Nokea
Surgical induction of labor refers to the use of
- A. Cytotec and mechanical cervical dilatation
- B. Sweeping of membranes and amniotomy
- C. Mechanical cervical dilatation and buscopan
- D. Artificial rupture of membranes and syntocinon
Correct Answer: B
Rationale: The correct answer is B: Sweeping of membranes and amniotomy.
1. Sweeping of membranes involves manually separating the amniotic sac from the lower part of the uterus, stimulating the release of prostaglandins to induce labor.
2. Amniotomy is the artificial rupture of membranes, which can accelerate labor by releasing amniotic fluid and initiating contractions.
3. These methods are commonly used for surgical induction of labor due to their effectiveness and minimal invasiveness compared to other options.
Incorrect choices:
A: Cytotec is a medication used for labor induction, but mechanical cervical dilatation is not a standard surgical method.
C: Buscopan is used for relaxation of smooth muscle and not commonly used for labor induction.
D: Syntocinon is a synthetic form of oxytocin used to induce or augment labor, but it is not typically used in surgical induction methods.
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The appropriate time to perform external cephalic version in a breech presentation is at
- A. 36 gestational weeks
- B. 38 gestational weeks
- C. 42 gestational weeks
- D. 40 gestational weeks
Correct Answer: A
Rationale: Rationale for correct answer (A): At 36 weeks, the baby has enough room to move, reducing risks of complications during external cephalic version. Earlier intervention also allows for possible repeat attempts if needed. This timing aligns with guidelines for optimal success rates.
Summary of other choices:
B: 38 weeks may be too late as the baby may have less space to turn.
C: 42 weeks is post-term and poses risks for both the baby and the mother.
D: 40 weeks is close to full term and may not allow for adequate time for successful version.
The correct statement about shoulder dystocia is
- A. It’s an impaction of the anterior shoulder after delivery of the head
- B. It’s an impaction of the posterior shoulder after delivery of the head
- C. Shoulder dystocia occurs due to compound presentation of the fetus
- D. Shoulder dystocia is not an emergency, it usually resolves on its own
Correct Answer: A
Rationale: The correct statement about shoulder dystocia is A: It’s an impaction of the anterior shoulder after delivery of the head. This is accurate as shoulder dystocia occurs when the anterior shoulder becomes impacted behind the maternal pubic symphysis. This can lead to difficulty delivering the shoulders after the head is delivered. B is incorrect as shoulder dystocia involves the anterior shoulder, not the posterior. C is incorrect as shoulder dystocia is not related to compound presentation. D is incorrect as shoulder dystocia is an obstetric emergency that requires prompt intervention to prevent complications for both the mother and the baby.
Prenatally, malaria parasites hide at the
- A. Bone marrow
- B. Placental bed
- C. Fetal circulation
- D. Uterine muscle
Correct Answer: B
Rationale: The correct answer is B: Placental bed. Malaria parasites hide in the placental bed during pregnancy to avoid detection by the immune system. This location provides a safe haven for the parasites to survive and replicate without being cleared by the mother's immune response. The placental bed offers a rich blood supply and a favorable environment for the parasites to thrive.
Incorrect choices:
A: Bone marrow - Malaria parasites do not typically hide in the bone marrow during pregnancy.
C: Fetal circulation - Malaria parasites do not hide in the fetal circulation; they primarily reside in the placental bed.
D: Uterine muscle - Malaria parasites do not hide in the uterine muscle; the placental bed is the main site of sequestration during pregnancy.
The term used to describe a situation whereby the fetal lie keeps varying after 36 gestational weeks is
- A. Unstable lie
- B. Compound lie
- C. Multiple lie
- D. Transverse lie
Correct Answer: A
Rationale: The correct answer is A: Unstable lie. After 36 weeks of gestation, the fetal lie should typically be consistent. An unstable lie refers to a situation where the fetal lie keeps changing position, indicating a potential complication. This can lead to difficulties during labor and delivery.
Summary:
B: Compound lie - Refers to a situation where the fetus is in an abnormal position, such as breech or transverse, alongside another part of the body presenting first.
C: Multiple lie - Not a recognized medical term.
D: Transverse lie - Refers to a situation where the fetus is positioned horizontally across the uterus, which can complicate delivery.
The AGACNP is receiving report from the recovery room on a patient who just had surgical resection for pheochromocytoma. He knows that which class of drugs should be available immediately to manage hypertensive crisis, a possible consequence of physical manipulation of the adrenal medulla?
- A. Alpha-adrenergic antagonists
- B. Beta-adrenergic antagonists
- C. Intravenous vasodilators
- D. Arteriolar dilators
Correct Answer: D
Rationale: Step-by-step rationale for why D is correct:
1. Arteriolar dilators such as sodium nitroprusside are used to manage hypertensive crisis by rapidly reducing blood pressure.
2. Pheochromocytoma surgery can result in catecholamine release, causing severe hypertension.
3. Arteriolar dilators act directly on blood vessels to lower blood pressure quickly.
4. Alpha-adrenergic antagonists (A) can worsen hypotension, beta-adrenergic antagonists (B) can lead to unopposed alpha-adrenergic effects, and intravenous vasodilators (C) may not act rapidly enough.