on his forearm that is still open and requires sutures. The appropriate management for this patient involves local anesthesia to reduce pain, thorough cleansing of the wound to prevent infection, and wound exploration to assess for any foreign bodies that may be present. Suturing the wound is necessary to promote proper healing and reduce the risk of complications. Antibiotic therapy may be indicated if signs of infection are present, but it is not mentioned in the scenario as a primary management step. Tetanus prophylaxis should also be considered given the mechanism of injury involving a dirty object.
What are the most effective strategies to reduce the risk of preterm labor in high-risk pregnancies?
- A. Bed rest
- B. Progesterone therapy
- C. Cervical cerclage
- D. Increased hydration
Correct Answer: B
Rationale: Progesterone therapy is evidence-based and effective in reducing preterm labor in high-risk pregnancies.
Mechanism of labour in left Sacro-anterior position (breech):
- A. Flexion, internal rotation, extension, external rotation
- B. Descent, engagement, flexion, internal rotation
- C. Flexion, external rotation, descent, expulsion
- D. Extension, flexion, engagement, delivery
Correct Answer: A
Rationale: The mechanism includes flexion, internal rotation, and extension of the breech baby.
Jake is a 32-year-old patient who is recovering from major abdominal surgery and organ resection following a catastrophic motor vehicle accident. Due to the nature of his injuries, a large portion of his jejunum had to be resected. In planning for his recovery and nutritional needs, the AGACNP considers that
- A. He will probably be able to transition to oral nutrition but will have lifetime issues with diarrhea
- B. His procedure has put him at significant risk for B12 absorption problems
- C. Most jejunum absorption functions will be assumed by the ileum
- D. Enteral nutrition will need to be delayed for 3 to 6 months to facilitate adaptation
Correct Answer: B
Rationale: The jejunum is the primary site for absorption of nutrients, including vitamin B12. Resection of a large portion of the jejunum can lead to malabsorption of vitamin B12, as this nutrient is primarily absorbed in the distal ileum but also partially absorbed in the jejunum. Thus, Jake is at significant risk for B12 absorption problems following his surgery, and close monitoring and potential supplementation may be needed to address this issue.
Signs of obstructed labour per vaginally include
- A. Dry vagina, Oedema of the cervix, Caput succedaneum
- B. Plenty amniotic fluid, Hot/dry vagina, meconium stained liquor
- C. Meconium stained liquor, Hot/dry vagina, Diluted urine
- D. Caput succedaneum, Oedema of the cervix, plenty amniotic fluid
Correct Answer: A
Rationale: Signs of obstructed labor include a dry vagina, oedema of the cervix, and caput succedaneum.