M. T. is a 71-year-old female who presents for evaluation of a lump on her chest. She denies any symptomsthere is no pain, erythema, edema, ecchymosis, or open areasit is just a lump. She has no idea how long it has been there and just noticed it a few weeks ago. Physical examination reveals a round, smooth, flesh-colored tumor. It is firm but not hard it has smooth borders. It measures 6 cm in diameter and is non-tender to palpation. The AGACNP suspects that this is a classic presentation of the most common chest wall tumor known as a

Correct Answer: B

Rationale: The correct answer is B: Lipoma. A lipoma is a common benign tumor made of fat cells. In this case, the patient's presentation of a painless, soft, round, flesh-colored lump with smooth borders is consistent with a lipoma. The absence of symptoms like pain, erythema, or tenderness further supports this diagnosis. Lipomas are usually non-tender to palpation and can grow to a significant size. The other choices (A, C, D) are not the correct answers because they do not align with the characteristics described in the patient's presentation. Neurolemma is associated with nerve sheath tumors, hemangioma with blood vessel tumors, and lymphangioma with lymphatic vessel tumors, none of which match the clinical findings in this case.

Correct Answer: B

Rationale: The correct answer is B: FALSE. In preeclampsia, epigastric pain is typically associated with liver and/or HELLP syndrome, not hyperacidity. Hyperacidity is more commonly seen in conditions like gastritis or peptic ulcers. Therefore, severe epigastric pain in preeclampsia is not related to hyperacidity. Other choices are not applicable as they do not provide relevant information to the question.

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.

Correct Answer: A

Rationale: Step-by-step rationale for why choice A is correct: 1. Pregnancy can lead to severe anaemia due to increased demand for iron and folate. 2. Pregnancy-induced physiological changes can exacerbate malaria-related anaemia. 3. Severe jaundice may occur in pregnant women with malaria due to liver dysfunction. 4. These effects are common during pregnancy and can worsen with malaria infection. Summary of why other choices are incorrect: - Choice B: Blood smear positivity is not always guaranteed in malaria, and severe anaemia is not the only effect. - Choice C: Therapy limitations can occur, but the presence of few parasites in severe cases is not a defining feature. - Choice D: Loss of pregnancy can happen, but it is not a universal effect of malaria during pregnancy, and severity is not based on parasite count alone.

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.

Correct Answer: B

Rationale: The correct answer is B: FALSE. Severe epigastric pain in preeclampsia is not associated with hyperacidity but is more likely due to complications such as HELLP syndrome or liver involvement. Preeclampsia is characterized by high blood pressure and proteinuria, not hyperacidity. Therefore, severe epigastric pain in preeclampsia should not be attributed to hyperacidity. Other choices are not applicable.

Correct Answer: D

Rationale: Rationale: 1. Obstructed labor can lead to prolonged pressure on the uterus, causing hemorrhage and uterine rupture (A). 2. Prolonged labor can result in fetal distress due to reduced oxygen supply and potential infection (B). 3. Therefore, both complications mentioned in A and B can occur in obstructed labor. Summary: A: Incorrect - Preterm birth and asphyxia are not directly related to obstructed labor. B: Incorrect - Only fetal distress and infection are commonly associated with obstructed labor. C: Incorrect - Both A and B are possible complications of obstructed labor, making D the correct choice.

Correct Answer: B

Rationale: Iron supplementation benefits pregnancy by correcting or preventing iron deficiency anemia in the mother. Anemia can lead to various complications for the mother and baby. Iron is essential for the production of hemoglobin, which carries oxygen to tissues. Therefore, by reducing anemia, iron supplementation ensures optimal oxygen delivery to both the mother and the developing fetus. This ultimately supports healthy pregnancy outcomes. Explanation for other choices: A: Iron supplementation does not directly increase fetal blood flow. C: While iron deficiency may increase the risk of miscarriage, iron supplementation alone does not prevent miscarriages. D: Iron is not directly involved in fetal bone growth, so iron supplementation does not enhance this aspect of fetal development.

Correct Answer: B

Rationale: The Kleihauer-Betke acid-elution test is recommended in the management of hemolytic jaundice prenatally because it helps determine the amount of fetal-maternal hemorrhage, which is crucial for assessing the need for Rh immune globulin administration to prevent Rh sensitization in Rh-negative mothers carrying Rh-positive fetuses. This test helps quantify the amount of fetal red blood cells in the maternal circulation, guiding appropriate management to prevent hemolytic disease of the newborn. The other choices (A, C, D) do not specifically require the Kleihauer-Betke test for management and are not directly related to fetal-maternal hemorrhage assessment.