Nokea
Aims of exchange transfusion procedure includes:
- A. Cure of haemolysis and restoration of hemoglobin level
- B. Cure of hypoxia and removal of all toxic materials
- C. Stabilization of baby’s immune system and liver functions
- D. Control of haemolysis and restoration of hemoglobin level
Correct Answer: D
Rationale: The correct answer is D because the main aims of an exchange transfusion procedure are to control haemolysis (process of breaking down red blood cells) and restore hemoglobin levels. This procedure involves removing the baby's blood and replacing it with donor blood to prevent complications from severe jaundice or other conditions. Choice A is incorrect because exchange transfusion does not necessarily cure haemolysis, but it helps control it. Choice B is incorrect as the procedure focuses on managing specific issues rather than removing all toxic materials. Choice C is incorrect because it does not directly address the primary goals of an exchange transfusion.
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Incidental antepartum haemorrhage is also referred to as
- A. Intraplacental haemorrhage
- B. Intrapartum haemorrhage
- C. Extraplacental haemorrhage
- D. Preterm haemorrhage
Correct Answer: C
Rationale: The correct answer is C: Extraplacental haemorrhage. Incidental antepartum haemorrhage refers to bleeding from a source other than the placenta, such as the cervix or vagina, before delivery. Intraplacental haemorrhage (choice A) refers to bleeding within the placenta itself, not outside it. Intrapartum haemorrhage (choice B) occurs during labor and delivery, not before. Preterm haemorrhage (choice D) is not a specific term used to describe antepartum bleeding. Therefore, the correct term for antepartum bleeding from a non-placental source is extraplacental haemorrhage.
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 clinical presentation of sudden, severe upper abdominal pain not related to food intake, along with the patient's position (lying on right side with hips and knees flexed), and presence of involuntary guarding suggest acute pancreatitis. The elevated white blood cell count indicates an inflammatory process. Dissecting aortic aneurysm (A) typically presents with abrupt, severe chest or back pain radiating to the abdomen, with signs of shock. Perforated peptic ulcer (C) presents with sudden, severe abdominal pain often related to food intake, with signs of peritonitis. Mallory-Weiss tear (D) presents with hematemesis after forceful or prolonged vomiting.
Diagnosis of obstructed labour (Abdominal examination):
- A. Palpation of the abdomen
- B. Tenderness in the lower abdomen
- C. Softening of the cervix
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A: Palpation of the abdomen. To diagnose obstructed labor, palpation of the abdomen is essential to assess the position and size of the fetus, as well as the presence of uterine contractions and fetal heart rate. Tenderness in the lower abdomen may indicate other conditions, not necessarily obstructed labor. Softening of the cervix is a sign of impending labor but not specific to obstructed labor. Therefore, palpation of the abdomen is the most appropriate choice for diagnosing obstructed labor.
Vaginal birth after caesarean section is known as
- A. Spontaneous vaginal delivery
- B. Trial of scar
- C. Spontaneous vertex delivery
- D. Trial of birth
Correct Answer: B
Rationale: The correct answer is B: Trial of scar. This term specifically refers to the process of attempting a vaginal birth after a previous caesarean section. It involves monitoring the previous cesarean scar for any signs of complications during labor.
A: Spontaneous vaginal delivery refers to giving birth vaginally without any previous cesarean section.
C: Spontaneous vertex delivery simply describes the position of the baby's head during birth.
D: Trial of birth is not a commonly used term in obstetrics and does not specifically relate to VBAC.
Which of the following is an indication for forceps delivery?
- A. Cephalopelvic disproportion
- B. Occipito posterior position
- C. Breech presentation
- D. Placenta abruption
Correct Answer: B
Rationale: The correct answer is B: Occipito posterior position. Forceps delivery may be indicated in this situation to help rotate the baby's head and facilitate delivery. Occipito posterior position can lead to prolonged labor and fetal distress, making forceps delivery necessary for a safe delivery.
Incorrect choices:
A: Cephalopelvic disproportion is not an indication for forceps delivery as it refers to mismatch between the size of the baby's head and the mother's pelvis.
C: Breech presentation typically requires a different approach such as cesarean section rather than forceps delivery.
D: Placenta abruption, a medical emergency, would not be managed with forceps delivery but rather require immediate intervention to prevent harm to both the mother and baby.