Nokea
A maternal febrile condition noted within the first three weeks of postpartum is suggestive of
- A. Puerperal sepsis
- B. Puerperal thrombosis
- C. Puerperal pyrexia
- D. Puerperal shock
Correct Answer: C
Rationale: The correct answer is C: Puerperal pyrexia. Maternal febrile condition within the first three weeks postpartum is suggestive of puerperal pyrexia, which is defined as a fever of 38°C or higher occurring after the first 24 hours post-delivery. This condition is commonly caused by endometritis, a uterine infection following childbirth. Puerperal sepsis (choice A) is a more severe form of infection involving systemic symptoms, while puerperal thrombosis (choice B) refers to blood clot formation. Puerperal shock (choice D) is a life-threatening condition resulting from severe infection or hemorrhage, which may present with fever but is not the primary symptom.
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Haematinics, dietary advice, and close surveillance are management plans for
- A. Moderate anaemia
- B. Mild anaemia
- C. Severe anaemia
- D. Anaemia prevention
Correct Answer: A
Rationale: The correct answer is A: Moderate anaemia. Haematinics, dietary advice, and close surveillance are appropriate management plans for moderate anaemia to improve iron levels and overall health. For mild anaemia, dietary changes alone may be sufficient. Severe anaemia often requires more aggressive treatments like blood transfusions. Anaemia prevention focuses on strategies to avoid developing anaemia rather than managing an existing case.
Predisposing factors to uterine rupture include
- A. Nulliparity, neglected obstructed labor
- B. Breech presentation, multiple pregnancy
- C. Neglected obstructed labor, high parity
- D. Obstetric maneuvers, breech presentation
Correct Answer: C
Rationale: The correct answer is C because neglected obstructed labor and high parity are well-established predisposing factors to uterine rupture. Neglected obstructed labor can cause prolonged pressure on the uterus, leading to weakening and potential rupture. High parity (having given birth multiple times) can also increase the risk of uterine rupture due to repeated stretching and strain on the uterine muscles.
A, B, and D are incorrect because nulliparity (never given birth), breech presentation, multiple pregnancy, and obstetric maneuvers are not as strongly associated with uterine rupture as neglected obstructed labor and high parity. These factors may increase the risk of other complications during childbirth but are not primary predisposing factors for uterine rupture.
Stuvia.com - The Marketplace to Buy and Sell your Study Material T. O. is a 44-year-old female patient who presents for evaluation of sudden, severe upper abdominal pain. She is clear about the onset, which was profound and occurred approximately one hour ago. She denies that the onset had any relationship to food or eating, and she denies nausea or vomiting. On examination, she is lying on her right side with her hips and knees flexed to draw her knees to her chest. Vital signs are stable, but examination reveals involuntary guarding. The abdomen is painful and tympanic to percussion in all quadrants. CBC reveals a white blood cell count of 15,600L. The AGACNP suspects
- A. Dissecting aortic aneurysm
- B. Acute pancreatitis
- C. Perforated peptic ulcer
- D. Mallory-Weiss tear
Correct Answer: B
Rationale: The correct answer is B: Acute pancreatitis. The patient's sudden, severe upper abdominal pain, unaffected by food intake, along with guarding and elevated white blood cell count, are indicative of acute pancreatitis. The patient's positioning (knees to chest) suggests relief from pain, which is characteristic of pancreatitis. A dissecting aortic aneurysm (choice A) typically presents with tearing chest or back pain. Perforated peptic ulcer (choice C) would present with a history of chronic ulcer symptoms. Mallory-Weiss tear (choice D) presents with a history of recent vomiting. Therefore, based on the patient's presentation and findings, acute pancreatitis is the most likely diagnosis.
When a hand/foot lies alongside the presenting part, the presentation is said to be
- A. Footling
- B. Transverse
- C. Compound
- D. Cephalic
Correct Answer: C
Rationale: The correct answer is C: Compound. When a hand or foot lies alongside the presenting part during childbirth, it is called a compound presentation. This can be a complication as it increases the risk of the presenting part not fitting through the birth canal properly.
A: Footling presentation occurs when the baby's foot or feet are the first to emerge from the birth canal.
B: Transverse presentation is when the baby is lying sideways in the uterus.
D: Cephalic presentation is the ideal position for vaginal delivery, with the baby's head down and ready to be born.
When a hand/foot lies alongside the presenting part, the presentation is said to be
- A. Footling
- B. Transverse
- C. Breech
- D. Unstable lie
Correct Answer: A
Rationale: The correct answer is A: Footling. When a hand/foot lies alongside the presenting part, it indicates a footling presentation where the foot is presenting first. This is a type of breech presentation, where the baby's buttocks or feet come out first. A transverse presentation would mean the baby is lying sideways, and an unstable lie refers to the baby's position not being fixed. Therefore, the presence of a hand/foot alongside the presenting part specifically indicates a footling presentation, making choice A the correct answer.