Nokea
What are the key indicators for cesarean section during labor?
- A. Fetal distress
- B. Failure to progress
- C. Breech presentation
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D, as all three choices are key indicators for cesarean section during labor. Fetal distress indicates the baby is not tolerating labor well. Failure to progress may lead to complications for the mother or baby. Breech presentation increases the risk of complications during vaginal delivery. Therefore, all three indicators warrant consideration for a cesarean section to ensure the safety of both the mother and the baby.
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Delivery of the head in a breech presentation is usually accomplished through
- A. Lovset maneuver
- B. Burns Marshall Method
- C. Mauriceau-Smellie-Veit maneuver
- D. Reverse woodscrew maneuver
Correct Answer: C
Rationale: The Mauriceau-Smellie-Veit maneuver is the correct answer for delivering the head in a breech presentation. This maneuver involves applying pressure to the fetal head with the fingers in the mouth to flex the head, guiding it through the pelvis. This technique helps prevent hyperextension of the head and facilitates a safe delivery. The Lovset maneuver involves rotating the fetus to disengage the impacted shoulder, not for delivering the head. The Burns Marshall Method is used for delivering the aftercoming head in a breech presentation. The Reverse woodscrew maneuver is a technique to disimpact a shoulder dystocia, not for delivering the head in a breech presentation.
The congenital abnormality of the respiratory tract, associated with abnormal apical position, is
- A. Laryngeal stridor
- B. Diaphragmatic hernia
- C. Choanal atresia
- D. Tracheo-bronchi fistula
Correct Answer: C
Rationale: The correct answer is C: Choanal atresia. The congenital abnormality of the respiratory tract with abnormal apical position is typically associated with choanal atresia, which is a blockage or narrowing of the back of the nasal passage. This condition can lead to respiratory distress in newborns due to difficulty breathing through the nose.
Explanation:
1. Laryngeal stridor (Choice A) is a high-pitched noise during breathing and is not typically associated with abnormal apical position.
2. Diaphragmatic hernia (Choice B) is a defect in the diaphragm that allows abdominal organs to move into the chest cavity, but it is not related to abnormal apical position.
3. Tracheo-bronchi fistula (Choice D) is an abnormal connection between the trachea and bronchi, which is not associated with abnormal apical position.
In summary, choanal atresia is the correct answer because it fits the description of
Mrs. Maroldo is an 81-year-old female who presents for evaluation of pain in her left lower quadrant. She has had this pain before and says she usually takes antibiotics and it goes away. However, this time it seems worse, and she has had it for 4 days even though she says she started taking her leftover antibiotics from the last episode. She denies any nausea or vomiting but says she simply isnt hungry. She had a little diarrhea yesterday but no bowel movements today. She has a temperature of 100.9F and a pulse of 104 bpm, respirations of 20 breaths per minute, and a blood pressure of 9460 mm Hg. She has some discomfort to deep palpation in the left lower quadrant. The AGACNP suspects
- A. Irritable bowel syndrome
- B. Inflammatory bowel disease
- C. Diverticulitis
- D. Appendicitis
Correct Answer: A
Rationale: The correct answer is A: Irritable bowel syndrome. Mrs. Maroldo's history of recurrent left lower quadrant pain that usually resolves with antibiotics suggests a chronic condition rather than an acute one like diverticulitis, appendicitis, or inflammatory bowel disease. Her lack of nausea, vomiting, and severe symptoms, along with the presence of diarrhea and no bowel movements, align more with irritable bowel syndrome. Additionally, her vital signs are not significantly elevated, ruling out acute conditions like appendicitis. Discomfort to deep palpation in the left lower quadrant is common in irritable bowel syndrome due to visceral hypersensitivity. Therefore, based on her chronic symptoms, lack of severe signs, and typical presentation, the most likely diagnosis is irritable bowel syndrome.
Diamorphic anaemia results due to deficiency of
- A. Iron and thiamine
- B. Iron and folic acid
- C. Folic acid and thiamine
- D. Liver enzymes and iron
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.
The MOST common type of breech presentation is
- A. Frank breech presentation
- B. Complete breech presentation
- C. Incomplete breech presentation
- D. Footling breech presentation
Correct Answer: A
Rationale: The correct answer is A: Frank breech presentation. This is because the frank breech presentation is the most common type of breech presentation, accounting for about 50-70% of all breech births. In a frank breech presentation, the baby's buttocks are presenting first with the legs extended up towards the head. This position is considered the most favorable for a vaginal delivery compared to the other types of breech presentations.
Summary of incorrect choices:
B: Complete breech presentation - This type of breech presentation occurs when the baby's buttocks are presenting first with the knees bent and the feet near the buttocks. It is less common than the frank breech presentation.
C: Incomplete breech presentation - In this type, one or both of the baby's legs are presenting first instead of the buttocks. It is less common than the frank breech presentation.
D: Footling breech presentation - This type occurs when one or both of the baby's feet