Nokea
A newborn infant opens her mouth and turns her head to the right when her right cheek is touched, which is consistent with which of the following reflexes?
- A. rooting reflex
- B. moro reflex
- C. tonic neck reflex ('fencing' reflex)
Correct Answer: A
Rationale: The rooting reflex helps the infant locate the nipple for feeding.
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A patient who is experiencing trouble becoming pregnant reported that she has only two to three menstrual periods per year. What is an initial explanation for this problem?
- A. Ovulation is difficult to predict.
- B. There is a definite lack of gonadotropin-releasing hormone.
- C. Something is blocking one or both fallopian tubes.
- D. Only one ovary is functioning.
Correct Answer: A
Rationale: The correct answer, A, is the initial explanation because irregular menstrual periods suggest infrequent ovulation, making it difficult to predict the fertile window for conception. Lack of gonadotropin-releasing hormone (B) would result in no ovulation at all. Blocked fallopian tubes (C) would prevent the egg from reaching the uterus, causing infertility. If only one ovary is functioning (D), the patient would still ovulate regularly from that ovary.
A patient presenting with chronic pelvic pain and heavy menstrual bleeding will be evaluated for what conditions? Select all that apply.
- A. endometriosis
- B. uterine fibroids
- C. ovarian cysts
- D. uterine polyps
Correct Answer: A,B,D
Rationale: The correct answer includes endometriosis, uterine fibroids, and uterine polyps due to their association with chronic pelvic pain and heavy menstrual bleeding. Endometriosis causes inflammation and scarring, leading to pain and abnormal bleeding. Uterine fibroids are non-cancerous growths in the uterus that can cause pain and heavy periods. Uterine polyps are overgrowths of the endometrial lining that can result in heavy bleeding. Ovarian cysts, although they can cause pelvic pain, are not typically associated with heavy menstrual bleeding.
Which are the most common sites of breast cancer metastasis?
- A. Kidneys
- B. Bones and liver
- C. Heart and blood vessels
- D. Skin
Correct Answer: B
Rationale: The correct answer is B: Bones and liver. Breast cancer commonly metastasizes to bones and liver due to their rich blood supply, making them favorable sites for cancer cells to spread. Bones provide a supportive environment for cancer growth, while liver offers a hospitable environment for circulating cancer cells. Other choices are incorrect as breast cancer rarely metastasizes to kidneys, heart, blood vessels, or skin. Kidneys are not common sites for breast cancer spread, and heart and blood vessels lack the conducive environment for cancer growth. Skin metastasis in breast cancer is rare and usually indicates advanced disease.
The vulva consists of which structure?
- A. Labia majora, minora, clitoris, mons pubis, and vestibular glands
- B. Penis, scrotum, and prostate gland
- C. Internal female structures, including the uterus and ovaries
- D. Openings of the urethra and vagina
Correct Answer: A
Rationale: The correct answer is A because the vulva comprises the labia majora, labia minora, clitoris, mons pubis, and vestibular glands. The labia majora and minora are outer and inner folds of skin, the clitoris is a sensitive organ, the mons pubis is a fatty area overlying the pubic bone, and the vestibular glands secrete lubrication. Choices B, C, and D are incorrect because they do not accurately represent the structures of the vulva. B refers to male reproductive structures, C to internal female organs, and D to specific openings rather than the entire vulva.
All of the following clinical features would be expected with 'postpartum blues' (adjustment reaction with depressed mood) EXCEPT
- A. frequent tearfulness
- B. irritability
- C. suicidal ideation
Correct Answer: C
Rationale: Suicidal ideation is not typical of postpartum blues and may indicate a more serious condition like postpartum depression or psychosis.