Nokea
In uterine inversion, the last part to be replaced is the
- A. Cervix
- B. Fundus
- C. Isthmus
- D. Body
Correct Answer: B
Rationale: In uterine inversion, the fundus is the last part to be replaced due to its position being the deepest inside the vagina. The fundus is the upper portion of the uterus and is the last part to invert back into its normal position. The cervix, isthmus, and body are parts of the uterus that are more easily replaced during the process of uterine inversion. The fundus being the final part to be replaced ensures the uterus is fully restored to its correct orientation.
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A neonate of a smear-negative mother just before birth receives BCG as usual.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: A
Rationale: The correct answer is A because BCG vaccination is recommended for newborns regardless of maternal smear status to prevent tuberculosis. The neonate is at risk of TB exposure postnatally and needs protection. Maternal smear status does not affect the indication for BCG in the newborn. Choice B is incorrect because withholding BCG in this case would leave the neonate vulnerable to TB. Choices C and D are not applicable as they do not provide any information.
Delivery of breech with an extended head is accomplished through
- A. Burns Marshall maneuver
- B. Lovset maneuver
- C. Mauriceau-Smellie-Veit
- D. McRobert’s maneuver
Correct Answer: C
Rationale: The correct answer is C: Mauriceau-Smellie-Veit maneuver for delivery of breech with an extended head. This maneuver involves flexing the head while still in the vagina to allow for easier delivery. The Burns Marshall maneuver (A) is for impacted fetal shoulders, Lovset maneuver (B) is for shoulder dystocia, and McRobert's maneuver (D) is for shoulder dystocia as well. The Mauriceau-Smellie-Veit maneuver is specifically designed for delivering a breech with an extended head, making it the correct choice in this scenario.
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.
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.
The AGACNP is rounding on a patient following splenectomy for idiopathic thrombocytopenia purpura. On postoperative day 2, a review of the laboratory studies is expected to reveal
- A. Increased MCV
- B. Increased Hgb
- C. Increased platelets
- D. Increased albumin
Correct Answer: B
Rationale: Step 1: Post-splenectomy, platelet count typically drops temporarily, leading to a risk of bleeding.
Step 2: To compensate, the body increases hemoglobin (Hgb) levels to maintain oxygen-carrying capacity.
Step 3: Therefore, on postoperative day 2, an increased Hgb level is expected.
Summary: A is incorrect because MCV is not typically affected in this scenario. C is incorrect because platelet count usually decreases post-splenectomy. D is incorrect as albumin levels are not directly impacted by splenectomy for ITP.