Nokea
Which of the following is highly associated with preterm babies?
- A. Social habits
- B. Genetic factors
- C. Multiple gestation
- D. Chronic conditions
Correct Answer: C
Rationale: The correct answer is C: Multiple gestation. Preterm birth is more common in multiple gestation pregnancies due to the increased strain on the mother's uterus and cervix. This can lead to early labor and delivery. Social habits (choice A) and genetic factors (choice B) may play a role in preterm birth but are not highly associated. Chronic conditions (choice D) can also contribute to preterm birth, but multiple gestation is a stronger predictor.
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The AGACNP is treating a patient with ascites. After a regimen of 200 mg of spironolactone daily, the patient demonstrates a weight loss of 0.75 kgday. The best approach to this patients management is to
- A. Continue the current regimen
- B. D/C the spironolactone and begin a loop diuretic
- C. Add a loop diuretic to the spironolactone
- D. Proceed to large-volume paracentesis
Correct Answer: A
Rationale: The correct answer is A: Continue the current regimen. Spironolactone is a potassium-sparing diuretic commonly used to treat ascites. The weight loss of 0.75 kg/day indicates that the current regimen is effective. Continuing the regimen is appropriate to avoid electrolyte imbalances. Discontinuing spironolactone (Choice B) can lead to rebound edema. Adding a loop diuretic (Choice C) may increase the risk of electrolyte disturbances. Large-volume paracentesis (Choice D) is reserved for cases of refractory ascites.
Chemical diabetes mellitus is a classification based on
- A. Symptom are absent and abnormal specific laboratory results
- B. Presence of symptoms and abnormal specific laboratory results
- C. Previous congenital abnormalities and unexplained stillbirth
- D. Previous birth of a baby weighing >4.3kg and spontaneous abortion
Correct Answer: A
Rationale: The correct answer is A: Symptom are absent and abnormal specific laboratory results. Chemical diabetes mellitus refers to a condition where there are abnormal specific laboratory results indicating diabetes without the presence of any symptoms. This classification is based on objective data from laboratory tests rather than subjective symptoms. Choices B, C, and D are incorrect as they do not align with the definition of chemical diabetes mellitus, which focuses on laboratory results rather than symptoms, congenital abnormalities, or pregnancy outcomes.
The commonest causative organism of pyelonephritis is
- A. Streptococcus faecalis
- B. Proteus vulgaris
- C. Staphylococcus pyogene
- D. Escherichia coli
Correct Answer: D
Rationale: The correct answer is D: Escherichia coli. E. coli is the most common causative organism of pyelonephritis due to its prevalence in the gastrointestinal tract. It has specific virulence factors that enable it to ascend the urinary tract and cause infection. Streptococcus faecalis, Proteus vulgaris, and Staphylococcus pyogene are less commonly associated with pyelonephritis compared to E. coli.
The presenting diameter in brow presentation is
- A. Mentovertical
- B. Submentobregmatic
- C. Suboccipitofrontal
- D. Occipitalfrontal
Correct Answer: C
Rationale: The presenting diameter in brow presentation is the suboccipitofrontal diameter. This is because in brow presentation, the fetal head is in a deflexed position, with the largest diameter being from the subocciput (back of the head) to the frontal bone (forehead). This allows the head to enter the pelvis in the transverse diameter.
A: Mentovertical - This refers to the chin to the top of the head, not the correct diameter for brow presentation.
B: Submentobregmatic - This refers to the chin to the bregma, not the correct diameter for brow presentation.
D: Occipitalfrontal - This refers to the back of the head to the forehead, not the correct diameter for brow presentation.
Ms. Kweke’s specific management until delivery (obstructed labour):
- A. Immediate caesarean section
- B. Observation with pain relief
- C. Manual repositioning of fetus
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A: Immediate caesarean section. In obstructed labor, prompt delivery is crucial to prevent harm to both the mother and the baby. A caesarean section is the most effective and timely intervention to safely deliver the baby and avoid complications such as fetal distress, maternal infection, and uterine rupture. Observation with pain relief (B) may delay necessary intervention, and manual repositioning of the fetus (C) is not sufficient in cases of obstructed labor. Choice D is incorrect because not all options are appropriate in this specific scenario.