Nokea
Cord presentation is when the
- A. Umbilical cord lies in front of the presenting part after the membranes have ruptured.
- B. Umbilical cord lies in front of the presenting part before membranes have ruptured
- C. Umbilical cord is tied around the fetal neck.
- D. Umbilical cord has prematurely been detached.
Correct Answer: A
Rationale: The correct answer is A because cord presentation occurs when the umbilical cord lies in front of the presenting part after the membranes have ruptured. This can lead to compression of the cord during labor, affecting fetal oxygenation. Option B is incorrect as it describes cord prolapse, where the cord lies in front of the presenting part before membrane rupture. Option C describes nuchal cord, where the cord is wrapped around the fetal neck. Option D describes cord abruption, where the cord detaches prematurely from the placenta.
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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 the submentobregmatic diameter. This is because in brow presentation, the fetal head is partially extended, causing the forehead (bregma) to be the presenting part. The submentobregmatic diameter is the distance between the chin (mentum) and the highest point of the forehead (bregma). This diameter is crucial for successful delivery in brow presentation as it is the smallest diameter that must pass through the maternal pelvis.
Summary of other choices:
B: Suboccipitofrontal - This diameter is not relevant in brow presentation as it involves the back of the head.
C: Occipitalfrontal - This diameter is the distance between the back of the head and the forehead, also not relevant in brow presentation.
D: Mentovertical - This diameter is the distance between the chin and the vertex of the head, not the forehead.
Greatly reduced eliminations and red rosy appearance of face are among the features of
- A. Hypothermia neonatorum
- B. Hypoglycemia neonatorum
- C. Hyperthermia neonatorum
- D. Hypocalcemia neonatorum
Correct Answer: C
Rationale: Certainly! The correct answer is C: Hyperthermia neonatorum. Greatly reduced eliminations and a red rosy appearance of the face are indicative of hyperthermia, which is an elevated body temperature. This condition can lead to dehydration and other complications.
A: Hypothermia neonatorum is characterized by low body temperature, not elevated.
B: Hypoglycemia neonatorum refers to low blood sugar levels, not related to the symptoms mentioned.
D: Hypocalcemia neonatorum is a deficiency of calcium in the blood, not associated with the given features.
In summary, hyperthermia neonatorum is the correct answer due to the specific symptoms presented, while the other choices do not align with the described features.
The commonest major cause of primary postpartum haemorrhage is
- A. Trauma of the genital tract
- B. Blood coagulation disorder
- C. Prolonged 3rd stage
- D. Atony of the uterus
Correct Answer: D
Rationale: Step 1: Atony of the uterus is the most common cause of primary postpartum hemorrhage due to inadequate uterine contractions.
Step 2: Trauma of the genital tract can lead to bleeding but is not as common as atony of the uterus in postpartum hemorrhage.
Step 3: Blood coagulation disorder can contribute to excessive bleeding but is not the primary cause of postpartum hemorrhage.
Step 4: Prolonged 3rd stage can result in postpartum hemorrhage but is typically secondary to uterine atony.
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: C
Rationale: The correct answer is C: Fluoroquinolone antibiotics. In this case, the patient presents with signs of sepsis and urinary retention, which are indicative of a possible prostatic abscess. Administering fluoroquinolone antibiotics could potentially mask the symptoms and delay further evaluation and treatment of the abscess. This can lead to worsening infection and sepsis. Therefore, the AGACNP should avoid prescribing fluoroquinolones until further evaluation is done to confirm or rule out a prostatic abscess.
Incorrect choices:
A: Digital prostate examination - This could help in assessing the prostate for abscess or other abnormalities.
B: Urinary catheterization - Necessary to relieve bladder distention and assess urine output.
D: Drainage of prostate abscess - If confirmed, drainage would be the appropriate intervention to address the abscess.
Specific management of moderate pre-eclampsia involves
- A. Admission at first contact
- B. Managing as an outpatient case
- C. Admission in the intensive care unit
- D. Encouraging plenty of oral fluids
Correct Answer: B
Rationale: Correct Answer: B (Managing as an outpatient case)
Rationale:
1. Moderate pre-eclampsia indicates stable condition.
2. Outpatient management allows close monitoring without hospitalization.
3. Early intervention can prevent progression to severe pre-eclampsia.
4. Hospital admission is reserved for severe cases or complications (not moderate).
5. Encouraging fluids is important, but not the specific management for pre-eclampsia.