Nokea
A primigravida is in second stage of labour for the past two hours. Fetal head is at +1 station. Inspite of effective uterine contractions,mother is unable to push as she is exhausted. What will be the next step in her management:
- A. Wait for another one hour.
- B. Give sedation to the mother.
- C. Shift her for emergency section.
- D. Instrumental delivery.
- E. Call the anaesthetist for regional anaesthesia.
Correct Answer: D
Rationale: Instrumental delivery (e.g. forceps or vacuum) is indicated for prolonged second stage due to maternal exhaustion provided the fetal head is engaged (+1 station). Cesarean section is considered if instrumental delivery is not feasible.
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The pathological retraction ring of Bandl is associated with:
- A. Preterm labour.
- B. Obstructed labour.
- C. Precipitate labour.
- D. Abruptio placenta.
- E. Chorioamnionitis.
Correct Answer: B
Rationale: Bandl’s ring a pathological retraction ring forms in obstructed labor due to prolonged intense uterine contractions leading to a visible ridge between the upper and lower uterine segments.
A primipara presents one week after delivery. She is tearful,has spells of cry and lack of appetite and sleep. What is the most likely diagnosis:
- A. Anaemia.
- B. Post-natal depression.
- C. Schizophrenia.
- D. Maniac disorders.
- E. High grade fever.
Correct Answer: B
Rationale: Post-natal depression is common in the first weeks postpartum presenting with tearfulness appetite loss and sleep disturbances. Other diagnoses are less likely without specific symptoms.
Which response by the nurse best explains why aspirin is preferred to acetaminophen (Tylenol) in the treatment of rheumatic fever?
- A. Aspirin controls fever better.
- B. Aspirin prevents infections.
- C. Aspirin relieves joint inflammation.
- D. Aspirin prevents cardiac enlargement.
Correct Answer: C
Rationale: Aspirin is preferred in rheumatic fever due to its anti-inflammatory properties, which relieve joint inflammation and pain associated with polyarthritis. Acetaminophen lacks significant anti-inflammatory effects, making aspirin more effective.
A 30 years old G3P2 at 28 weeks of gestation presents with severe pain in the right flank radiating to her groin. She also complaints of rigors and chills. Urine analysis reveals numerous pus cells. The most likely diagnosis is:
- A. Appendicitis.
- B. Pyelonephritis.
- C. Round ligament torsion.
- D. Meckel's diverticulum.
- E. Torsion of ovarian cyst.
Correct Answer: B
Rationale: Pyelonephritis a urinary tract infection affecting the kidneys presents with flank pain fever,chills,and pus cells in urine,as described. Appendicitis typically involves right lower quadrant pain and other options lack urinary findings or are less likely in pregnancy.
The mother of a healthy 15-hour-old term newborn asks the nurse if the PKU blood test could be completed now on her infant because she and her infant are being discharged to home. Which statement should be the basis for the nurse’s response?
- A. The PKU test must be completed when the infant is at least 1 month of age.
- B. The parents must be required to obtain the test within the first week after discharge if completed before 24 hours of age.
- C. The PKU test is best if completed after the infant is 24 hours old but before 7 days of age.
- D. The PKU test is not needed if the infant is tolerating feedings without diarrhea or vomiting.
Correct Answer: C
Rationale: The PKU test is most accurate after 24 hours and before 7 days allowing sufficient protein intake. Early discharge requires follow-up testing and feeding tolerance doesn’t exempt testing.