Nokea
Classical caesarean section is indicated for
- A. An anteriorly situated placenta praevia
- B. A posteriorly situated placenta praevia
- C. A gestation of more than 32 weeks
- D. Aesthetic purpose on maternal request
Correct Answer: A
Rationale: The correct answer is A because in cases of anteriorly situated placenta praevia, where the placenta partially or completely covers the cervix, a classical caesarean section is indicated to prevent severe bleeding during delivery. For choice B, a posteriorly situated placenta praevia does not necessitate a classical caesarean section. Choice C, gestation of more than 32 weeks, does not specifically indicate the need for a classical caesarean section. Choice D, aesthetic purpose on maternal request, is not a valid medical indication for a classical caesarean section.
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A correct statement about shoulder dystocia is
- A. It is an impaction of the anterior shoulder after delivery of the head
- B. It is an impaction of the posterior shoulder after delivery of the head
- C. Shoulder dystocia occurs due to compound presentation of the fetus
- D. Shoulder dystocia is not an emergency and resolves on its own effort gradually
Correct Answer: A
Rationale: Rationale for Correct Answer (A): Shoulder dystocia is an impaction of the anterior shoulder after delivery of the head because the anterior shoulder gets stuck behind the pubic symphysis during childbirth. This can lead to serious complications for both the mother and the baby if not managed promptly.
Summary of Incorrect Choices:
B: Impaction of the posterior shoulder is not referred to as shoulder dystocia; it is the impaction of the anterior shoulder that causes the complication.
C: Shoulder dystocia is not caused by a compound presentation of the fetus, which refers to a situation where more than one fetal part presents at the maternal pelvis simultaneously.
D: Shoulder dystocia is indeed an emergency that requires immediate intervention, as delays can lead to birth injuries and complications. It does not resolve on its own and needs medical assistance.
Which one of the following statements is CORRECT with regards to precipitate delivery?
- A. May lead to uterine atony due to the moderate contractions experienced by client
- B. Puerperal sepsis is likely to result from unhygienic measures incorporated post-natally
- C. With adequate monitoring of the prenatal mother, precipitate delivery minimally recurs
- D. May cause cervical lacerations because of rapid descent and delivery of the baby
Correct Answer: D
Rationale: The correct answer is D because precipitate delivery, characterized by rapid descent and delivery of the baby, can cause cervical lacerations due to the fast and forceful passage of the baby through the birth canal. This can result in tearing of the cervical tissue. Choice A is incorrect because uterine atony is not typically associated with precipitate delivery. Choice B is incorrect as puerperal sepsis is not directly related to the speed of delivery. Choice C is incorrect as the occurrence of precipitate delivery does not guarantee reduced risk of recurrence with prenatal monitoring.
What is the most common cause of fetal distress during labor?
- A. Umbilical cord prolapse
- B. Uterine rupture
- C. Placental insufficiency
- D. Fetal position
Correct Answer: C
Rationale: The correct answer is C: Placental insufficiency. Placental insufficiency can lead to decreased oxygen and nutrient supply to the fetus, causing fetal distress during labor. This can result in abnormal fetal heart rate patterns and potential complications.
A: Umbilical cord prolapse can also cause fetal distress but is less common than placental insufficiency.
B: Uterine rupture is a serious complication but typically presents with maternal symptoms rather than fetal distress.
D: Fetal position can impact labor progress but is not typically the primary cause of fetal distress.
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.
The AGACNP knows that when evaluating a patient with suspected acute pyelonephritis, which of the following is not a common feature?
- A. Pyuria
- B. Fever
- C. CVA tenderness
- D. Gross hematuria
Correct Answer: A
Rationale: The correct answer is A: Pyuria. Pyuria is a common feature in acute pyelonephritis, as it indicates the presence of white blood cells in the urine due to the infection. Fever, CVA tenderness, and gross hematuria are all common features of acute pyelonephritis. Fever is a systemic response to infection, CVA tenderness indicates inflammation of the kidney, and gross hematuria is often seen due to inflammation and damage to the kidney tissue. Therefore, the absence of pyuria would be unexpected in a patient with suspected acute pyelonephritis.