Nokea
Which one of the following drugs when used by a pregnant woman is likely to lead to oligohydramnios?
- A. Diazepam
- B. Captopril
- C. Ampicillin
- D. Pethidine
Correct Answer: B
Rationale: The correct answer is B: Captopril. Captopril is an angiotensin-converting enzyme (ACE) inhibitor that can lead to oligohydramnios in pregnant women due to its effect on reducing fetal renal function. This can result in decreased amniotic fluid levels. Diazepam (A) is a benzodiazepine used for anxiety and is not associated with oligohydramnios. Ampicillin (C) is an antibiotic commonly used during pregnancy and does not cause oligohydramnios. Pethidine (D) is an opioid analgesic with no known association with oligohydramnios in pregnancy.
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The MOST common type of breech presentation is
- A. Frank breech presentation
- B. Complete breech presentation
- C. Incomplete breech presentation
- D. Footling breech presentation
Correct Answer: A
Rationale: The correct answer is A: Frank breech presentation. This is because the frank breech presentation is the most common type of breech presentation, accounting for about 50-70% of all breech births. In a frank breech presentation, the baby's buttocks are presenting first with the legs extended up towards the head. This position is considered the most favorable for a vaginal delivery compared to the other types of breech presentations.
Summary of incorrect choices:
B: Complete breech presentation - This type of breech presentation occurs when the baby's buttocks are presenting first with the knees bent and the feet near the buttocks. It is less common than the frank breech presentation.
C: Incomplete breech presentation - In this type, one or both of the baby's legs are presenting first instead of the buttocks. It is less common than the frank breech presentation.
D: Footling breech presentation - This type occurs when one or both of the baby's feet
Use of bed cradle in the management of leg thrombosis is meant to:
- A. Keep the legs straight
- B. Prevent embolism
- C. Control body temperature
- D. Promote venous drainage
Correct Answer: D
Rationale: The use of bed cradle in leg thrombosis management is to promote venous drainage. Elevating the legs on a bed cradle helps improve blood flow back to the heart, reducing swelling and preventing blood clots. Keeping the legs straight (A) is not the main purpose. Preventing embolism (B) is important but not the direct purpose of a bed cradle. Controlling body temperature (C) is unrelated to the use of a bed cradle for leg thrombosis.
The term used to describe the situation whereby there is the presence of more than one part of the fetus on the pelvic brim at the onset of labor is
- A. Unstable lie
- B. Fetal malpresentation
- C. Fetal malposition
- D. Compound presentation
Correct Answer: D
Rationale: The correct answer is D: Compound presentation. This term refers to the situation where there is more than one part of the fetus on the pelvic brim at the onset of labor. This can include a hand or arm alongside the head or another body part. The other choices are incorrect because: A: Unstable lie refers to the fetus being in a transverse position. B: Fetal malpresentation indicates an abnormal presentation of the fetus, such as breech or transverse. C: Fetal malposition refers to the fetus being in a suboptimal position, like occiput posterior. Thus, the best choice is D as it specifically describes the scenario of multiple fetal parts on the pelvic brim.
Which of the following types of aortic aneurysms requires immediate surgical intervention?
- A. Type A
- B. Type B
- C. Descending
- D. Symptomatic
Correct Answer: A
Rationale: The correct answer is A: Type A aortic aneurysm. Type A involves the ascending aorta, which is more critical due to proximity to the heart. Immediate surgical intervention is necessary to prevent catastrophic complications like aortic dissection or rupture. Choice B, Type B, usually involves the descending aorta and can often be managed through medical therapy initially. Choice C, Descending aneurysm, may not require immediate surgery unless symptomatic or rapidly expanding. Choice D, Symptomatic aneurysm, could refer to any type and would need further evaluation to determine the urgency of surgical intervention.
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 correct answer is B: His procedure has put him at significant risk for B12 absorption problems.
Rationale:
1. Jejunum is primarily responsible for nutrient absorption, including B12.
2. Resection of a large portion of the jejunum can lead to malabsorption of B12.
3. B12 is essential for neurological function and red blood cell production.
4. Patients with significant jejunum resection are at high risk for B12 deficiency.
5. Monitoring B12 levels and potentially requiring supplementation is crucial for patients like Jake.
Summary of other choices:
A: Incorrect. Lifetime issues with diarrhea are not necessarily expected following jejunum resection.
C: Incorrect. The ileum may assume some functions of the jejunum but cannot fully compensate.
D: Incorrect. Enteral nutrition should not be delayed for months as it is essential for Jake's recovery and nutritional needs.