Nokea
While participating in sports, it is not uncommon for people to be subjected to sudden rotational injuries that result in the abrupt rotation of the cerebral cortex around the more fixed midbrain structures. This can interrupt input and outflow from the reticular activating system and result in what clinical phenomenon?
- A. Epidural hematoma
- B. Uncal herniation
- C. Concussion
- D. Contrecoup injury
Correct Answer: A
Rationale: The correct answer is A: Epidural hematoma.
1. Sudden rotational injuries can cause tearing of the middle meningeal artery, leading to an epidural hematoma.
2. The hematoma can compress the brain, disrupting the reticular activating system, causing altered consciousness.
3. Uncal herniation (B) involves herniation of the uncus, not rotation-related.
4. Concussion (C) is a mild traumatic brain injury, not directly related to rotational injuries.
5. Contrecoup injury (D) is when the brain impacts the opposite side of the skull due to sudden deceleration, not rotation-induced.
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How does maternal age impact pregnancy risks?
- A. Older mothers are at higher risk for preeclampsia
- B. Younger mothers are at higher risk of miscarriage
- C. Advanced age increases cesarean rates
- D. Both A and C
Correct Answer: D
Rationale: The correct answer is D because both statements A and C are true. Older mothers have a higher risk of developing preeclampsia due to age-related complications. Additionally, advanced maternal age is associated with an increased likelihood of requiring a cesarean section due to factors like decreased uterine elasticity. Statement B is incorrect as younger mothers are not at higher risk of miscarriage compared to older mothers. This is because maternal age is not a significant factor in miscarriage risk.
Jennifer is an RN applicant for a staff nurse position in the surgical ICU. She has had a screening PPD and comes back in 48 hours to have it read. There is a 12-mm induration at the site of injection. A chest radiograph is negative. The AGACNP knows that the next step in Jennifers evaluation and management should include
- A. No further care, because the chest radiograph is negative
- B. Quantiferon serum assay for exposure
- C. Consideration of prophylactic therapy
- D. Beginning therapy for pulmonary TB pending sputum cultures
Correct Answer: A
Rationale: The correct answer is A: No further care, because the chest radiograph is negative. In this scenario, Jennifer has a positive PPD test with a 12-mm induration but a negative chest radiograph, indicating latent TB infection. The negative chest radiograph rules out active TB disease. As a result, Jennifer does not require further evaluation or treatment for active TB. The positive PPD alone does not warrant further investigations such as Quantiferon assay (B) or prophylactic therapy (C) as these are not indicated for latent TB infection without active disease. Beginning therapy for pulmonary TB (D) is unnecessary and potentially harmful as Jennifer does not have active TB. Thus, the correct course of action is to provide no further care based on the negative chest radiograph.
What are the risks of a VBAC (vaginal birth after cesarean)?
- A. Uterine rupture
- B. Postpartum hemorrhage
- C. Placenta previa
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A: Uterine rupture. This is the most significant risk associated with VBAC, where the scar from the previous cesarean section may tear during labor. This can lead to severe complications for both the mother and baby. Postpartum hemorrhage (B) and placenta previa (C) are potential risks in any pregnancy but are not specifically increased in VBAC. Therefore, the correct answer is A, as it directly relates to the unique risk of VBAC.
Precipitate labour is an unusually rapid labour
- A. That is concluded in less than three hours
- B. Where the external cervical os fails to dilate despite good uterine contractions
- C. That is concluded in more than three hours
- D. Where the external cervical os fails to dilate due to poor uterine contractions.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Precipitate labor is defined as unusually rapid labor.
2. Option A states that it is concluded in less than three hours, aligning with the definition.
3. Option B talks about cervical dilation, which is not a defining factor of precipitate labor.
4. Option C contradicts the definition as it mentions a duration longer than three hours.
5. Option D mentions poor uterine contractions, which are not characteristic of precipitate labor.
Summary:
Option A is correct because it aligns with the definition of precipitate labor being rapid, while the other options are incorrect as they do not accurately describe the characteristics of precipitate labor.
A characteristic of monozygotic twins is that
- A. They are always of the same sex
- B. They share a similar fingerprint pattern
- C. They have different blood groups
- D. Superfetation is a common finding
Correct Answer: A
Rationale: The correct answer is A: They are always of the same sex. This is because monozygotic twins, also known as identical twins, develop from a single fertilized egg that splits into two embryos. As a result, they share the same genetic material and are always of the same sex.
Choice B is incorrect because fingerprint patterns are not determined by genetics and can vary even between identical twins. Choice C is incorrect because monozygotic twins share the same blood type since they have the same genetic makeup. Choice D is incorrect as superfetation, the occurrence of multiple pregnancies in the same uterus but from different ovulations, is extremely rare and not a common finding in monozygotic twins.