Nokea
How does the maternal microbiome influence the health of the fetus during pregnancy?
- A. By increasing fetal weight
- B. By altering immune development
- C. By reducing placental oxygen levels
- D. By enhancing amniotic fluid
Correct Answer: B
Rationale: The correct answer is B: By altering immune development. The maternal microbiome plays a crucial role in shaping the fetal immune system during pregnancy. Microbes in the mother's body can influence the development of the fetus's immune system through various mechanisms, such as immune cells crossing the placenta. This interaction helps the fetus develop tolerance to maternal antigens.
Choice A (By increasing fetal weight) is incorrect because the maternal microbiome's influence is not primarily related to weight gain. Choice C (By reducing placental oxygen levels) is incorrect as it does not directly relate to the immune system development. Choice D (By enhancing amniotic fluid) is incorrect as the main influence is on the immune system rather than amniotic fluid enhancement.
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Deep transverse arrest is
- A. Where flexion is always well maintained.
- B. Caused by strong uterine contractions throughout labor.
- C. Caused by a sacrum that is well curved.
- D. Where the level of the occiput and the sinciput is the same.
Correct Answer: D
Rationale: The correct answer is D because deep transverse arrest occurs when the level of the occiput and the sinciput is the same, leading to a failure of descent of the fetal head through the pelvis. This alignment issue hinders the progress of labor despite adequate contractions.
A: Incorrect. Flexion being well maintained is not a defining characteristic of deep transverse arrest.
B: Incorrect. While strong uterine contractions can contribute to labor challenges, deep transverse arrest is specifically related to the alignment of the fetal head.
C: Incorrect. The curvature of the sacrum is not directly related to deep transverse arrest.
Placental parasitation is associated with
- A. Candidiasis prenatally
- B. Tuberculosis prenatally
- C. Multiple gestation
- D. Malaria prenatally
Correct Answer: D
Rationale: Placental parasitation is associated with Malaria prenatally because the Plasmodium parasite can infect the placenta through the bloodstream, leading to severe complications for both the mother and the fetus. This infection can result in low birth weight, preterm birth, and even stillbirth. Candidiasis, Tuberculosis, and Multiple gestation are not directly associated with placental parasitation. Candidiasis is a fungal infection, Tuberculosis is a bacterial infection, and Multiple gestation refers to carrying more than one fetus during pregnancy. Therefore, the correct answer is D, Malaria prenatally, due to the direct impact of Plasmodium parasite on the placenta and its implications on pregnancy outcomes.
When counseling a patient about treatment modalities for achalasia, the AGACNP advised that which of the following is the treatment of choice?
- A. Calcium channel antagonists
- B. Intrasphincter botulinum injection
- C. Pneumatic dilation
- D. Myotomy and partial fundoplication
Correct Answer: A
Rationale: Rationale for choice A: Calcium channel antagonists are the treatment of choice for achalasia as they help relax the lower esophageal sphincter, improving swallowing. This is a non-invasive option that can provide symptom relief for many patients.
Summary for other choices:
B: Intrasphincter botulinum injection is a temporary solution and not considered the treatment of choice.
C: Pneumatic dilation is another option for achalasia but is typically used if calcium channel antagonists are ineffective.
D: Myotomy and partial fundoplication is a more invasive surgical option and usually considered if other treatments fail.
During induction of labor with syntocinon, drops increase is stopped prematurely on
- A. Achieving three moderate contractions
- B. Realizing normal maternal observations
- C. Achieving progressive cervical dilatation
- D. Observing normal fetal-related observations
Correct Answer: C
Rationale: Step-by-step rationale for choice C:
1. Progressive cervical dilatation indicates effective labor progress.
2. Stopping the syntocinon drops prematurely allows natural labor progression.
3. Prematurely stopping drops before reaching full dilation may hinder labor.
4. Achieving cervical dilatation is a crucial indicator for successful labor.
Summary:
A: Contractions should be strong, not just moderate.
B: Maternal observations alone do not determine labor progress.
D: Fetal-related observations are important but not the primary indicator for stopping drops.
In breech delivery, the midwife is advised to keep her hands off the breech as it progressively descends so as to
- A. Ascertain the fetal wellbeing in utero
- B. Allow enough room for the fetus to pass
- C. Allow gravitating descent of the fetus
- D. Prevent excessive traction being applied
Correct Answer: D
Rationale: The correct answer is D: Prevent excessive traction being applied. This is because in a breech delivery, excessive traction can lead to complications such as fetal injuries or umbilical cord prolapse. The midwife should avoid pulling on the baby's legs or body to prevent undue stress on the baby. The other choices are incorrect because: A: Ascertain the fetal wellbeing in utero - this is typically done through other means such as fetal monitoring. B: Allow enough room for the fetus to pass - this should be done by ensuring proper positioning and allowing natural descent. C: Allow gravitating descent of the fetus - this is not a recommended practice as it can cause complications.