Nokea
Kleihauer-Betke acid-elution test is recommended in the management of
- A. Moderate physiological jaundice
- B. Hemolytic jaundice prenatally
- C. Severe hepatosplenomegaly
- D. Hemolytic jaundice postnatally
Correct Answer: B
Rationale: The Kleihauer-Betke acid-elution test is recommended in the management of hemolytic jaundice prenatally because it helps determine the amount of fetal-maternal hemorrhage, which is crucial for assessing the need for Rh immune globulin administration to prevent Rh sensitization in Rh-negative mothers carrying Rh-positive fetuses. This test helps quantify the amount of fetal red blood cells in the maternal circulation, guiding appropriate management to prevent hemolytic disease of the newborn. The other choices (A, C, D) do not specifically require the Kleihauer-Betke test for management and are not directly related to fetal-maternal hemorrhage assessment.
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Use of bed cradle in the management of leg thrombosis is meant to:
- A. Keep the legs straight
- B. Prevent embolism
- C. Control body temperature
- D. Promote venous drainage
Correct Answer: D
Rationale: The use of bed cradle in leg thrombosis management is to promote venous drainage. Elevating the legs on a bed cradle helps improve blood flow back to the heart, reducing swelling and preventing blood clots. Keeping the legs straight (A) is not the main purpose. Preventing embolism (B) is important but not the direct purpose of a bed cradle. Controlling body temperature (C) is unrelated to the use of a bed cradle for leg thrombosis.
Five (5) major factors predisposed to uterine rupture:
- A. Previous C-section, uterine scars, fetal macrosomia, trauma, prolonged labor
- B. Malpresentation, premature rupture of membranes, obesity, malnutrition, anemia
- C. Uterine fibroids, excessive weight gain, smoking, poor prenatal care
- D. All of the above
Correct Answer: A
Rationale: Rationale for Correct Answer (A):
1. Previous C-section and uterine scars weaken the uterine wall.
2. Fetal macrosomia (large baby) increases pressure on the uterus.
3. Trauma can cause direct injury to the uterus.
4. Prolonged labor can lead to uterine overdistension and fatigue, increasing rupture risk.
Summary of Incorrect Choices:
B: Malpresentation, premature rupture of membranes, obesity, malnutrition, anemia are not direct factors for uterine rupture.
C: Uterine fibroids, excessive weight gain, smoking, poor prenatal care can contribute to complications but not primary causes of uterine rupture.
D: Not all factors in choices B and C are predisposing factors for uterine rupture, making this choice incorrect.
Which one of the following is an obstetric emergency?
- A. Aftercoming head in breech
- B. Complete cephalic presentation
- C. Complete breech presentation
- D. Complete rupture of the uterus
Correct Answer: D
Rationale: The correct answer is D, complete rupture of the uterus. This is an obstetric emergency due to the risk of severe bleeding and potential harm to both the mother and the fetus. A ruptured uterus can lead to life-threatening complications such as hemorrhage and shock. In contrast, options A, B, and C are not considered obstetric emergencies. Aftercoming head in breech, complete cephalic presentation, and complete breech presentation are normal variations in labor that do not typically require immediate intervention like a ruptured uterus does.
M. T. is a 71-year-old female who presents for evaluation of a lump on her chest. She denies any symptomsthere is no pain, erythema, edema, ecchymosis, or open areasit is just a lump. She has no idea how long it has been there and just noticed it a few weeks ago. Physical examination reveals a round, smooth, flesh-colored tumor. It is firm but not hard it has smooth borders. It measures 6 cm in diameter and is non-tender to palpation. The AGACNP suspects that this is a classic presentation of the most common chest wall tumor known as a
- A. Neurolemma
- B. Lipoma
- C. Hemangioma
- D. Lymphangioma
Correct Answer: B
Rationale: The correct answer is B: Lipoma. A lipoma is a common benign tumor made of fat cells. In this case, the patient's presentation of a painless, soft, round, flesh-colored lump with smooth borders is consistent with a lipoma. The absence of symptoms like pain, erythema, or tenderness further supports this diagnosis. Lipomas are usually non-tender to palpation and can grow to a significant size. The other choices (A, C, D) are not the correct answers because they do not align with the characteristics described in the patient's presentation. Neurolemma is associated with nerve sheath tumors, hemangioma with blood vessel tumors, and lymphangioma with lymphatic vessel tumors, none of which match the clinical findings in this case.
Which one of the following is an endogenous cause of puerperal sepsis?
- A. Chlamydia trachomatis
- B. Escherichia coli
- C. Clostridium tetani
- D. Pseudomonas aeruginosa
Correct Answer: B
Rationale: The correct answer is B: Escherichia coli. Puerperal sepsis is often caused by endogenous bacteria from the mother's own flora. E. coli is a common endogenous bacteria found in the gastrointestinal tract and can cause infection during childbirth. Chlamydia trachomatis is a sexually transmitted infection, not typically associated with puerperal sepsis. Clostridium tetani causes tetanus, not puerperal sepsis. Pseudomonas aeruginosa is an environmental pathogen, not typically an endogenous cause of puerperal sepsis.