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Prolonged second stage of labor in nulliparous women is labor for more than
- A. 1 hour
- B. 2 hours
- C. 4 hours
- D. 8 hours
Correct Answer: C
Rationale: The correct answer is C: 4 hours. This is based on the definition of prolonged second stage in nulliparous women, which is labor lasting more than 4 hours. This duration is considered abnormal and may lead to increased risk of maternal and fetal complications. Choice A (1 hour) is too short and does not meet the criteria for prolonged second stage. Choice B (2 hours) is also insufficient based on the established timeframe. Choice D (8 hours) exceeds the duration for prolonged second stage, indicating a more advanced stage of labor. Therefore, the most appropriate and accurate timeframe for prolonged second stage in nulliparous women is 4 hours.
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The presenting diameter in brow presentation is
- A. Mentovertical
- B. Submentobregmatic
- C. Suboccipitofrontal
- D. Occipitalfrontal
Correct Answer: C
Rationale: The presenting diameter in brow presentation is the suboccipitofrontal diameter. This is because in brow presentation, the fetal head is in a deflexed position, with the largest diameter being from the subocciput (back of the head) to the frontal bone (forehead). This allows the head to enter the pelvis in the transverse diameter.
A: Mentovertical - This refers to the chin to the top of the head, not the correct diameter for brow presentation.
B: Submentobregmatic - This refers to the chin to the bregma, not the correct diameter for brow presentation.
D: Occipitalfrontal - This refers to the back of the head to the forehead, not the correct diameter for brow presentation.
How can healthcare providers support women after stillbirth?
- A. Offer emotional counseling
- B. Explain causes clearly
- C. Support in planning future pregnancies
- D. All of the above
Correct Answer: D
Rationale: 1. Emotional counseling helps women cope with grief.
2. Explaining causes provides closure and understanding.
3. Supporting future pregnancies ensures better outcomes.
4. All options address different aspects of support needed after stillbirth.
5. Therefore, providing emotional counseling, explaining causes, and supporting future pregnancies collectively offer comprehensive care.
Aims of exchange transfusion procedure includes:
- A. Cure of haemolysis and restoration of hemoglobin level
- B. Cure of hypoxia and removal of all toxic materials
- C. Stabilization of baby’s immune system and liver functions
- D. Control of haemolysis and restoration of hemoglobin level
Correct Answer: D
Rationale: The correct answer is D because exchange transfusion aims to control hemolysis by removing the damaged red blood cells and replacing them with healthy ones, thus restoring hemoglobin levels. This procedure does not cure haemolysis or hypoxia entirely, nor does it stabilize the immune system or liver functions. It specifically targets controlling hemolysis and restoring hemoglobin levels to improve the patient's condition.
Janice is a 32-year-old female who presents for evaluation of abdominal pain. She has no significant medical or surgical history and denies any history of ulcers, reflux, or gastritis. However, she is now in significant pain and is afraid something is really wrong. She describes what started out as a dull discomfort in the upper part of her stomach a few hours ago but has now become more profound and centered on the right side just under her ribcage. She has not vomited but says she feels nauseous. Physical exam reveals normal vital signs except for a pulse of 117 bpm. She is clearly uncomfortable, and palpation of the abdomen reveals tenderness with deep palpation of the right upper quadrant. The AGACNP orders which imaging study to investigate the likely cause?
- A. Abdominal radiographs
- B. CT scan of the abdomen with contrast
- C. Right upper quadrant ultrasound
- D. A HIDA scan
Correct Answer: D
Rationale: The correct answer is D: A HIDA scan. A HIDA scan is the most appropriate imaging study for investigating the likely cause in this case because the patient's symptoms (abdominal pain centered on the right side just under the ribcage, tenderness in the right upper quadrant) are suggestive of a possible gallbladder issue, such as cholecystitis or biliary colic. A HIDA scan is specifically used to evaluate the gallbladder and biliary system.
A: Abdominal radiographs would not provide detailed information about the gallbladder or biliary system, and are not the best choice in this scenario.
B: A CT scan of the abdomen with contrast can be helpful in some situations, but it may not provide the specific information needed to evaluate the gallbladder and biliary system.
C: Right upper quadrant ultrasound is a good initial imaging study for evaluating gallbladder disease, but a HIDA scan is more specific for functional assessment of
A patient being monitored post-heart transplant suffers a bradyarrhythmia. The AGACNP knows that which of the following medications is not indicated as part of emergency intervention for bradycardic abnormalities in a posttransplant patient?
- A. Isoproterenol 0.2 to 0.6 mg IV bolus
- B. External pacemaking
- C. Atropine 0.5 mg IV
- D. Epinephrine 1 mg IV
Correct Answer: A
Rationale: The correct answer is A: Isoproterenol 0.2 to 0.6 mg IV bolus. Isoproterenol is a non-selective beta-adrenergic agonist that can worsen graft rejection in heart transplant patients. The appropriate intervention for bradyarrhythmia in posttransplant patients is external pacemaking or pharmacological agents like atropine or epinephrine. Isoproterenol should be avoided due to its potential to stimulate the immune system and increase the risk of rejection. It is crucial to choose interventions that address the bradycardia without compromising the patient's transplant graft.