Nokea
Positive fasting blood sugar and oral glucose tolerance test, as well as being symptomatic, is diagnostic of
- A. Potential diabetes mellitus
- B. Gestational diabetes mellitus
- C. Clinical diabetes mellitus
- D. Chemical diabetes mellitus
Correct Answer: B
Rationale: The correct answer is B, Gestational diabetes mellitus. This condition is diagnosed when a pregnant woman exhibits symptoms of diabetes and has elevated fasting blood sugar and abnormal oral glucose tolerance test results. This specific combination of symptoms and test results during pregnancy points towards gestational diabetes mellitus.
A: Potential diabetes mellitus - Incorrect. The symptoms combined with abnormal test results suggest an active condition, not potential.
C: Clinical diabetes mellitus - Incorrect. While the symptoms and test results indicate diabetes, the context of pregnancy suggests gestational diabetes.
D: Chemical diabetes mellitus - Incorrect. This term is not commonly used in medical practice and does not specifically address the condition in the given scenario.
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The MOST immediate action to take for a client in active labor at 32 weeks with a cord prolapse is to
- A. Push the cord back into the uterus with a gloved hand
- B. Cover cord with sterile dry gauze
- C. Place the client in knee-chest position
- D. Prepare the client for immediate vaginal delivery
Correct Answer: C
Rationale: The correct answer is C: Place the client in knee-chest position. This helps relieve pressure on the cord and prevents further compression, ensuring adequate blood flow to the fetus. Pushing the cord back in (A) can worsen the situation. Covering the cord (B) does not address the urgent need to relieve pressure. Immediate vaginal delivery (D) may not be possible or safe at 32 weeks. Placing the client in the knee-chest position is the most immediate and effective action to manage cord prolapse.
Presence of a turtle’s sign is clearly indicative of
- A. Prolonged labor
- B. Occipito-posterior position
- C. Shoulder dystocia
- D. Shoulder presentation
Correct Answer: C
Rationale: The presence of a turtle sign during delivery is indicative of shoulder dystocia. This occurs when the baby's shoulders get stuck behind the mother's pelvic bones during delivery, leading to difficulty in delivering the baby's shoulders. The turtle sign refers to the retraction of the baby's head back into the birth canal after delivery of the head, resembling a turtle retracting into its shell. This sign is a clear indicator of shoulder dystocia. Choices A, B, and D are incorrect because prolonged labor, occipito-posterior position, and shoulder presentation do not specifically involve the retraction of the baby's head like in shoulder dystocia.
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. In eclampsia, magnesium sulphate is the drug of choice because it helps prevent seizures by reducing neuromuscular irritability and blocking peripheral neuromuscular transmission. It also has vasodilatory effects, improving uteroplacental blood flow. Phenobarbitone (A) is not recommended due to its sedative effects. Calcium gluconate (B) is used to treat hyperkalemia, not eclampsia. Sodium bicarbonate (D) is used for metabolic acidosis, not eclampsia. In summary, magnesium sulphate is preferred for its efficacy in preventing and managing seizures in eclampsia.
The MAIN clinical feature of puerperal psychosis is
- A. Episodic insomnia
- B. Neglect of hygiene
- C. Major depression
- D. Mild headache
Correct Answer: C
Rationale: The correct answer is C, major depression. Puerperal psychosis is a severe mental health condition that occurs in the postpartum period, characterized by symptoms such as hallucinations, delusions, and disorganized thinking. Major depression is a key clinical feature, often accompanied by mood disturbances and severe emotional distress.
Rationale:
- A: Episodic insomnia is a common symptom in various mental health disorders but not specific to puerperal psychosis.
- B: Neglect of hygiene may occur in severe cases but is not the main clinical feature of puerperal psychosis.
- D: Mild headache is not a characteristic symptom of puerperal psychosis, which is primarily marked by severe psychiatric symptoms.
Classical vitamin K deficiency bleeding occurs
- A. Within the first 24 hours of birth
- B. Within the neonatal stage
- C. Within the infancy stage
- D. Within the first week of birth
Correct Answer: B
Rationale: Classical vitamin K deficiency bleeding occurs within the neonatal stage because newborns have low levels of vitamin K, which is essential for blood clotting. This deficiency typically manifests between 1-7 days after birth. Bleeding within the first 24 hours (choice A) is unlikely as it is too early for vitamin K deficiency to cause symptoms. Bleeding within infancy (choice C) is incorrect as it specifically refers to the neonatal stage. Bleeding within the first week of birth (choice D) is a close distractor, but the critical period for classical vitamin K deficiency bleeding is within the neonatal stage, which is slightly more specific than the first week of birth.