Nokea
Complete uterine rupture: b) Define complete uterine rupture
- A. Rupture involving only the serosa
- B. Rupture involving the entire uterine layers
- C. A tear without uterine contractions
- D. None of the above
Correct Answer: B
Rationale: Complete uterine rupture involves a full-thickness disruption of all uterine layers, including the serosa, myometrium, and endometrium. This leads to a complete separation of the uterine wall, potentially resulting in severe bleeding and fetal distress. Choice A is incorrect as it only involves the outermost layer of the uterus. Choice C is incorrect as uterine contractions are usually present during uterine rupture. Choice D is incorrect as the correct definition of complete uterine rupture involves the entire uterine layers being affected.
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The earliest onset of cephalohematoma is
- A. Six hours postnatally
- B. Twelve hours postnatally
- C. Eighteen hours postnatally
- D. Immediately after birth
Correct Answer: A
Rationale: The correct answer is A: Six hours postnatally. Cephalohematoma is a collection of blood between a baby's skull and the periosteum. It typically appears several hours after birth due to trauma during delivery, causing bleeding under the periosteum. This allows time for the blood to accumulate and form a distinct swelling, making the onset around six hours postnatally. Choices B, C, and D are incorrect as they do not align with the typical timeline for the development of cephalohematoma.
The type of cord prolapse characterized by presence of the fetal umbilical cord alongside the presenting part is
- A. Occult umbilical cord prolapse
- B. Overt umbilical cord prolapse
- C. Funic cord prolapse
- D. Complete cord prolapse
Correct Answer: C
Rationale: The correct answer is C: Funic cord prolapse. Funic cord prolapse is characterized by the fetal umbilical cord being alongside the presenting part. This type of cord prolapse is a more specific term used to describe the exact position of the cord in relation to the presenting part.
The other choices are incorrect because:
- A: Occult umbilical cord prolapse refers to a hidden or concealed cord prolapse, where the cord is not visible externally.
- B: Overt umbilical cord prolapse is when the cord is visible externally before the presenting part.
- D: Complete cord prolapse implies that the entire cord has descended through the cervix before the presenting part, not just alongside it.
Therefore, the correct choice is C as it accurately describes the specific positioning of the umbilical cord in relation to the presenting part during cord prolapse.
Janice is a 32-year-old female who presents for evaluation of abdominal pain. She has no significant medical or surgical history and denies any history of ulcers, reflux, or gastritis. However, she is now in significant pain and is afraid something is really wrong. She describes what started out as a dull discomfort in the upper part of her stomach a few hours ago but has now become more profound and centered on the right side just under her ribcage. She has not vomited but says she feels nauseous. Physical exam reveals normal vital signs except for a pulse of 117 bpm. She is clearly uncomfortable, and palpation of the abdomen reveals tenderness with deep palpation of the right upper quadrant. The AGACNP orders which imaging study to investigate the likely cause?
- A. Abdominal radiographs
- B. CT scan of the abdomen with contrast
- C. Right upper quadrant ultrasound
- D. A HIDA scan
Correct Answer: D
Rationale: The correct answer is D: A HIDA scan. A HIDA scan is the most appropriate imaging study for investigating the likely cause in this case because the patient's symptoms (abdominal pain centered on the right side just under the ribcage, tenderness in the right upper quadrant) are suggestive of a possible gallbladder issue, such as cholecystitis or biliary colic. A HIDA scan is specifically used to evaluate the gallbladder and biliary system.
A: Abdominal radiographs would not provide detailed information about the gallbladder or biliary system, and are not the best choice in this scenario.
B: A CT scan of the abdomen with contrast can be helpful in some situations, but it may not provide the specific information needed to evaluate the gallbladder and biliary system.
C: Right upper quadrant ultrasound is a good initial imaging study for evaluating gallbladder disease, but a HIDA scan is more specific for functional assessment of
The presenting diameter in brow presentation is
- A. Submentobregmatic
- B. Suboccipitofrontal
- C. Occipitalfrontal
- D. Mentovertical
Correct Answer: A
Rationale: The presenting diameter in brow presentation is Submentobregmatic (choice A) because it refers to the distance from the submentum (chin) to the bregma (anterior fontanelle). This is the appropriate measurement for the brow presentation as the brow is the prominent part between the forehead and the chin.
Choice B (Suboccipitofrontal) is incorrect because it refers to the distance from the subocciput to the frontal bone, which is not relevant to brow presentation.
Choice C (Occipitalfrontal) is incorrect because it describes the distance from the occiput to the frontal bone, which again is not specific to brow presentation.
Choice D (Mentovertical) is incorrect as it denotes the distance from the chin to the vertex, which is not the relevant measurement for brow presentation.
The relationship between abdominal pain and vomiting typically can be characterized by saying
- A. When the vomiting precedes pain, the likelihood of surgical abdomen increases appreciably
- B. Conditions that may produce only mild nausea in the younger patient often will cause vomiting in older patients
- C. The majority of surgical abdomens do not produce vomiting as a primary symptom
- D. The presence of bile in vomitus suggests pyloric stenosis
Correct Answer: D
Rationale: Step 1: The presence of bile in vomitus suggests that the vomit originated from the small intestine or stomach, indicating an obstruction in the pyloric region.
Step 2: Pyloric stenosis is a condition characterized by narrowing of the opening from the stomach to the small intestine, leading to projectile vomiting with bile.
Step 3: Therefore, the presence of bile in vomitus suggests pyloric stenosis, making option D the correct answer.
Summary: Option A is incorrect because vomiting preceding pain does not necessarily indicate a surgical abdomen. Option B is incorrect as the severity of symptoms is not solely based on age. Option C is incorrect as some surgical abdomens can present with vomiting as a primary symptom.