Nokea
Which one of the following clinical features indicates neonatal intracranial injury?
- A. An oedematous swelling on the newborn’s scalp that resolves in 48 hours
- B. Notable bleeding between the epicranial aponeurosis & the periosteum
- C. Evidence of excessive molding or abnormal stretching of the fetal head
- D. Peripheral cyanosis as noted by the midwife on the neonate’s peripheries
Correct Answer: C
Rationale: Rationale for choice C:
1. Excessive molding or abnormal stretching of the fetal head can indicate neonatal intracranial injury due to the trauma during birth.
2. This feature suggests possible compression or trauma to the baby's head during delivery.
3. It may lead to intracranial hemorrhage or other injuries, requiring close monitoring and medical intervention.
Summary of other choices:
A. An oedematous swelling resolving in 48 hours is likely a normal finding (cephalohematoma) and not specific to intracranial injury.
B. Notable bleeding between the epicranial aponeurosis & periosteum may indicate cephalohematoma or caput succedaneum, not necessarily intracranial injury.
D. Peripheral cyanosis is related to oxygenation and circulation, not specific to intracranial injury.
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What are common complications of multiple gestations?
- A. Premature labor
- B. Twin-to-twin transfusion syndrome
- C. Preeclampsia
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Multiple gestations are at higher risk for complications such as premature labor, where contractions start before 37 weeks, leading to preterm birth. Twin-to-twin transfusion syndrome can occur in identical twins sharing a placenta, causing unequal blood flow. Preeclampsia, characterized by high blood pressure and organ damage, is more common in multiple pregnancies. Therefore, all choices A, B, and C are correct as they are common complications associated with multiple gestations.
The AGACNP knows that treatment for this likely will include
- A. Observation
- B. Hyperextension casting
- C. Jewett brace
- D. Surgical intervention
Correct Answer: B
Rationale: The correct answer is B: Hyperextension casting. The AGACNP knows that this treatment is appropriate for a condition that requires immobilization and support while allowing controlled movement. Hyperextension casting provides stability and support while promoting healing. Observation (A) would not provide adequate treatment for a condition requiring immobilization. Jewett brace (C) is typically used for spinal fractures, not for conditions that require hyperextension casting. Surgical intervention (D) would be considered if conservative measures like casting have failed.
The CORRECT statement with regards to face to pubis delivery is
- A. It results due to a 135˚ anterior rotation of the occiput
- B. It results due to a persistent occipito posterior position
- C. It results due to a 45˚ anterior rotation of the occiput
- D. It results due to a 45˚ anterior rotation of the sinciput
Correct Answer: C
Rationale: Rationale:
Face to pubis delivery occurs when the fetal face presents towards the mother's pubic bone during birth. Choice C is correct because a 45˚ anterior rotation of the occiput is needed for this positioning. This allows the fetal face to be directed towards the mother's pubis for a successful face to pubis delivery. Choices A and D are incorrect as they mention incorrect angles of rotation. Choice B is incorrect as a persistent occipito posterior position would result in a face to sacrum delivery, not face to pubis.
Secondary postpartum haemorrhage mostly occurs between the 8th-14th day postpartumly and can extend up to the first 46 days following delivery.
- A. TRUE
- B. FALSE
- C. Rarely True
- D. Sometimes True
Correct Answer: A
Rationale: The correct answer is A because secondary postpartum hemorrhage typically occurs between the 8th-14th day postpartum and can extend up to 6 weeks after delivery. This timeframe aligns with the physiological changes and healing process after childbirth.
Choice B is incorrect because it contradicts the established timeframe for secondary postpartum hemorrhage.
Choice C is incorrect as secondary postpartum hemorrhage is not rare but rather a recognized complication that can occur after childbirth.
Choice D is incorrect as secondary postpartum hemorrhage does not happen sporadically, but rather follows a defined timeframe based on postpartum physiological changes.
Psychosis during puerperium mostly manifests as
- A. Mania
- B. Bipolar
- C. Depression
- D. Infection
Correct Answer: C
Rationale: The correct answer is C: Depression. Psychosis during puerperium commonly manifests as postpartum depression, characterized by feelings of extreme sadness, anxiety, and fatigue. This is due to hormonal changes and stress associated with childbirth. Mania (choice A) and bipolar disorder (choice B) are less common during this period. Infection (choice D) is not a typical manifestation of psychosis during puerperium. Overall, postpartum depression is the most prevalent and well-documented form of psychosis in the postpartum period.