Nokea
Which of the following is NOT a source of pain in labour?
- A. Uterine contractions
- B. Socio-cultural norms
- C. Cervical dilatation
- D. Pelvic floor stretching
Correct Answer: B
Rationale: Step 1: Uterine contractions are a physiological process in labor causing pain due to muscle contractions.
Step 2: Cervical dilatation involves the opening of the cervix, which can cause pain and discomfort.
Step 3: Pelvic floor stretching occurs as the baby moves through the birth canal, leading to pain.
Step 4: Socio-cultural norms do not directly cause physical pain in labor, making choice B the correct answer. Other choices directly relate to physical processes causing pain.
You may also like to solve these questions
The main diagnostic feature of puerperal pyrexia is
- A. Fever ≥ 38°C for three consecutive occasions
- B. Fever ≥ 38°C for three days continuously
- C. Fever ≥ 38°C for three weeks continuously
- D. Fever ≥ 38°C for six days occasionally
Correct Answer: A
Rationale: The correct answer is A: Fever ≥ 38°C for three consecutive occasions. Puerperal pyrexia is defined as fever occurring after childbirth. The key diagnostic feature is the presence of fever (≥ 38°C) on three consecutive occasions, indicating a persistent infection. Choice B is incorrect because it doesn't specify the need for consecutive occasions. Choice C is incorrect as it extends the duration of fever to three weeks, which is too long for typical puerperal pyrexia. Choice D is incorrect as it mentions "occasionally" instead of "consecutively," which is not indicative of a consistent fever pattern seen in puerperal pyrexia.
A student AGACNP just beginning his clinical rotation is observing his preceptor perform a physical survey on a patient who is brought in following a serious motor vehicle accident. The student observes that the physical examination includes rectovaginal examination, inspection of the urethral meatus, and palpation of the pelvic landmarks. The student knows the patient is being assessed for
- A. Peritoneal bleeding
- B. Retroperitoneal bleeding
- C. Paresthesia
- D. Pelvic fracture
Correct Answer: A
Rationale: The correct answer is A: Peritoneal bleeding. In a patient with a serious motor vehicle accident, a physical examination that includes rectovaginal examination, inspection of the urethral meatus, and palpation of pelvic landmarks is aimed at assessing for signs of internal bleeding, particularly peritoneal bleeding. Rectovaginal examination can detect blood in the rectouterine pouch, inspection of the urethral meatus can reveal blood at the urethral opening, and palpation of pelvic landmarks can identify tenderness or instability associated with internal bleeding. These findings would be indicative of potential peritoneal bleeding requiring urgent evaluation and management.
Summary of other choices:
B: Retroperitoneal bleeding - While physical examination findings may include signs such as flank ecchymosis or tenderness, the specific examinations mentioned are not typically performed to assess retroperitoneal bleeding.
C: Paresthesia - Paresthesia refers to abnormal sensations like tingling or numbness and
The baby dies immediately after birth due to the presence of
- A. Pulmonary stenosis
- B. Aortic coarctation
- C. Truncus arteriosus
- D. Ductus arteriosus
Correct Answer: C
Rationale: The correct answer is C: Truncus arteriosus. In this congenital heart defect, a single large blood vessel arises from the heart instead of the normal two separate vessels (aorta and pulmonary artery). This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygen supply to the body. This condition is incompatible with life, causing immediate death after birth.
A: Pulmonary stenosis and B: Aortic coarctation are also congenital heart defects but do not typically result in immediate death after birth. Pulmonary stenosis obstructs blood flow to the lungs, while aortic coarctation causes narrowing of the aorta.
D: Ductus arteriosus is a normal fetal blood vessel that connects the pulmonary artery and the aorta but usually closes shortly after birth. Failure of closure can lead to health issues, but it is not typically a cause of immediate death after birth.
Deep transverse arrest is
- A. Where flexion is always well maintained.
- B. Caused by strong uterine contractions throughout labor.
- C. Caused by a sacrum that is well curved.
- D. Where the level of the occiput and the sinciput is the same.
Correct Answer: D
Rationale: The correct answer is D because deep transverse arrest refers to a situation where the fetal head fails to rotate and descend in the pelvis due to the occiput and sinciput being at the same level. This leads to a prolonged labor. Choice A is incorrect because flexion can be inadequate in deep transverse arrest. Choice B is incorrect because it is not solely caused by uterine contractions but rather fetal malposition. Choice C is incorrect because a well-curved sacrum is not a defining factor in deep transverse arrest.
Mr. Costigan is a 50-year-old male patient who recently had a screening colonoscopy because it was recommended by his primary care provider as a screening measure. He received a report that noted inflammatory polyps. He is concerned because one of his friends had polyps that turned into cancer. While advising Mr. Costigan, the AGACNP tells him that
- A. The polyps are considered precancerous, but if he has a colonoscopy every 3 to 5 years, any new polyps can be removed before they become malignant
- B. The primary danger is when there is a family history of colon cancer; he should discuss with his mother and father the presence of any colon cancer in the family
- C. There is no chance that these polyps could become cancerous, and their presence does not require any additional action or concern on his part
- D. He would be best served at this point to discuss with an oncologist the risks and benefits of aggressive versus conservative treatment.
Correct Answer: B
Rationale: Step 1: Family history of colon cancer is a significant risk factor for developing colon cancer.
Step 2: By discussing with his parents, Mr. Costigan can determine if there is a family history of colon cancer.
Step 3: Knowing this information can help assess his own risk and guide appropriate screening and preventive measures.
Step 4: The primary danger for Mr. Costigan lies in potential genetic predisposition rather than the presence of inflammatory polyps.
Step 5: Therefore, discussing with family members about any history of colon cancer is crucial for his overall risk assessment and management.
Summary:
- Choice A is incorrect as the frequency of colonoscopy should be individualized based on the patient's risk factors.
- Choice C is incorrect as all polyps have the potential to become cancerous, especially inflammatory polyps.
- Choice D is incorrect as consulting an oncologist at this stage is premature without first assessing family history.