Nokea
The most common cause of heart disease in pregnant woman in Pakistan is:
- A. Congenital heart disease.
- B. Cardiomyopathy.
- C. Myocardial infarction.
- D. Cardiomegaly.
- E. Rheumatic heart disease.
Correct Answer: E
Rationale: Rheumatic heart disease is the most common cause of heart disease in pregnant women in developing countries like Pakistan due to high prevalence of rheumatic fever. Congenital heart disease is less common and other options are rare in pregnancy.
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The nurse is caring for the newborn infant. Which initial measures should the nurse take to maintain the newborn’s axillary body temperature between 97.7°F (36.5°C) and 98.9°F (37.2°C)? Select all that apply.
- A. Carefully dry the infant immediately after birth.
- B. Place the infant skin-to-skin with the mother.
- C. Apply leggings to both of the newborn’s legs.
- D. Cover the infant’s head with a stocking cap.
- E. Place the infant in a bassinette close to the wall.
Correct Answer: A,B,D
Rationale: Drying the newborn prevents heat loss through evaporation. Skin-to-skin contact with the mother assists in maintaining body temperature. A stocking cap conserves heat. Leggings are unnecessary and placing the bassinette near a wall causes radiation heat loss.
After the delivery of fetus,placenta should be removed by:
- A. Fundal pressure.
- B. D & C.
- C. Brandt-Andrews method.
- D. Manual removal.
- E. C-section.
Correct Answer: C
Rationale: The Brandt-Andrews method using controlled cord traction is the standard technique for delivering the placenta in the third stage of labor. Other methods are used only in complications.
A G2P1 with previous cesarean section due to obstructed labour comes for first antenatal visit at 34 weeks of gestation. She is seeking advice for home delivery this time. What will be the most dangerous complication in her case if we allow her to deliver at home by untrained birth attendent:
- A. Prolonged latent phase.
- B. Arrest in second stage of labour.
- C. Delayed progress in active phase of labour.
- D. Rupture uterus.
- E. Placental retention.
Correct Answer: D
Rationale: Uterine rupture is a life-threatening complication in women with a previous cesarean section especially during labor managed by untrained attendants due to the risk of scar dehiscence. Other complications are less immediately dangerous.
Which nursing action is most appropriate at this time?
- A. Recognize that the fluid is cerebrospinal fluid (CSF) and remove the dressing, observing for the source of the leakage.
- B. Recognize that the fluid is CSF and call the chaplain because death of the child is imminent.
- C. Recognize that the fluid is CSF and notify the operating room because additional surgery will be necessary.
- D. Recognize that the fluid is CSF and reinforce the dressing until the physician can change it.
Correct Answer: D
Rationale: Clear drainage on a head dressing post-craniotomy is likely CSF, indicating a leak. Reinforcing the dressing prevents infection and maintains a sterile barrier until the physician assesses the leak.
The nurse is caring for a preterm infant with respiratory distress syndrome (RDS). Which intervention should the nurse implement to maximize the infant’s respiratory status?
- A. Check blood glucose levels every 4 hours.
- B. Cool and humidify all inspired gases.
- C. Weigh the infant every other day.
- D. Place the infant in a prone position.
Correct Answer: D
Rationale: The prone position improves oxygenation in collapsed alveoli for RDS infants with cardiorespiratory monitoring. Glucose checks cold gases and infrequent weighing don’t aid respiration.