Traumatic diaphragmatic hernias present in both acute and chronic forms. Patients with a more chronic form are most likely to be present with

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Band 7 Midwifery Interview Questions and Answers Questions

Question 1 of 5

Traumatic diaphragmatic hernias present in both acute and chronic forms. Patients with a more chronic form are most likely to be present with

Correct Answer: A

Rationale: The correct answer is A: Respiratory insufficiency. Chronic traumatic diaphragmatic hernias can lead to gradual compromise of respiratory function due to herniation of abdominal contents into the chest cavity, causing compression of the lungs and reduced lung capacity. This results in symptoms such as dyspnea, cough, and chest pain. Sepsis (B) is more commonly associated with acute traumatic diaphragmatic hernias. Bowel obstruction (C) is a possible complication but typically presents with acute symptoms like abdominal pain and distension. Anemia (D) is not a common presentation of diaphragmatic hernias.

Question 2 of 5

Mrs. Coates is a 65-year-old female who is on postoperative day 1 following a duodenal resection for a bleeding ulcer. She had an uneventful immediate postoperative course, but throughout the course of day 1 she has complained of a mild abdominal discomfort that has progressed throughout the day. This evening the AGACNP is called to the bedside to evaluate the patient for persistent and progressive discomfort. Likely causes of her symptoms include all of the following except

Correct Answer: C

Rationale: The correct answer is C: Gastric retention. Mrs. Coates' symptoms of persistent and progressive discomfort are not likely due to gastric retention because she underwent a duodenal resection for a bleeding ulcer, which would bypass the stomach. Therefore, gastric retention is not a possible cause. A: Colic due to return of peristalsis is a possible cause as peristalsis returning after surgery can cause discomfort. B: Leakage from the duodenal stump is a possible cause as it can lead to abdominal discomfort postoperatively. D: Hemorrhage is a possible cause given her history of bleeding ulcer and surgery.

Question 3 of 5

In myelodysplastic syndromes, the primary indications for splenectomy include

Correct Answer: D

Rationale: The correct answer is D: Portal hypertension. In myelodysplastic syndromes, splenectomy is indicated primarily for portal hypertension due to extramedullary hematopoiesjson in the spleen, leading to increased blood flow and pressure in the portal vein. This can alleviate symptoms such as ascites and variceal bleeding. Choices A, B, and C are incorrect as major hemolysis, massive splenomegaly, and sustained leukocyte elevation are not primary indications for splenectomy in myelodysplastic syndromes.

Question 4 of 5

Hepatic encephalopathy is a clinical syndrome seen in patients with chronic liver disease its presentation may range from mild personality changes, to psychosis, to coma. The primary chemical mediators of hepatic encephalopathy include all of the following except

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.

Question 5 of 5

The AGACNP is covering an internal medicine service and is paged by staff to see a patient who has just pulled out his ET tube. After the situation has been assessed, it is clear that the patient will go into respiratory failure and likely die if he is not reintubated. The patient is awake and alert and is adamant that he does not want to be reintubated. The AGACNP is concerned that there is not enough time to establish a DNRthe patient needs to be reintubated immediately and already is becoming obtunded. Which ethical principles are in conflict here?

Correct Answer: A

Rationale: The correct answer is A: Veracity and beneficence. Veracity refers to truthfulness, and the AGACNP is facing a conflict between being honest with the patient about the need for reintubation (veracity) and providing beneficence by ensuring the patient receives necessary medical care to prevent harm. The patient's autonomy and right to make decisions are not directly in conflict since the patient is conscious, and autonomy is respected by honoring the patient's wishes. Justice is also not in conflict here as it does not pertain to the immediate ethical dilemma of reintubation. Autonomy and beneficence are not in direct conflict as the patient's autonomy is being respected by allowing them to make an informed decision. Nonmalfeasance is not directly applicable in this scenario.

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