Caesarean section performed at 30 gestational weeks is BEST performed through a
- A. Lower segment incision
- B. Upper segment incision
- C. Extra-peritoneal incision
- D. Classical type of incision
Correct Answer: A
Rationale: A lower segment incision is the best choice for a cesarean section at 30 weeks gestation.
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Postmaturity is pregnancy equal to or more than
- A. 38 completed weeks
- B. 42 completed weeks
- C. 40 completed weeks
- D. 36 completed weeks
Correct Answer: B
Rationale: Postmaturity refers to pregnancies that last beyond 42 weeks.
Why is adequate prenatal care crucial for reducing maternal mortality?
- A. Early detection of complications
- B. Encourages healthy behaviors
- C. Reduces the likelihood of preterm birth
- D. All of the above
Correct Answer: D
Rationale: Prenatal care helps detect complications, promotes healthy behaviors, and reduces preterm birth risk.
R. R. is a 61-year-old male patient who presents with a chief complaint of fever and urinary symptoms. He was in his usual state of good health when for no apparent reason he developed pain in his back and perineal region, as well as fever and chills. He presents as septic. He had urinary hesitancy and decreased stream but now reports that he has not passed urine in more than 12 hours. Palpation of the lower abdomen is consistent with bladder distention. The AGACNP knows that which of the following is contraindicated in this circumstance?
- A. Digital prostate examination
- B. Urinary catheterization
- C. Fluoroquinolone antibiotics
- D. Drainage of prostate abscess
Correct Answer: D
Rationale: In a patient with suspected prostatic abscess and urinary retention, urinary catheterization is contraindicated due to the risk of spreading infection and causing potential complications such as septicemia or worsening of the abscess. The introduction of a catheter can disrupt the abscess capsule, leading to dissemination of the infection. Therefore, other methods of decompression and treatment should be considered, such as drainage of the abscess or other appropriate interventions guided by a healthcare provider.
The AGACNP is managing a patient in the ICU who is being treated for a pulmonary embolus. Initially the patient was stable, awake, alert, and oriented, but during the last several hours the patient has become increasingly lethargic. At change of shift, the oncoming staff nurse appreciates a profound change in the patients mental status from the day before. Vital signs and hemodynamic parameters are as follows BP 8854 mm Hg Pulse 110 bpm Respiratory rate 22 breaths per minute SaO2 93 on a 50 mask Systemic vascular resistance (SVR) 1600 dynes seccm5 Cardiac index 1.3 Lmin Pulmonary capillary wedge pressure (PCWP) 8 mm Hg This clinical picture is most consistent with which shock state?
- A. Hypovolemic
- B. Cardiogenic
- C. Distributive
- D. Obstructive
Correct Answer: B
Rationale: The patient's presentation with low blood pressure, tachycardia, tachypnea, decreased oxygen saturation, and altered mental status is most consistent with distributive shock. Distributive shock is characterized by systemic vasodilation and decreased systemic vascular resistance (SVR), leading to inadequate perfusion of tissues and organs despite normal or high cardiac output. In this case, the low SVR (1600 dynes ∙ sec/cm5) and low blood pressure indicate vasodilation. The patient's pulmonary capillary wedge pressure (PCWP) of 8 mm Hg is not consistent with cardiogenic shock, where elevated PCWP would be expected. Additionally, there are no signs of obstructive shock, such as a history of pulmonary embolism but rather clinical findings that suggest distributive shock. Hypovolemic shock would typically present with signs of volume depletion and would be less likely in this patient with stable mental status initially.
Which one of the following is a prerequisite for forceps delivery?
- A. Intact membranes
- B. Ruptured membranes
- C. Cephalic presentation
- D. Full urinary bladder
Correct Answer: B
Rationale: Ruptured membranes are a prerequisite for forceps delivery to avoid injury to the membranes.