Perception and reaction to labor pain is highly influenced by
- A. Labor preparedness and fatigue
- B. Culture and level of education
- C. Culture and age of the woman
- D. Number of deliveries and anxiety
Correct Answer: B
Rationale: The correct answer is B - Culture and level of education. Culture influences beliefs about pain and coping mechanisms. Education can affect understanding of pain and pain management techniques. Labor preparedness and fatigue (A) may impact pain perception but are not as influential. Age (C) alone does not determine pain perception. Number of deliveries and anxiety (D) can play a role but are not as significant as culture and education.
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What role does the placenta play in managing fetal waste products?
- A. Filters toxins
- B. Facilitates nutrient absorption
- C. Removes carbon dioxide
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because the placenta performs multiple functions in managing fetal waste products. It filters toxins, facilitates nutrient absorption, and removes carbon dioxide. The placenta acts as a barrier between the mother and the fetus, allowing for the exchange of nutrients and waste products. Therefore, all of the above choices are correct in describing the role of the placenta in managing fetal waste products. The other choices are incorrect because they do not encompass all the functions that the placenta serves in this context.
Which one of the following signs is indicative of possible shoulder dystocia during delivery?
- A. Failure of internal rotation of the head
- B. Fetal head retracts against the perineum
- C. Gentle traction aids in effecting the delivery
- D. The occiput slowly restitutes towards the left side
Correct Answer: B
Rationale: The correct answer is B: Fetal head retracts against the perineum. This sign indicates possible shoulder dystocia as it suggests the baby's shoulders are impacted and unable to pass through the birth canal. The retraction of the fetal head against the perineum is a classic sign of shoulder dystocia, which requires specific maneuvers to dislodge the shoulders and facilitate delivery.
A: Failure of internal rotation of the head is not specific to shoulder dystocia.
C: Gentle traction should not be applied in cases of shoulder dystocia as it can worsen the situation.
D: The occiput restituting towards the left side is not a sign of shoulder dystocia, as it refers to the rotation of the fetal head during delivery.
Vaginal delivery is possible in
- A. Brow presentation
- B. Face presentation
- C. Shoulder presentation
- D. Unstable lie
Correct Answer: B
Rationale: The correct answer is B: Face presentation. Vaginal delivery is possible in face presentation as the fetus is in a position where the face is presenting first, allowing for delivery. In this presentation, the chin is usually tucked onto the chest, making it easier for the baby's head to pass through the birth canal.
A: Brow presentation is incorrect because it indicates the baby's head is extended slightly, making it more difficult for vaginal delivery.
C: Shoulder presentation is incorrect as it can lead to a shoulder dystocia, making vaginal delivery dangerous and difficult.
D: Unstable lie is incorrect because it refers to the baby being in a transverse position, making vaginal delivery impossible without intervention.
The AGACNP knows that treatment for this likely will include
- A. Observation
- B. Hyperextension casting
- C. Jewett brace
- D. Surgical intervention
Correct Answer: A
Rationale: The correct answer is A: Observation. As an AGACNP, observation is crucial for monitoring the progression of the condition before considering any invasive treatments. Hyperextension casting (B) and Jewett brace (C) are more specific interventions for spinal conditions and not typically indicated for this scenario. Surgical intervention (D) is typically considered only if conservative treatments fail, making it a last resort option. Therefore, observation allows for a conservative approach to assess the patient's response to initial management before considering more aggressive interventions.
Signs of obstructed labor per vaginally include
- A. Dry vagina, Oedema of the cervix, Caput succedaneum
- B. Plenty amniotic fluid, Hot/dry vagina, meconium stained liquor
- C. Meconium stained liquor, Hot/dry vagina, Diluted urine
- D. Caput succedaneum, Oedema of the cervix, plenty amniotic fluid
Correct Answer: A
Rationale: The correct answer is A because signs of obstructed labor include a dry vagina due to prolonged pressure, oedema of the cervix due to prolonged contractions, and caput succedaneum which is swelling of the baby's scalp from prolonged pressure.
Choice B is incorrect because plenty of amniotic fluid is not a sign of obstructed labor. A hot/dry vagina is not a typical sign of obstructed labor. Meconium-stained liquor can be a sign of fetal distress, but not specifically obstructed labor.
Choice C is incorrect because meconium-stained liquor is a sign of fetal distress, not necessarily obstructed labor. A hot/dry vagina is not a typical sign of obstructed labor. Diluted urine is not a typical sign of obstructed labor.
Choice D is incorrect because while caput succedaneum is a sign of obstructed labor, oedema of the cervix is more indicative of obstructed labor than plenty of amni