Nokea
Mechanism of labour in left Sacro-anterior position (breech):
- A. Flexion, internal rotation, extension, external rotation
- B. Descent, engagement, flexion, internal rotation
- C. Flexion, external rotation, descent, expulsion
- D. Extension, flexion, engagement, delivery
Correct Answer: A
Rationale: The mechanism includes flexion, internal rotation, and extension of the breech baby.
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Among the major predisposing factors of cardiac disease prenatally are
- A. Rheumatic heart disease and leukaemia
- B. Ischaemic heart disease and dehydration
- C. Uncontrolled hypertension and obesity
- D. Smoking and peptic ulcer disease
Correct Answer: C
Rationale: Uncontrolled hypertension and obesity are major predisposing factors for cardiac disease.
The AGACNP recognizes that which of the following diagnostic studies is essential in all cases of acute abdomen?
- A. Abdominal radiograph
- B. Contrast radiography
- C. Chest radiography
- D. Ultrasonography
Correct Answer: C
Rationale: Ultrasonography is considered essential in all cases of acute abdomen because it is a valuable tool in evaluating various abdominal organs non-invasively. It can quickly identify common causes of acute abdomen such as cholecystitis, pancreatitis, appendicitis, and other intra-abdominal pathologies. Ultrasonography also has the advantage of being radiation-free and can be performed rapidly at the bedside, making it a preferred initial diagnostic modality in the evaluation of acute abdominal pain. Abdominal radiograph, contrast radiography, and chest radiography may have limited utility in the evaluation of acute abdomen compared to ultrasonography.
A definitive indication for elective caesarean section includes
- A. Cord prolapse denoted in first stage
- B. Failure of first stage to progress
- C. Major degree of placenta praevia
- D. Fetal compromise denoted in first stage
Correct Answer: C
Rationale: A major degree of placenta praevia is a definitive indication for elective cesarean section.
Justin F. is seen in the emergency department with an 8-cm jagged laceration on the dorsal surface of his right forearm. He says he was working with his brother-in-law yesterday morning building a deck on the back of his home. A pile of wooden planks fell on top of him, and he sustained a variety of cuts and superficial injuries. He cleaned the wound with soap and water but didnt want to go to the emergency room because he didnt want to risk being in the waiting room for hours. He wrapped up his arm and went back to work, and then took a normal shower and went to bed last night. This morning the cut on his arm was still flapping open, and he realized he needed sutures. The appropriate management of this patient includes
- A. Proper cleansing and covering of the laceration, along with antibiotic therapy
- B. Local anesthesia, cleansing, and wound exploration for foreign bodies
- C. Local anesthesia, cleansing, and suture repair
- D. Cleansing, covering, antibiotic therapy, and tetanus prophylaxis
Correct Answer: D
Rationale: In this scenario, the patient presents with a jagged laceration on his forearm that is still open and requires sutures. The appropriate management for this patient involves local anesthesia to reduce pain, thorough cleansing of the wound to prevent infection, and wound exploration to assess for any foreign bodies that may be present. Suturing the wound is necessary to promote proper healing and reduce the risk of complications. Antibiotic therapy may be indicated if signs of infection are present, but it is not mentioned in the scenario as a primary management step. Tetanus prophylaxis should also be considered given the mechanism of injury involving a dirty object.
The presenting diameter in face presentation is
- A. Submento-vertical
- B. Mento-vertical
- C. Suboccipito-bregmatic
- D. Submento-bregmatic
Correct Answer: A
Rationale: In face presentation, the presenting diameter is submento-vertical.