Nokea
A mother with a cord prolapse is given oxygen at a rate of 4 liters/minute in order to
- A. Relieve maternal distress
- B. Promote her relative rest
- C. Improve fetal oxygenation
- D. Achieve the effect of tocolysis
Correct Answer: C
Rationale: The correct answer is C: Improve fetal oxygenation. Oxygen at 4 liters/minute is given to increase oxygen levels which can help improve oxygenation to the fetus during a cord prolapse scenario. This can be crucial in preventing fetal distress and hypoxia.
Explanation for Incorrect Choices:
A: Relieve maternal distress - Oxygen is primarily given in this scenario to benefit the fetus, not to relieve maternal distress.
B: Promote her relative rest - Oxygen is not administered to promote rest, but to address the immediate concern of fetal oxygenation.
D: Achieve the effect of tocolysis - Oxygen does not have a role in tocolysis, which is the inhibition of uterine contractions.
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A clinical feature that is indicative of transient tachypnea of the newborn is
- A. Rapid respirations of up to 120/minute
- B. There’s marked recession of the rib cage
- C. Mostly common following a normal delivery
- D. Diminished respirations of less than 40/minute
Correct Answer: A
Rationale: Step 1: Transient tachypnea of the newborn is characterized by rapid respirations due to delayed reabsorption of fetal lung fluid.
Step 2: Rapid respirations of up to 120/minute is a common clinical feature seen in newborns with transient tachypnea.
Step 3: This rapid breathing pattern distinguishes it from other conditions.
Step 4: Marked recession of the rib cage is more indicative of respiratory distress syndrome.
Step 5: Transient tachypnea can occur in both normal and cesarean deliveries, so choice C is incorrect.
Step 6: Diminished respirations of less than 40/minute would not be expected in transient tachypnea.
Summary: Choice A is correct because rapid respirations are a key clinical feature of transient tachypnea, while the other choices do not align with its characteristic presentation.
Flexion-distraction injuries of the thoracolumbar spine are most commonly caused by
- A. Blunt trauma
- B. Rotational injury
- C. Seat belts
- D. Gunshot wounds
Correct Answer: C
Rationale: The correct answer is C: Seat belts. Flexion-distraction injuries of the thoracolumbar spine are commonly caused by seat belts due to the mechanism of injury during a motor vehicle accident. When a sudden deceleration occurs, the body is restrained by the seat belt while the spine continues to move forward, leading to hyperflexion of the spine. This results in distraction forces at the thoracolumbar junction, causing injury.
Blunt trauma (choice A) can cause various types of spinal injuries but is not specifically associated with flexion-distraction injuries. Rotational injury (choice B) typically leads to injuries such as fractures or dislocations, not flexion-distraction injuries. Gunshot wounds (choice D) can cause direct spinal damage, but they do not typically result in flexion-distraction injuries.
The Brain Trauma Foundation recommends intracranial pressure monitoring for all of the following patients except those with
- A. GCS of 3 to 8 and abnormal head CT
- B. GCS of 3 to 8 and hypotension
- C. GCS of 3 to 8 and > 40 years old
- D. GCS of 3 to 8 and bradycardia
Correct Answer: B
Rationale: The correct answer is B (GCS of 3 to 8 and hypotension) because hypotension is not a specific indication for intracranial pressure (ICP) monitoring according to the Brain Trauma Foundation guidelines. The rationale is that hypotension is a systemic issue affecting overall perfusion, whereas ICP monitoring is specifically for assessing intracranial dynamics.
A, C, and D are incorrect choices because they all involve conditions that could potentially indicate increased intracranial pressure and the need for monitoring. A) Abnormal head CT indicates structural brain injury, C) age > 40 is a risk factor for poor outcomes after traumatic brain injury, and D) bradycardia can be a sign of increased ICP affecting brainstem function. Therefore, these conditions warrant ICP monitoring according to guidelines.
The commonly used inhalational analgesia during labour is
- A. Entonox
- B. Trilene
- C. Oxygen
- D. Nitrous oxide
Correct Answer: A
Rationale: The correct answer is A: Entonox. Entonox, a mixture of nitrous oxide and oxygen, is commonly used for inhalational analgesia during labor due to its fast-acting and safe properties. Nitrous oxide provides pain relief without affecting the baby's heart rate or causing sedation. Trilene (B) is not commonly used during labor due to potential side effects on the baby. Oxygen (C) is not an analgesic but is often used in conjunction with Entonox. Nitrous oxide (D) is the active component in Entonox and is the primary analgesic agent in this mixture.
What are the risks of cesarean sections?
- A. Infection
- B. Blood loss
- C. Prolonged recovery
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because all the choices (A, B, and C) are risks associated with cesarean sections. Infection can occur at the incision site, blood loss is a common concern during surgery, and cesarean sections typically have a longer recovery time compared to vaginal delivery. Therefore, all of these risks are potential complications of undergoing a cesarean section. The other choices (A, B, and C) are incorrect individually because they only represent a subset of the risks associated with cesarean sections, while choice D encompasses all potential risks.