Nokea
Which one of the following statements is correct about secondary post-partum haemorrhage?
- A. Mostly occurs between the 8th-14th day post-partum
- B. Results due to bleeding immediately after delivery
- C. Can extend up to the first 46 days following delivery
- D. Is diagnosed by presence of persistent lochia serosa
Correct Answer: C
Rationale: The correct answer is C because secondary post-partum hemorrhage can occur up to 6 weeks (46 days) after delivery, typically due to delayed complications like retained placental fragments or infection. Choice A is incorrect because most secondary post-partum hemorrhage occurs after the first week. Choice B is incorrect as it describes primary post-partum hemorrhage, which occurs within 24 hours of delivery. Choice D is incorrect since lochia serosa is a normal discharge present in the early post-partum period and is not specific to diagnosing secondary post-partum hemorrhage.
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A maternal febrile condition noted within the first three weeks of postpartum is suggestive of
- A. Puerperal sepsis
- B. Puerperal thrombosis
- C. Puerperal pyrexia
- D. Puerperal shock
Correct Answer: C
Rationale: The correct answer is C: Puerperal pyrexia. Maternal febrile condition within the first three weeks postpartum is suggestive of puerperal pyrexia, which is defined as a fever of 38°C or higher occurring after the first 24 hours post-delivery. This condition is commonly caused by endometritis, a uterine infection following childbirth. Puerperal sepsis (choice A) is a more severe form of infection involving systemic symptoms, while puerperal thrombosis (choice B) refers to blood clot formation. Puerperal shock (choice D) is a life-threatening condition resulting from severe infection or hemorrhage, which may present with fever but is not the primary symptom.
Classical vitamin K deficiency bleeding occurs
- A. Within the first 24 hours of birth
- B. Within the neonatal stage
- C. Within the infancy stage
- D. Within the first week of birth
Correct Answer: B
Rationale: Classical vitamin K deficiency bleeding occurs within the neonatal stage because newborns have low levels of vitamin K, which is essential for blood clotting. This deficiency typically manifests between 1-7 days after birth. Bleeding within the first 24 hours (choice A) is unlikely as it is too early for vitamin K deficiency to cause symptoms. Bleeding within infancy (choice C) is incorrect as it specifically refers to the neonatal stage. Bleeding within the first week of birth (choice D) is a close distractor, but the critical period for classical vitamin K deficiency bleeding is within the neonatal stage, which is slightly more specific than the first week of birth.
Mrs. Jenner is a 41-year-old female who is being evaluated for persistent nausea. She had an abdominal CT scan that reported three hepatic hemangiomas ranging from 3 to 5 cm. The AGACNP knows that the appropriate response to this report is to
- A. Arrange for large-bore needle biopsy
- B. Order hepatic ultrasound annually to follow progression
- C. Consult surgery for resection
- D. Document the finding in the patient’s chart
Correct Answer: B
Rationale: The correct answer is B. Ordering hepatic ultrasound annually to follow progression is the appropriate response for hepatic hemangiomas. Biopsy is not recommended due to the risk of bleeding. Surgery is usually not required unless there are complications. Documenting the finding is important but does not address the need for monitoring. Ultrasound allows for non-invasive monitoring of the hemangiomas over time to assess for growth or complications, guiding further management if needed.
When examining a patient with abdominal pain, the AGACNP knows that tenderness to percussion is analogous to
- A. Tympany
- B. Guarding
- C. Rebound tenderness
- D. Somatic pain
Correct Answer: C
Rationale: The correct answer is C: Rebound tenderness. Tenderness to percussion is similar to rebound tenderness because both involve assessing pain upon release of pressure. Rebound tenderness specifically evaluates pain when the examiner quickly removes pressure, indicating peritoneal inflammation. Tympany (A) refers to a drum-like sound upon percussion, not pain. Guarding (B) is involuntary muscle contractions in response to palpation, not percussion. Somatic pain (D) is localized pain arising from skin, muscles, or bones, not related to percussion tenderness.
Which of the following is not a true statement with respect to decision making for a cognitively impaired patient?
- A. Only a court can declare a patient incompetent
- B. Impaired cognition does not make a person incompetent
- C. Living wills typically are honored if a person is terminally ill
- D. A patient can give informed consent if not declared incompetent
Correct Answer: C
Rationale: The correct answer is C because living wills typically are not always honored for cognitively impaired patients. Step-by-step rationale: A) Incorrect - A court can declare a patient incompetent if they are unable to make decisions. B) Incorrect - Impaired cognition can indeed make a person incompetent. D) Incorrect - A patient must have the capacity to understand information and make decisions to give informed consent.