Mr. Nelson is a 65-year-old male who has been advised that he is a candidate for coronary artery bypass grafting. He has been doing some internet research and is asking about whether or not he should have a beating heart bypass. Regarding off-pump coronary bypass grafting, the AGACNP advises Mr. Nelson that

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Question 1 of 9

Mr. Nelson is a 65-year-old male who has been advised that he is a candidate for coronary artery bypass grafting. He has been doing some internet research and is asking about whether or not he should have a beating heart bypass. Regarding off-pump coronary bypass grafting, the AGACNP advises Mr. Nelson that

Correct Answer: A

Rationale: The correct answer is A: There is a slightly higher risk of neurologic complications. Rationale: 1. Off-pump bypass grafting involves performing surgery on a beating heart without the use of a heart-lung machine. 2. The lack of cardiopulmonary bypass during off-pump surgery can lead to reduced blood flow to the brain, increasing the risk of neurologic complications. 3. This is why the AGACNP advises Mr. Nelson about the slightly higher risk of neurologic complications associated with off-pump bypass. 4. Choice B is incorrect as long-term results actually suggest similar or better patency rates for grafts in off-pump surgery. 5. Choice C is incorrect as the statement about the incidence increasing significantly in the last 10 years is not relevant to the risks of off-pump surgery. 6. Choice D is incorrect as off-pump surgery is not considerably more expensive and the correlation with better long-term outcomes is debatable.

Question 2 of 9

Justin F. is seen in the emergency department with an 8-cm jagged laceration on the dorsal surface of his right forearm. He says he was working with his brother-in-law yesterday morning building a deck on the back of his home. A pile of wooden planks fell on top of him, and he sustained a variety of cuts and superficial injuries. He cleaned the wound with soap and water but didnt want to go to the emergency room because he didnt want to risk being in the waiting room for hours. He wrapped up his arm and went back to work, and then took a normal shower and went to bed last night. This morning the cut on his arm was still flapping open, and he realized he needed sutures. The appropriate management of this patient includes

Correct Answer: C

Rationale: The correct answer is C: Local anesthesia, cleansing, and suture repair. 1. Local anesthesia is needed to minimize pain during the procedure. 2. Cleansing is crucial to remove contaminants and reduce the risk of infection. 3. Suture repair is necessary for a jagged laceration of this size to promote proper wound healing and minimize scarring. Summary of other choices: A: Antibiotic therapy is not routinely needed for clean lacerations, and covering alone may not provide adequate wound closure. B: While wound exploration for foreign bodies is important, it is not the immediate priority for this patient with an open, flapping laceration. D: While cleansing, covering, and tetanus prophylaxis are important, antibiotic therapy is not routinely needed for clean lacerations.

Question 3 of 9

ed rosy appearance on the face and greatly reduced eliminations are among the features of

Correct Answer: C

Rationale: Step-by-step rationale for why choice C is correct: 1. Hyperthermia neonatorum refers to elevated body temperature in newborns. 2. The ed rosy appearance on the face is a common symptom of hyperthermia due to increased blood flow to the skin. 3. Greatly reduced eliminations can be a sign of dehydration associated with hyperthermia. 4. The other choices (hypothermia, hypoglycemia, hypocalcemia) do not align with the symptoms described.

Question 4 of 9

What is the impact of maternal stress on fetal development?

Correct Answer: D

Rationale: The correct answer is D because maternal stress can indeed lead to low birth weight, increase the risk of preterm labor, and affect brain development in the fetus. Stress hormones can interfere with the placental function, affecting the transfer of nutrients to the fetus and leading to low birth weight. Stress can also trigger early contractions, potentially resulting in preterm labor. Furthermore, maternal stress can impact fetal brain development through the release of stress hormones that can alter the development of the fetal brain structures. Therefore, all of the choices (A, B, and C) are correct in demonstrating the impact of maternal stress on fetal development.

Question 5 of 9

Which one of the following is an endogenous cause of puerperal sepsis?

Correct Answer: B

Rationale: The correct answer is B: Escherichia coli. Puerperal sepsis is often caused by endogenous bacteria from the mother's own flora. E. coli is a common endogenous bacteria found in the gastrointestinal tract and can cause infection during childbirth. Chlamydia trachomatis is a sexually transmitted infection, not typically associated with puerperal sepsis. Clostridium tetani causes tetanus, not puerperal sepsis. Pseudomonas aeruginosa is an environmental pathogen, not typically an endogenous cause of puerperal sepsis.

Question 6 of 9

Homeopathy, music therapy, and hydrotherapy are among the

Correct Answer: D

Rationale: The correct answer is D: Non-pharmacological methods of pain relief. Homeopathy, music therapy, and hydrotherapy are all non-pharmacological approaches that do not involve the use of medication to manage pain. They focus on alternative techniques to alleviate pain, such as using natural remedies, music, or water-based therapies. These methods aim to address pain through holistic approaches that do not rely on traditional pharmaceutical interventions. A: Systemic methods of pain relief typically involve medications that affect the entire body, such as opioids. B: Regional analgesia methods target specific areas for pain relief, like nerve blocks. C: Inhalational analgesia involves administering pain relief medications through inhalation, such as nitrous oxide. In summary, the other choices are incorrect because they do not accurately describe the non-pharmacological nature of homeopathy, music therapy, and hydrotherapy in managing pain.

Question 7 of 9

Diamorphic anaemia results due to deficiency of

Correct Answer: B

Rationale: The correct answer is B: Iron and folic acid. Diamorphic anemia is characterized by the presence of both microcytic and macrocytic red blood cells, which can be caused by a deficiency in both iron and folic acid. Iron deficiency leads to microcytic anemia, while folic acid deficiency results in macrocytic anemia. Thiamine deficiency (Choice A) primarily affects the nervous system and does not directly cause diamorphic anemia. Liver enzymes deficiency (Choice D) does not directly lead to diamorphic anemia. Folic acid and thiamine deficiency (Choice C) can cause individual types of anemia but not diamorphic anemia.

Question 8 of 9

A correct statement about shoulder dystocia is

Correct Answer: A

Rationale: Rationale for Correct Answer (A): Shoulder dystocia is an impaction of the anterior shoulder after delivery of the head because the anterior shoulder gets stuck behind the pubic symphysis during childbirth. This can lead to serious complications for both the mother and the baby if not managed promptly. Summary of Incorrect Choices: B: Impaction of the posterior shoulder is not referred to as shoulder dystocia; it is the impaction of the anterior shoulder that causes the complication. C: Shoulder dystocia is not caused by a compound presentation of the fetus, which refers to a situation where more than one fetal part presents at the maternal pelvis simultaneously. D: Shoulder dystocia is indeed an emergency that requires immediate intervention, as delays can lead to birth injuries and complications. It does not resolve on its own and needs medical assistance.

Question 9 of 9

Use of bed cradle in the management of leg thrombosis is meant to:

Correct Answer: D

Rationale: The use of bed cradle in leg thrombosis management is to promote venous drainage. Elevating the legs on a bed cradle helps improve blood flow back to the heart, reducing swelling and preventing blood clots. Keeping the legs straight (A) is not the main purpose. Preventing embolism (B) is important but not the direct purpose of a bed cradle. Controlling body temperature (C) is unrelated to the use of a bed cradle for leg thrombosis.

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