Nokea
The baby dies immediately after birth due to the presence of
- A. Pulmonary stenosis
- B. Aortic coarctation
- C. Truncus arteriosus
- D. Ductus arteriosus
Correct Answer: C
Rationale: The correct answer is C: Truncus arteriosus. In this congenital heart defect, a single large blood vessel arises from the heart instead of the normal two separate vessels (aorta and pulmonary artery). This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygen supply to the body. This condition is incompatible with life, causing immediate death after birth.
A: Pulmonary stenosis and B: Aortic coarctation are also congenital heart defects but do not typically result in immediate death after birth. Pulmonary stenosis obstructs blood flow to the lungs, while aortic coarctation causes narrowing of the aorta.
D: Ductus arteriosus is a normal fetal blood vessel that connects the pulmonary artery and the aorta but usually closes shortly after birth. Failure of closure can lead to health issues, but it is not typically a cause of immediate death after birth.
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When caring for a mother following an assisted vaginal delivery, it’s MOST important to remember that
- A. A vacuum extractor is safer than forceps because it causes less trauma to the baby & the mother’s perineum
- B. The baby will develop a cephalhematoma as a result of the instrumentation which is a normal expected outcome
- C. The use of instruments during the birth process is a fairly rare occurrence for women
- D. Additional nursing interventions are needed to ensure an uncomplicated postpartum
Correct Answer: D
Rationale: The correct answer is D because additional nursing interventions are necessary to ensure an uncomplicated postpartum period. After an assisted vaginal delivery, the mother may experience increased pain, perineal trauma, and a higher risk of postpartum hemorrhage. Nursing interventions such as pain management, wound care, monitoring for signs of infection, and emotional support are crucial for the mother's recovery.
A is incorrect because both vacuum extractors and forceps can cause trauma to the baby and mother's perineum, and the safety of one over the other depends on various factors.
B is incorrect as the development of a cephalhematoma is not a normal expected outcome of assisted vaginal delivery and should be monitored and managed appropriately if it occurs.
C is incorrect as the use of instruments during childbirth, while not as common as spontaneous vaginal deliveries, is not rare and can be necessary in certain situations to ensure the safety of the mother and baby.
When examining a patient with abdominal pain, the AGACNP knows that tenderness to percussion is analogous to
- A. Tympany
- B. Guarding
- C. Rebound tenderness
- D. Somatic pain
Correct Answer: A
Rationale: The correct answer is A: Tympany. Tenderness to percussion is analogous to tympany as both indicate the presence of gas-filled structures. When a patient experiences tenderness to percussion in the abdomen, it suggests that there is gas or air present in the abdomen, leading to a hollow, drum-like sound upon percussion, which is characteristic of tympany. Guarding (B) is the involuntary contraction of abdominal muscles to protect the underlying organs, not related to percussion. Rebound tenderness (C) is the pain experienced when pressure is released during palpation, not percussion. Somatic pain (D) refers to pain originating from the skin, muscles, or bones, not related to percussion findings.
A condition of trial of scar is
- A. Estimated fetal weight of less than 3600g
- B. Availability of a level one hospital nearby
- C. Not more than two previous caesarean section scars
- D. An adequate pelvis with true conjugate 10.5cm
Correct Answer: C
Rationale: Rationale for Correct Answer (C): A trial of scar is indicated when a woman has had no more than two previous caesarean sections. This is because the risk of uterine rupture increases with each subsequent caesarean section due to scar tissue weakening. Limiting the number of previous scars reduces this risk. Therefore, option C is correct.
Summary of Incorrect Choices:
A: Estimated fetal weight is not a determining factor for a trial of scar.
B: Availability of a level one hospital nearby is important for emergency situations but not a criteria for trial of scar.
D: Adequate pelvis with true conjugate 10.5cm is important for vaginal delivery but not a specific requirement for a trial of scar.
Diagnosis of occipito-posterior position:
- A. External examination and ultrasound
- B. Physical exam with pelvic exam findings
- C. Regular contractions and maternal discomfort
- D. Both A and B
Correct Answer: D
Rationale: Step-by-step rationale:
1. External examination can reveal the position of the baby's head.
2. Ultrasound can confirm the baby's position accurately.
3. Physical exam and pelvic exam findings can provide additional information.
4. Combining both methods (A and B) ensures a comprehensive assessment for accurate diagnosis.
Summary:
- Choice A alone may not provide sufficient information.
- Choice B alone may not be as accurate as combined with ultrasound.
- Choice C is not specific to diagnosing occipito-posterior position.
- Choice D is correct as it combines external examination, ultrasound, and physical exam for accurate diagnosis.
Which of the following is NOT a source of pain in labour?
- A. Uterine contractions
- B. Socio-cultural norms
- C. Cervical dilatation
- D. Pelvic floor stretching
Correct Answer: B
Rationale: Step 1: Uterine contractions are a physiological process in labor causing pain due to muscle contractions.
Step 2: Cervical dilatation involves the opening of the cervix, which can cause pain and discomfort.
Step 3: Pelvic floor stretching occurs as the baby moves through the birth canal, leading to pain.
Step 4: Socio-cultural norms do not directly cause physical pain in labor, making choice B the correct answer. Other choices directly relate to physical processes causing pain.