Nokea
Bipartite placenta and succenturiate lobe are causes of
- A. Placenta abruptio
- B. Placenta calcification
- C. Placenta praevia
- D. Placental insufficiency
Correct Answer: D
Rationale: The correct answer is D: Placental insufficiency. A bipartite placenta and succenturiate lobe are structural abnormalities that can lead to placental insufficiency. This is because these conditions can interfere with proper blood flow and nutrient exchange between the mother and fetus, resulting in decreased oxygen and nutrients reaching the fetus, leading to placental insufficiency. Placental abruption (choice A), placental calcification (choice B), and placenta previa (choice C) are not directly associated with bipartite placenta or succenturiate lobe and do not specifically cause placental insufficiency.
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Delivery of the head in a complete breech presentation is usually accomplished through
- A. Lovset maneuver
- B. Mauriceau-Smellie-Veit
- C. Burns Marshall method
- D. Gentle traction of the neck
Correct Answer: B
Rationale: The correct answer is B: Mauriceau-Smellie-Veit. This method involves flexing the hips, extending the thighs, and applying suprapubic pressure to deliver the head in a complete breech presentation. This technique helps to avoid hyperextension of the neck and potential spinal cord injury. The Lovset maneuver (A) is used for delivering the arms in a breech presentation. The Burns Marshall method (C) involves performing an episiotomy and delivering the baby by flexion and traction on the legs. Gentle traction of the neck (D) is not recommended as it can cause spinal cord injury. Mauriceau-Smellie-Veit is the preferred method for safe delivery of the head in a complete breech presentation.
Use of bed cradle in the management of leg thrombosis is meant to:
- A. Keep the legs straight
- B. Prevent embolism
- C. Control body temperature
- D. Promote venous drainage
Correct Answer: D
Rationale: The use of bed cradle in leg thrombosis management is to promote venous drainage. Elevating the legs on a bed cradle helps improve blood flow back to the heart, reducing swelling and preventing blood clots. Keeping the legs straight (A) is not the main purpose. Preventing embolism (B) is important but not the direct purpose of a bed cradle. Controlling body temperature (C) is unrelated to the use of a bed cradle for leg thrombosis.
P. T. is a 58-year-old female who is admitted with chest pain and shortness of breath and is found to have a large pulmonary embolus. Her systolic blood pressure is falling, and a diagnosis of obstructive shock is made. Cardiac pressure would likely demonstrate
- A. Elevated atrial and decreased ventricular pressures
- B. Elevated right-sided and decreased left-sided pressures
- C. Elevated left ventricular pressure and decreased cardiac output
- D. Elevated left ventricular pressure and decreased systemic vascular resistance
Correct Answer: C
Rationale: The correct answer is C because in obstructive shock due to a large pulmonary embolus, there is increased resistance to blood flow out of the right ventricle, leading to elevated right ventricular pressure. This causes a backup of blood into the pulmonary circulation, increasing left ventricular pressure. The increased left ventricular pressure results in decreased cardiac output as the left ventricle struggles to pump against the increased resistance.
A: Elevated atrial and decreased ventricular pressures - This is incorrect as obstructive shock typically results in elevated ventricular pressures due to increased resistance.
B: Elevated right-sided and decreased left-sided pressures - This is partially true, but C is a more complete answer that explains the consequences of these pressures on cardiac output.
D: Elevated left ventricular pressure and decreased systemic vascular resistance - This is incorrect as obstructive shock leads to increased, not decreased, systemic vascular resistance due to the embolus obstructing blood flow.
The AGACNP knows that which of the following must be evaluated as a cause of her abdominal pain?
- A. HELLP syndrome
- B. Placental abruption
- C. Spontaneous hepatic rupture
- D. Preterm labor
Correct Answer: A
Rationale: The correct answer is A: HELLP syndrome. This must be evaluated as a cause of abdominal pain in a pregnant patient because it is a serious condition characterized by hemolysis, elevated liver enzymes, and low platelet count. These abnormalities can lead to abdominal pain, especially in the right upper quadrant. Placental abruption (B) presents with vaginal bleeding and uterine tenderness, not specific abdominal pain. Spontaneous hepatic rupture (C) is rare and usually presents with sudden severe abdominal pain. Preterm labor (D) typically presents with regular uterine contractions and lower abdominal discomfort, not specific upper quadrant pain like in HELLP syndrome.
Which one of the following is an obstetric emergency?
- A. Aftercoming head in breech
- B. Complete cephalic presentation
- C. Complete breech presentation
- D. Complete rupture of the uterus
Correct Answer: D
Rationale: The correct answer is D, complete rupture of the uterus. This is an obstetric emergency due to the risk of severe bleeding and potential harm to both the mother and the fetus. A ruptured uterus can lead to life-threatening complications such as hemorrhage and shock. In contrast, options A, B, and C are not considered obstetric emergencies. Aftercoming head in breech, complete cephalic presentation, and complete breech presentation are normal variations in labor that do not typically require immediate intervention like a ruptured uterus does.