Nokea
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.
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How can maternal smoking during pregnancy affect fetal development?
- A. Causes low birth weight
- B. Increases the risk of preterm birth
- C. Affects lung development
- D. All of the above
Correct Answer: D
Rationale: Maternal smoking during pregnancy can affect fetal development in multiple ways. Smoking can cause low birth weight by restricting oxygen and nutrients to the fetus, leading to growth issues. It can also increase the risk of preterm birth due to the harmful chemicals in cigarette smoke. Furthermore, smoking can affect lung development in the fetus, leading to respiratory issues. Therefore, the correct answer is D - All of the above, as maternal smoking can have a comprehensive impact on fetal development, including low birth weight, preterm birth, and lung development issues.
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.
Classical vitamin K deficiency bleeding occurs
- A. Within the first 24 hours of birth
- B. Within the neonatal stage
- C. Within the infancy stage
- D. Within the first week of birth
Correct Answer: B
Rationale: Classical vitamin K deficiency bleeding occurs within the neonatal stage because newborns have low levels of vitamin K, which is essential for blood clotting. This deficiency typically manifests between 1-7 days after birth. Bleeding within the first 24 hours (choice A) is unlikely as it is too early for vitamin K deficiency to cause symptoms. Bleeding within infancy (choice C) is incorrect as it specifically refers to the neonatal stage. Bleeding within the first week of birth (choice D) is a close distractor, but the critical period for classical vitamin K deficiency bleeding is within the neonatal stage, which is slightly more specific than the first week of birth.
Predisposing factors to uterine rupture include
- A. Nulliparity, neglected obstructed labor
- B. Breech presentation, multiple pregnancy
- C. Neglected obstructed labor, high parity
- D. Obstetric maneuvers, breech presentation
Correct Answer: C
Rationale: The correct answer is C because neglected obstructed labor and high parity are well-established predisposing factors to uterine rupture. Neglected obstructed labor can cause prolonged pressure on the uterus, leading to weakening and potential rupture. High parity (having given birth multiple times) can also increase the risk of uterine rupture due to repeated stretching and strain on the uterine muscles.
A, B, and D are incorrect because nulliparity (never given birth), breech presentation, multiple pregnancy, and obstetric maneuvers are not as strongly associated with uterine rupture as neglected obstructed labor and high parity. These factors may increase the risk of other complications during childbirth but are not primary predisposing factors for uterine rupture.
Mallory-Weiss syndrome is a complication of
- A. Placenta praevia
- B. Cardiac disease
- C. Postpartum haemorrhage
- D. Hyperemesis gravidarum
Correct Answer: D
Rationale: Mallory-Weiss syndrome is caused by severe vomiting leading to tears in the esophagus. Hyperemesis gravidarum is severe nausea and vomiting during pregnancy, which can result in Mallory-Weiss syndrome. Placenta praevia, cardiac disease, and postpartum hemorrhage are not directly associated with Mallory-Weiss syndrome.