Nokea
In deep transverse arrest,
- A. The occipito-frontal diameter is caught at the bispinous diameter of the pelvic outlet
- B. The sub-occipito-bregmatic diameter is caught at the bispinous diameter of pelvic outlet
- C. The resulting outcome is usually a face to pubis delivery
- D. The sagittal suture is found at the oblique diameter of the pelvis
Correct Answer: D
Rationale: The correct answer is D because in deep transverse arrest, the sagittal suture of the fetal head is typically aligned with the oblique diameter of the pelvis, causing an obstruction in the descent of the baby. This alignment leads to a difficult labor scenario where the baby's head cannot pass through the pelvis due to the mismatch in diameters. Choices A, B, and C are incorrect because they do not accurately describe the specific anatomical alignment that characterizes deep transverse arrest. Choice A refers to occipito-frontal diameter, choice B refers to sub-occipito-bregmatic diameter, and choice C mentions a face to pubis delivery, which are not the defining features of deep transverse arrest.
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For questions 91 & 92, match the following with the statements in column A by indicating the correct number
- A. Colicky uterus
- B. Constriction ring dystocia
- C. Precipitate labour
- D. Cervical dystocia
Correct Answer: C
Rationale: The correct answer is C: Precipitate labor. Precipitate labor refers to a rapid labor and delivery process. It is matched with the statement in column A because it is associated with a sudden and quick progression of labor, leading to a rapid delivery of the baby. The other choices are incorrect because:
A: Colicky uterus - This term is not related to rapid labor but rather refers to uterine contractions that are painful and intermittent.
B: Constriction ring dystocia - This term describes a condition where there is a tight band around the uterus, causing difficulty in the delivery process, which is different from the rapid progression seen in precipitate labor.
D: Cervical dystocia - This term refers to a condition where there are issues with the dilation or effacement of the cervix, not directly related to the speed of labor as in precipitate labor.
The AGACNP is evaluating a patient who reportedly fell down a flight of steps. Her history is significant for several emergency room visits, but she denies any significant medical conditions. Some documentation in her chart indicates that she may have been subjected to physical abuse. Today she presents with a periorbital ecchymosis of the left eye and swelling in the left side of the face. Her neurologic examination is within normal limits. Which head imaging study would be most useful in assessing for findings consistent with a history of abuse?
- A. Radiographs
- B. CT scan without contrast
- C. MRI
- D. PET scan
Correct Answer: B
Rationale: The correct answer is B: CT scan without contrast. A CT scan is the most useful imaging study in assessing for findings consistent with a history of abuse in this patient. CT scan is preferred for acute trauma to the head as it provides detailed images of the brain, skull, and facial bones. It can detect acute hemorrhages, fractures, or other signs of trauma. In this case, the patient's presentation with periorbital ecchymosis and facial swelling raises suspicion for traumatic injury, which can be assessed effectively with a CT scan.
Radiographs (choice A) are not as sensitive as CT scans in detecting subtle fractures or soft tissue injuries in the head and face. MRI (choice C) is not typically used in acute trauma assessment and may not provide timely information needed in this case. PET scan (choice D) is not indicated for evaluating traumatic head injuries and is more commonly used for assessing metabolic and functional activity in the body.
In laryngeal stridor, the noise is more marked during
- A. Inspiration
- B. Expiration
- C. Feeding
- D. Play
Correct Answer: A
Rationale: The correct answer is A: Inspiration. Laryngeal stridor is caused by narrowed or obstructed airway, resulting in noisy breathing. During inspiration, the air is drawn through the narrowed larynx, causing the stridor sound. During expiration, the air is leaving the body, so the noise may not be as prominent. Choices C and D, feeding and play, are unrelated to the respiratory process and do not affect the presence of laryngeal stridor.
The drug of choice in the management of eclampsia is
- A. Phenobarbitone
- B. Calcium gluconate
- C. Magnesium sulphate
- D. Sodium bicarbonate
Correct Answer: C
Rationale: The correct answer is C: Magnesium sulphate. It is the drug of choice in managing eclampsia due to its ability to prevent and control seizures. Magnesium sulfate is a central nervous system depressant that reduces neuronal excitability and neuromuscular transmission, thus preventing seizures. It also helps in lowering blood pressure and preventing complications. Phenobarbitone (A) is not the first-line treatment for eclampsia. Calcium gluconate (B) is used for calcium deficiency, not eclampsia. Sodium bicarbonate (D) is used to correct acidosis, not for managing eclampsia.
A maternal cause of shoulder presentation includes
- A. A sub-septate uterus
- B. Oligohydramnios
- C. Prematurity
- D. Multiple pregnancy
Correct Answer: B
Rationale: The correct answer is B: Oligohydramnios. Oligohydramnios leads to reduced volume of amniotic fluid, which can result in poor fetal movements and inadequate cushioning for the fetus. This can increase the likelihood of abnormal fetal positions like shoulder presentation. Other choices are incorrect because: A: A sub-septate uterus is a structural uterine abnormality and not directly related to shoulder presentation. C: Prematurity may lead to preterm labor but is not specifically associated with shoulder presentation. D: Multiple pregnancy can increase the risk of malpresentation but is not a direct maternal cause of shoulder presentation.