Nokea
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.
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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.
A major predisposing factor to cardiac disease in pregnancy includes
- A. Rheumatic heart disease
- B. Notable peripheral oedema
- C. Easy fatiguability
- D. Basal crepitation
Correct Answer: A
Rationale: The correct answer is A: Rheumatic heart disease. This is because rheumatic heart disease is a known risk factor for cardiac complications during pregnancy due to the strain pregnancy places on the heart. Choice B, notable peripheral edema, is a symptom of heart failure but not a predisposing factor. Choice C, easy fatiguability, is a non-specific symptom and not a direct predisposing factor. Choice D, basal crepitation, is a sign of possible lung pathology and not directly related to cardiac disease in pregnancy. Therefore, the correct answer is A as it directly relates to an increased risk of cardiac issues during pregnancy.
Convulsions in amniotic fluid embolism are confused for
- A. Antepartum eclampsia
- B. Presence of stroke
- C. Pre-existing epilepsy
- D. Postpartum eclampsia
Correct Answer: D
Rationale: The correct answer is D, postpartum eclampsia. In amniotic fluid embolism, convulsions are often mistaken for postpartum eclampsia due to similar symptoms such as seizures and altered mental status. Postpartum eclampsia occurs after delivery, usually within 48 hours, while antepartum eclampsia occurs before delivery. Presence of stroke and pre-existing epilepsy are not directly related to convulsions in amniotic fluid embolism. Thus, D is the correct choice as it closely resembles the presentation of convulsions in amniotic fluid embolism.
Mrs. Jenner is a 41-year-old female who is being evaluated for persistent nausea. She had an abdominal CT scan that reported three hepatic hemangiomas ranging from 3 to 5 cm. The AGACNP knows that the appropriate response to this report is to
- A. Arrange for large-bore needle biopsy
- B. Order hepatic ultrasound annually to follow progression
- C. Consult surgery for resection
- D. Document the finding in the patient’s chart
Correct Answer: B
Rationale: The correct answer is B. Ordering hepatic ultrasound annually to follow progression is the appropriate response for hepatic hemangiomas. Biopsy is not recommended due to the risk of bleeding. Surgery is usually not required unless there are complications. Documenting the finding is important but does not address the need for monitoring. Ultrasound allows for non-invasive monitoring of the hemangiomas over time to assess for growth or complications, guiding further management if needed.
A mother with a cord prolapse is given oxygen at a rate of 4 liters/minute in order to
- A. Relieve maternal distress
- B. Promote her relative rest
- C. Improve fetal oxygenation
- D. Achieve the effect of tocolysis
Correct Answer: C
Rationale: The correct answer is C: Improve fetal oxygenation. Oxygen at 4 liters/minute is given to increase oxygen levels which can help improve oxygenation to the fetus during a cord prolapse scenario. This can be crucial in preventing fetal distress and hypoxia.
Explanation for Incorrect Choices:
A: Relieve maternal distress - Oxygen is primarily given in this scenario to benefit the fetus, not to relieve maternal distress.
B: Promote her relative rest - Oxygen is not administered to promote rest, but to address the immediate concern of fetal oxygenation.
D: Achieve the effect of tocolysis - Oxygen does not have a role in tocolysis, which is the inhibition of uterine contractions.