The AGACNP is rounding on a patient following splenectomy for idiopathic thrombocytopenia purpura. On postoperative day 2, a review of the laboratory studies is expected to reveal

Correct Answer: A

Rationale: The correct answer is A: Increased MCV. Following splenectomy, there is a compensatory increase in red blood cell production, leading to an increase in Mean Corpuscular Volume (MCV) due to the release of larger, younger red blood cells into circulation. This is known as stress erythropoiesis. Summary: B: Increased Hgb - Hgb levels may not necessarily increase post-splenectomy as it depends on factors such as bleeding or hydration status. C: Increased platelets - Platelet count is not expected to increase immediately post-splenectomy. D: Increased albumin - Albumin levels are not directly influenced by splenectomy for idiopathic thrombocytopenia purpura.

Correct Answer: D

Rationale: The correct answer is D: Hyperbaric oxygen. SSHL is a medical emergency that requires prompt intervention. Hyperbaric oxygen therapy increases oxygen delivery to the inner ear, potentially reversing the hearing loss. Acyclovir (A) is used for viral infections, not SSHL. Furosemide (B) is a diuretic used for treating fluid retention, not SSHL. Warfarin (C) is an anticoagulant and is not indicated for SSHL. In summary, hyperbaric oxygen is the appropriate choice for managing SSHL due to its potential to improve oxygen delivery to the inner ear.

Correct Answer: A

Rationale: The correct answer is A: Frank breech, complete breech, footling breech. In a frank breech presentation, the baby's buttocks are aimed at the birth canal with legs flexed at the hips and extended at the knees. In a complete breech presentation, the baby's buttocks are aimed at the birth canal with legs flexed at the hips and knees. In a footling breech presentation, one or both of the baby's feet are positioned to come out first. These are the three main types of breech presentations. Choices B, C, and D do not accurately describe the different types of breech presentations, making them incorrect.

Correct Answer: A

Rationale: The correct answer is A (1000-500 gm) because extremely low birth weight babies are typically defined as those weighing less than 1000 grams (1kg) at birth. This range specifically includes weights below 1000 grams, making it the most accurate choice. Choice B (500-1500 gm) is incorrect because it includes weights above the threshold for extremely low birth weight (1000 gm). Choice C (1001-1500 gm) is incorrect because it excludes babies weighing less than 1000 gm, which are considered extremely low birth weight. Choice D (1500-2000 gm) is also incorrect as it includes weights above the range for extremely low birth weight babies.

Correct Answer: C

Rationale: The correct answer is C because culture and level of education can significantly impact how women perceive and react to labor pain. Culture shapes beliefs, norms, and attitudes towards pain, influencing coping mechanisms. Education can enhance understanding of pain management techniques. Option A lacks specificity on how preparedness and fatigue affect perception. Option B oversimplifies by only considering culture and age. Option D overlooks the influence of education and focuses solely on anxiety and number of deliveries.

Correct Answer: B

Rationale: The correct answer is B: Ammonia. Ammonia is a primary chemical mediator of hepatic encephalopathy. In patients with chronic liver disease, the liver's ability to detoxify ammonia is compromised, leading to its accumulation in the bloodstream and subsequent neurotoxic effects causing encephalopathy. Gamma-aminobutyric acid (GABA), false neurotransmitters, and serotonin are all implicated in the pathophysiology of hepatic encephalopathy. GABA is involved in neurotransmission, false neurotransmitters are substances that disrupt normal neurotransmission, and serotonin levels are altered in hepatic encephalopathy.

Correct Answer: B

Rationale: The correct answer is B: Assess fetal lung maturity. Amniotic fluid analysis measures the levels of substances like surfactant, which indicates lung maturity. This helps in determining if the fetus is ready for delivery. Other choices are incorrect because amniotic fluid analysis is not primarily used to detect fetal infections (A), determine fetal position (C), or assess placental health (D). These functions are typically achieved through other diagnostic tests or imaging techniques.

Correct Answer: A

Rationale: The correct answer is A: External cephalic version. This procedure involves manually manipulating the baby from a breech position to a head-down position. It is recommended as a safe and effective way to manage breech presentations, reducing the need for a cesarean section. Immediate cesarean (B) is not always necessary and should be reserved for specific medical reasons. Pelvic X-ray (C) is not routinely recommended for managing breech presentations. Induction of labor (D) is not the primary strategy for managing breech presentations, as it does not address the positioning of the baby.

Correct Answer: A

Rationale: The correct answer is A because Bishop's score assesses the readiness of the cervix for labor by evaluating descent (station of the fetal head), presentation (fetal position), and cervical dilatation, which are key indicators of cervical ripening and effacement. Descent shows the progress of the fetus through the birth canal, presentation indicates the fetal position for delivery, and cervical dilatation reflects the opening of the cervix for labor. Choices B, C, and D are incorrect as they do not encompass all the essential components of Bishop's score, which focuses on descent, presentation, and cervical dilatation.