Nokea
Diagnosis of occipito-posterior position:
- A. External examination and ultrasound
- B. Physical exam with pelvic exam findings
- C. Regular contractions and maternal discomfort
- D. Both A and B
Correct Answer: D
Rationale: Step-by-step rationale:
1. External examination can reveal the position of the baby's head.
2. Ultrasound can confirm the baby's position accurately.
3. Physical exam and pelvic exam findings can provide additional information.
4. Combining both methods (A and B) ensures a comprehensive assessment for accurate diagnosis.
Summary:
- Choice A alone may not provide sufficient information.
- Choice B alone may not be as accurate as combined with ultrasound.
- Choice C is not specific to diagnosing occipito-posterior position.
- Choice D is correct as it combines external examination, ultrasound, and physical exam for accurate diagnosis.
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Which of the following is NOT a source of pain in labour?
- A. Uterine contractions
- B. Socio-cultural norms
- C. Cervical dilatation
- D. Pelvic floor stretching
Correct Answer: B
Rationale: Step 1: Uterine contractions are a physiological process in labor causing pain due to muscle contractions.
Step 2: Cervical dilatation involves the opening of the cervix, which can cause pain and discomfort.
Step 3: Pelvic floor stretching occurs as the baby moves through the birth canal, leading to pain.
Step 4: Socio-cultural norms do not directly cause physical pain in labor, making choice B the correct answer. Other choices directly relate to physical processes causing pain.
Causes of puerperal pyrexia are entirely obstetrically related.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: Step 1: Puerperal pyrexia refers to fever occurring after childbirth.
Step 2: Causes can be obstetric (infection) or non-obstetric (e.g., urinary tract infection).
Step 3: Non-obstetric causes are also common postpartum.
Step 4: Therefore, puerperal pyrexia is not entirely obstetrically related.
Step 5: Hence, the correct answer is B (FALSE).
Mr. Costigan is a 50-year-old male patient who recently had a screening colonoscopy because it was recommended by his primary care provider as a screening measure. He received a report that noted inflammatory polyps. He is concerned because one of his friends had polyps that turned into cancer. While advising Mr. Costigan, the AGACNP tells him that
- A. The polyps are considered precancerous, but if he has a colonoscopy every 3 to 5 years, any new polyps can be removed before they become malignant
- B. The primary danger is when there is a family history of colon cancer; he should discuss with his mother and father the presence of any colon cancer in the family
- C. There is no chance that these polyps could become cancerous, and their presence does not require any additional action or concern on his part
- D. He would be best served at this point to discuss with an oncologist the risks and benefits of aggressive versus conservative treatment.
Correct Answer: B
Rationale: Step 1: Family history of colon cancer is a significant risk factor for developing colon cancer.
Step 2: By discussing with his parents, Mr. Costigan can determine if there is a family history of colon cancer.
Step 3: Knowing this information can help assess his own risk and guide appropriate screening and preventive measures.
Step 4: The primary danger for Mr. Costigan lies in potential genetic predisposition rather than the presence of inflammatory polyps.
Step 5: Therefore, discussing with family members about any history of colon cancer is crucial for his overall risk assessment and management.
Summary:
- Choice A is incorrect as the frequency of colonoscopy should be individualized based on the patient's risk factors.
- Choice C is incorrect as all polyps have the potential to become cancerous, especially inflammatory polyps.
- Choice D is incorrect as consulting an oncologist at this stage is premature without first assessing family history.
Icterus gravis and hydrops fetalis are conditions highly associated with:
- A. Rhesus D incompatibility
- B. ABO incompatibility
- C. Physiological jaundice
- D. Instant perinatal death
Correct Answer: A
Rationale: The correct answer is A: Rhesus D incompatibility. Icterus gravis and hydrops fetalis are conditions associated with hemolytic disease of the newborn, caused by Rhesus D incompatibility between the mother and fetus. This occurs when the mother is Rh-negative and the baby is Rh-positive, leading to the production of antibodies by the mother that attack the baby's red blood cells. This can result in severe jaundice (icterus gravis) and excessive fluid accumulation in the fetus (hydrops fetalis).
Summary:
- Choice B (ABO incompatibility) is incorrect because it typically causes less severe jaundice and anemia compared to Rhesus D incompatibility.
- Choice C (Physiological jaundice) is incorrect as it is a common benign condition in newborns due to immature liver function.
- Choice D (Instant perinatal death) is incorrect as it does not specifically relate to the conditions mentioned.
Obstructed labor MAINLY results due to
- A. Maternal exhaustion
- B. Cephalopelvic disproportion
- C. Microsomic fetus
- D. Fetal exsanguination
Correct Answer: B
Rationale: The correct answer is B: Cephalopelvic disproportion. This condition occurs when the baby's head is too large to pass through the mother's pelvis during labor. This leads to obstructed labor, causing complications for both the mother and the baby. Maternal exhaustion (A) may occur as a result of prolonged labor but is not the primary cause of obstructed labor. Microsomic fetus (C) refers to a small baby and would not typically cause obstructed labor. Fetal exsanguination (D) is the loss of blood from the fetus and is not a common cause of obstructed labor. Cephalopelvic disproportion is the most common reason for obstructed labor as it directly affects the passage of the baby through the birth canal.