Clinical diagnosis of polyhydramnios is based on an excessive amount of amniotic fluid exceeding

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Question 1 of 9

Clinical diagnosis of polyhydramnios is based on an excessive amount of amniotic fluid exceeding

Correct Answer: D

Rationale: The correct answer is D: 3000 ml. Polyhydramnios is diagnosed when the amniotic fluid volume exceeds 2000 to 3000 ml. This is because amniotic fluid serves important functions in protecting the fetus and aiding in fetal movements. Having an excessively high volume can lead to complications such as preterm labor, fetal malpresentation, and placental abruption. Choices A, B, and C are incorrect as they do not fall within the range typically used to diagnose polyhydramnios. A: 1500 ml and C: 1900 ml are below the threshold, while B: 2500 ml is at the lower end but still not exceeding the diagnostic range for polyhydramnios.

Question 2 of 9

What are the symptoms of a urinary tract infection (UTI) during pregnancy?

Correct Answer: D

Rationale: The correct answer is D (All of the above) because during pregnancy, UTI symptoms include painful urination, increased frequency of urination, and lower abdominal pain. Painful urination is a common symptom due to inflammation of the urinary tract. Increased frequency of urination is caused by the pressure of the growing uterus on the bladder. Lower abdominal pain can also occur due to the infection. Therefore, all these symptoms are indicative of a UTI during pregnancy. Other choices are incorrect as they do not encompass the comprehensive range of symptoms typically seen in a UTI during pregnancy.

Question 3 of 9

A patient presents with a 2-day history of abdominal pain, fever, vomiting, and diarrhea. A surgical abdomen is ruled out, and radiography demonstrates inflammation of the small bowel and colon. Microscopy supports a diagnosis of Campylobacter jejuni, and the patient is prepared for discharge from the emergency room. Important patient education includes advising her that

Correct Answer: D

Rationale: Step 1: Campylobacter jejuni is a bacteria commonly associated with foodborne illness, often found in undercooked poultry and unpasteurized milk. Step 2: The patient's symptoms and microbiological findings are consistent with Campylobacter infection. Step 3: Advising the patient that there is no readily identified food source of this bacteria is important for preventing future exposure and potential reinfection. Step 4: Choices A, B, and C are incorrect as they do not address the specific educational need related to food safety and prevention of Campylobacter infection.

Question 4 of 9

Mr. Novello is an 81-year old male patient who presents with crampy abdominal pain in the hypogastrum and a vague history as to his last normal bowel movement. Physical examination reveals distention and high-pitched bowel sounds. The patient says he has never has this kind of problem before and denies any history of abdominal surgery. Abdominal radiographs reveal a frame pattern of colonic distention. The AGACNP considers

Correct Answer: C

Rationale: The correct answer is C: Decompression of the colon with rectal tube. This is the most appropriate intervention for a patient with acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome. In this condition, there is colonic distention without an actual mechanical obstruction, leading to symptoms like abdominal pain, distention, and high-pitched bowel sounds. Decompression with a rectal tube can help relieve the distention and prevent complications like perforation. Choice A (stimulant laxative) is incorrect because ACPO is not due to simple constipation, so laxatives would not be effective. Choice B (carcinoma of the bowel) is unlikely given the acute onset and lack of risk factors. Choice D (angiography for mesenteric ischemia) is not indicated in this case as there are no signs of acute ischemia. In summary, the correct choice is C because it directly addresses the underlying issue of colonic distention in

Question 5 of 9

The presenting diameter in brow presentation is

Correct Answer: A

Rationale: The presenting diameter in brow presentation is Submentobregmatic (choice A) because it refers to the distance from the submentum (chin) to the bregma (anterior fontanelle). This is the appropriate measurement for the brow presentation as the brow is the prominent part between the forehead and the chin. Choice B (Suboccipitofrontal) is incorrect because it refers to the distance from the subocciput to the frontal bone, which is not relevant to brow presentation. Choice C (Occipitalfrontal) is incorrect because it describes the distance from the occiput to the frontal bone, which again is not specific to brow presentation. Choice D (Mentovertical) is incorrect as it denotes the distance from the chin to the vertex, which is not the relevant measurement for brow presentation.

Question 6 of 9

There are no other abnormal findings. This suggests that Mr. Thornton

Correct Answer: B

Rationale: The correct answer is B because the absence of any other abnormal findings suggests that Mr. Thornton is currently experiencing an anterior wall infarction. This is indicated by the localized area of myocardial necrosis due to prolonged ischemia. Option A is incorrect because ischemia would typically present with reversible changes rather than necrosis. Option C is incorrect as NSTEMI would show some abnormal findings. Option D is incorrect as STEMI would show more significant ECG changes and enzyme elevation. In summary, the absence of other abnormalities points towards an acute event like an anterior wall infarction.

Question 7 of 9

A patient being monitored post-heart transplant suffers a bradyarrhythmia. The AGACNP knows that which of the following medications is not indicated as part of emergency intervention for bradycardic abnormalities in a posttransplant patient?

Correct Answer: A

Rationale: The correct answer is A: Isoproterenol 0.2 to 0.6 mg IV bolus. Isoproterenol is a non-selective beta-adrenergic agonist that can worsen graft rejection in heart transplant patients. The appropriate intervention for bradyarrhythmia in posttransplant patients is external pacemaking or pharmacological agents like atropine or epinephrine. Isoproterenol should be avoided due to its potential to stimulate the immune system and increase the risk of rejection. It is crucial to choose interventions that address the bradycardia without compromising the patient's transplant graft.

Question 8 of 9

The commonest major cause of primary postpartum haemorrhage is

Correct Answer: D

Rationale: Step 1: Atony of the uterus is the most common cause of primary postpartum hemorrhage due to inadequate uterine contractions. Step 2: Trauma of the genital tract can lead to bleeding but is not as common as atony of the uterus in postpartum hemorrhage. Step 3: Blood coagulation disorder can contribute to excessive bleeding but is not the primary cause of postpartum hemorrhage. Step 4: Prolonged 3rd stage can result in postpartum hemorrhage but is typically secondary to uterine atony.

Question 9 of 9

Which one of the following statements is correct with regards to face presentation?

Correct Answer: C

Rationale: The correct answer is C: Majority are classified as secondary face presentation. In face presentation, the fetal head is hyperextended, presenting the face to the birth canal. Primary face presentation is rare. The bi-parietal diameter is not the presenting diameter in face presentation, as it is in vertex presentation. Locating the anterior fontanelle is not diagnostic of face presentation, as the fontanelles can be difficult to palpate during labor. Therefore, the correct statement is that the majority of face presentations are classified as secondary face presentation.

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