Classical vitamin K deficiency bleeding occurs

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.

Correct Answer: D

Rationale: Maternal smoking during pregnancy can affect fetal development in multiple ways. Smoking can cause low birth weight by restricting oxygen and nutrients to the fetus, leading to growth issues. It can also increase the risk of preterm birth due to the harmful chemicals in cigarette smoke. Furthermore, smoking can affect lung development in the fetus, leading to respiratory issues. Therefore, the correct answer is D - All of the above, as maternal smoking can have a comprehensive impact on fetal development, including low birth weight, preterm birth, and lung development issues.

Correct Answer: C

Rationale: The correct answer is C: Magnesium sulphate. In eclampsia, magnesium sulphate is the drug of choice because it helps prevent seizures by reducing neuromuscular irritability and blocking peripheral neuromuscular transmission. It also has vasodilatory effects, improving uteroplacental blood flow. Phenobarbitone (A) is not recommended due to its sedative effects. Calcium gluconate (B) is used to treat hyperkalemia, not eclampsia. Sodium bicarbonate (D) is used for metabolic acidosis, not eclampsia. In summary, magnesium sulphate is preferred for its efficacy in preventing and managing seizures in eclampsia.

Correct Answer: B

Rationale: Breech presentation refers to the bottom or feet-first position of the baby in the uterus. This is the correct answer (B) because it accurately defines breech presentation. Choice A (head-first presentation) is incorrect as it describes the typical vertex presentation. Choices C (oblique lie) and D (transverse lie) are also incorrect as they refer to other abnormal fetal positions that are different from breech presentation.

Correct Answer: A

Rationale: The correct answer is A: Increases risk of gestational diabetes. Maternal obesity can lead to insulin resistance, increasing the likelihood of developing gestational diabetes during pregnancy. This condition can have negative effects on both the mother and the baby. B: Miscarriage is not directly linked to maternal obesity but can be influenced by other factors. C: Maternal obesity is not a direct cause of anemia during pregnancy. Anemia is usually related to iron deficiency or other factors. D: Maternal obesity is actually associated with an increased risk of preterm labor, not a reduced chance. This is due to various complications such as hypertension and preeclampsia.

Correct Answer: D

Rationale: The correct answer is D: His symptoms occur in 5 to 10% of people after ulcer surgery. This is the correct answer because the patient's symptoms of decreased capacity for intake and nausea after eating are common post-operative complications following ulcer surgery. By stating this fact to the patient, the AGACNP is providing reassurance that these symptoms are not unusual. Explanation for why the other choices are incorrect: A: Endoscopy is not necessary at this point since the symptoms described by the patient are known post-operative complications and do not indicate an urgent need for endoscopy. B: While gastroparesis can be a complication of ulcer surgery, there is no information in the case to suggest that the patient has chronic gastroparesis. C: Jumping to the conclusion that medication is unlikely to help and another surgery may be needed is premature and not supported by the information provided in the case.

Correct Answer: A

Rationale: The correct answer is A: Footling. When a hand/foot lies alongside the presenting part, it indicates a footling presentation where the foot is presenting first. This is a type of breech presentation, where the baby's buttocks or feet come out first. A transverse presentation would mean the baby is lying sideways, and an unstable lie refers to the baby's position not being fixed. Therefore, the presence of a hand/foot alongside the presenting part specifically indicates a footling presentation, making choice A the correct answer.

Correct Answer: A

Rationale: The correct answer is A: Rheumatic heart disease. This is because rheumatic heart disease is a known risk factor for cardiac complications during pregnancy due to the strain pregnancy places on the heart. Choice B, notable peripheral edema, is a symptom of heart failure but not a predisposing factor. Choice C, easy fatiguability, is a non-specific symptom and not a direct predisposing factor. Choice D, basal crepitation, is a sign of possible lung pathology and not directly related to cardiac disease in pregnancy. Therefore, the correct answer is A as it directly relates to an increased risk of cardiac issues during pregnancy.

Correct Answer: D

Rationale: The correct answer is D: Hypergastrinemia and acid hypersecretion. Gastrinoma is a tumor that secretes excessive gastrin, leading to elevated gastrin levels. High gastrin levels stimulate acid secretion in the stomach, resulting in acid hypersecretion. Therefore, the combination of hypergastrinemia and acid hypersecretion is almost diagnostic of gastrinoma. A: Hypogastrinemia and acid hyposecretion is incorrect because gastrinoma leads to increased gastrin levels and subsequent acid hypersecretion. B: Hypergastrinemia and acid hyposecretion is incorrect because gastrinoma is associated with acid hypersecretion, not hyposecretion. C: Hypogastrinemia and acid hypersecretion is incorrect because gastrinoma causes elevated gastrin levels and acid hypersecretion, not hypogastrinemia. In summary, the correct answer D aligns with the pathophysiology of gastrinoma, while the