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 condition, there is a single large vessel arising from the heart that gives rise to the systemic, pulmonary, and coronary arteries. This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygenation of the body, causing immediate death after birth.
A: Pulmonary stenosis and B: Aortic coarctation typically do not cause immediate death after birth.
D: Ductus arteriosus is a normal fetal structure that closes shortly after birth and its presence would not directly cause immediate death.
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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 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.
Clinical diagnosis of polyhydramnios is based on an amount of amniotic fluid exceeding
- A. 1500 ml
- B. 3000 ml
- C. 1900 ml
- D. 2500 ml
Correct Answer: B
Rationale: The correct answer is B: 3000 ml. Polyhydramnios is diagnosed when the amniotic fluid volume exceeds 2000-3000 ml. This amount is considered excessive and can indicate various maternal or fetal health conditions. Choice A (1500 ml) is too low to qualify as polyhydramnios. Choice C (1900 ml) falls within the normal range of amniotic fluid volume. Choice D (2500 ml) is close to the threshold but may not always be considered excessive. Therefore, the correct diagnosis of polyhydramnios is based on an amniotic fluid volume exceeding 3000 ml.
When a hand/foot lies alongside the presenting part, the presentation is said to be
- A. Footling
- B. Transverse
- C. Compound
- D. Cephalic
Correct Answer: C
Rationale: The correct answer is C: Compound. When a hand or foot lies alongside the presenting part during childbirth, it is called a compound presentation. This can be a complication as it increases the risk of the presenting part not fitting through the birth canal properly.
A: Footling presentation occurs when the baby's foot or feet are the first to emerge from the birth canal.
B: Transverse presentation is when the baby is lying sideways in the uterus.
D: Cephalic presentation is the ideal position for vaginal delivery, with the baby's head down and ready to be born.
Neoadjuvant chemotherapy treatment for cancer is given to facilitate surgical resection. When the outcomes of cancer therapies are evaluated, the terms complete response and partial response often are used. Partial response means that
- A. 50% of the patients treated with a given regimen demonstrate remission
- B. 50% of the patients treated survive to the 5-year point
- C. The tumor mass has reduced by > 50%
- D. In 50% of cases, the tumor converts from unresectable to resectable
Correct Answer: C
Rationale: The correct answer is C because partial response in cancer therapy typically refers to a reduction in tumor size by more than 50%. This reduction indicates some positive effect of the treatment on the tumor.
Choice A is incorrect because partial response is not solely based on the percentage of patients demonstrating remission, it is about the tumor response.
Choice B is incorrect because survival at 5 years is related to overall survival rate, not specifically to the tumor response.
Choice D is incorrect because the conversion from unresectable to resectable is more related to the operability of the tumor, rather than the response to chemotherapy.