Which one of the following is a characteristic of fetal post-maturity syndrome?

Correct Answer: C

Rationale: The correct answer is C: Wrinkled, peeling skin. Post-maturity syndrome occurs when a pregnancy extends beyond 42 weeks, causing the baby to lose the protective layer of vernix caseosa, leading to dry, peeling skin. Closed eyes and being unusually alert (A) are not specific to post-maturity syndrome. Long, frail fingernails (B) are not a typical characteristic of post-maturity. Excess vernix caseosa (D) is actually a characteristic of a premature baby, not a post-mature one.

Correct Answer: C

Rationale: The correct answer is C: A long history of alcohol use. In this case, T. S. is brain dead and has a donor notation. However, a long history of alcohol use can lead to liver damage, making her liver unsuitable for donation. Encephalopathy (A) is a brain disorder but does not necessarily impact liver suitability. Hepatitis C infection (B) can affect the liver, but it doesn't automatically disqualify someone from being a donor. Biliary cirrhosis (D) refers to a specific liver condition, but it does not preclude someone from being a liver donor unless it has severely damaged the liver beyond use.

Correct Answer: B

Rationale: The correct answer is B: Severe asphyxia and prematurity. In eclampsia, maternal hypertension can lead to placental insufficiency, reducing oxygen and nutrient supply to the fetus, resulting in severe asphyxia and premature birth. This is due to the high risk of placental abruption and intrauterine growth restriction. Other choices are incorrect because cerebral hemorrhage and pneumonia (choice A) are not commonly associated with neonatal complications of eclampsia. Fractures and soft tissue trauma (choice C) are not typical complications of eclampsia in neonates. Respiratory distress and hypoglycemia (choice D) are more commonly seen in neonates born to mothers with gestational diabetes, not eclampsia.

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: B

Rationale: The correct answer is B: Face presentation. Vaginal delivery is possible in face presentation as the fetus is in a position where the face is presenting first, allowing for delivery. In this presentation, the chin is usually tucked onto the chest, making it easier for the baby's head to pass through the birth canal. A: Brow presentation is incorrect because it indicates the baby's head is extended slightly, making it more difficult for vaginal delivery. C: Shoulder presentation is incorrect as it can lead to a shoulder dystocia, making vaginal delivery dangerous and difficult. D: Unstable lie is incorrect because it refers to the baby being in a transverse position, making vaginal delivery impossible without intervention.

Correct Answer: A

Rationale: The correct answer is A: Fetal macrosomia. Prolonged pregnancy increases the risk of fetal macrosomia due to continued fetal growth beyond the normal term. This can lead to complications during delivery, such as shoulder dystocia and birth injuries. Placental dysfunction and cesarean section are possible outcomes of prolonged pregnancy but are not directly associated with fetal risks in this context. Shoulder dystocia is a potential complication of fetal macrosomia but is not a direct fetal risk of prolonged pregnancy.

Correct Answer: B

Rationale: The correct answer is B. It is important to manage medications appropriately preoperatively to minimize complications. Metoprolol, a beta blocker, should be continued up until the day of surgery to prevent rebound hypertension or tachycardia. Metformin should be held on the day of surgery to avoid potential lactic acidosis due to its effects on kidney function. Warfarin should be discontinued 5-7 days before surgery to reduce the risk of bleeding. Vitamin E can increase bleeding risk and should be discontinued. Choice A is incorrect as not all medications should be taken until the morning of surgery. Choice C is incorrect as warfarin should be held earlier than 5 days before surgery. Choice D is incorrect as metformin should be held on the day of surgery, regardless of blood sugar levels, to prevent lactic acidosis.

Correct Answer: C

Rationale: The correct answer is C: Marked limitation of physical activity. In cardiac disease grading, grade III signifies marked limitation of physical activity. This indicates that the patient experiences symptoms with less than ordinary physical activity, such as shortness of breath or chest pain. This grade reflects significant impairment in daily activities due to cardiac issues. A: Patient is comfortable even at rest - This describes grade I, where patients are comfortable at rest. B: Patient is asymptomatic initially - This describes pre-symptomatic stages before any limitations in physical activity. D: Absolute limitation of physical activity - This is more severe and indicative of grade IV, where any physical activity causes discomfort or symptoms.

Correct Answer: D

Rationale: The correct initial action for the AGACNP is to provide counseling to the patient regarding her options (Choice D). This is important to ensure the patient's safety, well-being, and autonomy. Counseling will allow the patient to explore her feelings, understand her options, and make an informed decision about her next steps. Reporting the physical assault to law enforcement (Choice A) should only be done with the patient's consent to respect her wishes. Having the patient sign a release to go home with her husband (Choice B) could potentially put the patient at risk of further harm. Consulting psychiatry for a psych hold (Choice C) may not be appropriate unless the patient is deemed a danger to herself or others.