Nokea
Which of the following is NOT a source of pain in labour?
- A. Uterine contractions
- B. Socio-cultural norms
- C. Cervical dilatation
- D. Pelvic floor stretching
Correct Answer: B
Rationale: Step 1: Uterine contractions are a physiological process in labor causing pain due to muscle contractions.
Step 2: Cervical dilatation involves the opening of the cervix, which can cause pain and discomfort.
Step 3: Pelvic floor stretching occurs as the baby moves through the birth canal, leading to pain.
Step 4: Socio-cultural norms do not directly cause physical pain in labor, making choice B the correct answer. Other choices directly relate to physical processes causing pain.
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The main diagnostic feature of puerperal pyrexia is
- A. Fever ≥ 38°C for three consecutive occasions
- B. Fever ≥ 38°C for three days continuously
- C. Fever ≥ 38°C for three weeks continuously
- D. Fever ≥ 38°C for six days occasionally
Correct Answer: A
Rationale: The correct answer is A: Fever ≥ 38°C for three consecutive occasions. Puerperal pyrexia is defined as fever occurring after childbirth. The key diagnostic feature is the presence of fever (≥ 38°C) on three consecutive occasions, indicating a persistent infection. Choice B is incorrect because it doesn't specify the need for consecutive occasions. Choice C is incorrect as it extends the duration of fever to three weeks, which is too long for typical puerperal pyrexia. Choice D is incorrect as it mentions "occasionally" instead of "consecutively," which is not indicative of a consistent fever pattern seen in puerperal pyrexia.
When examining a patient with abdominal pain, the AGACNP knows that tenderness to percussion is analogous to
- A. Tympany
- B. Guarding
- C. Rebound tenderness
- D. Somatic pain
Correct Answer: A
Rationale: The correct answer is A: Tympany. Tenderness to percussion is analogous to tympany as both indicate the presence of gas-filled structures. When a patient experiences tenderness to percussion in the abdomen, it suggests that there is gas or air present in the abdomen, leading to a hollow, drum-like sound upon percussion, which is characteristic of tympany. Guarding (B) is the involuntary contraction of abdominal muscles to protect the underlying organs, not related to percussion. Rebound tenderness (C) is the pain experienced when pressure is released during palpation, not percussion. Somatic pain (D) refers to pain originating from the skin, muscles, or bones, not related to percussion findings.
Mother-to-child transmission of TB organisms never occurs during labor.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: Step 1: TB can be transmitted from an infected mother to her child during labor.
Step 2: The TB bacteria can be present in the mother's respiratory secretions.
Step 3: During labor, the baby can inhale these bacteria and contract TB.
Step 4: Therefore, the statement that mother-to-child transmission of TB organisms never occurs during labor is FALSE.
Summary: Option B is correct because it accurately reflects the possibility of mother-to-child transmission of TB during labor. Option A is incorrect as it contradicts the factual information. Options C and D are not applicable as they provide no information.
The Brain Trauma Foundation recommends intracranial pressure monitoring for all of the following patients except those with
- A. GCS of 3 to 8 and abnormal head CT
- B. GCS of 3 to 8 and hypotension
- C. GCS of 3 to 8 and > 40 years old
- D. GCS of 3 to 8 and bradycardia
Correct Answer: A
Rationale: The correct answer is A because the Brain Trauma Foundation recommends intracranial pressure monitoring for patients with traumatic brain injury and a GCS of 3 to 8, regardless of the head CT findings. Intracranial pressure monitoring helps in the management of elevated intracranial pressure, which can be life-threatening. Abnormal head CT findings may indicate the need for immediate intervention, but intracranial pressure monitoring is still recommended for all patients in this GCS range to guide treatment decisions. Choices B, C, and D are incorrect because hypotension, age > 40 years old, and bradycardia are not factors that would exclude a patient from needing intracranial pressure monitoring in the presence of a GCS of 3 to 8.
In breech delivery, the midwife is advised to keep her hands off the breech as it progressively descends so as to
- A. Ascertain the fetal wellbeing in utero
- B. Allow enough room for the fetus to pass
- C. Allow gravitating descent of the fetus
- D. Prevent excessive traction being applied
Correct Answer: D
Rationale: The correct answer is D: Prevent excessive traction being applied. This is because in a breech delivery, excessive traction can lead to complications such as fetal injuries or umbilical cord prolapse. The midwife should avoid pulling on the baby's legs or body to prevent undue stress on the baby. The other choices are incorrect because: A: Ascertain the fetal wellbeing in utero - this is typically done through other means such as fetal monitoring. B: Allow enough room for the fetus to pass - this should be done by ensuring proper positioning and allowing natural descent. C: Allow gravitating descent of the fetus - this is not a recommended practice as it can cause complications.