Nokea
Which one of the following is involved in the management of cord prolapse?
- A. Placing client on all fours position
- B. Application of fundal pressure
- C. Placing client on Trendelenburg position
- D. Labor augmentation using oxytocin regimen
Correct Answer: C
Rationale: The correct answer is C: Placing client on Trendelenburg position. This helps prevent compression of the cord by moving the presenting part off the cord. Placing the client on all fours (choice A) may worsen cord compression. Application of fundal pressure (choice B) is contraindicated as it can further compress the cord. Labor augmentation with oxytocin (choice D) is not indicated in cord prolapse management as it does not address the immediate risk to the fetus. Trendelenburg position is the recommended intervention to alleviate cord compression and improve fetal oxygenation.
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Diamorphic anaemia results due to deficiency of
- A. Iron and thiamine
- B. Iron and folic acid
- C. Folic acid and thiamine
- D. Liver enzymes and iron
Correct Answer: B
Rationale: The correct answer is B: Iron and folic acid. Diamorphic anemia is characterized by the presence of both microcytic and macrocytic red blood cells, which can be caused by a deficiency in both iron and folic acid. Iron deficiency leads to microcytic anemia, while folic acid deficiency results in macrocytic anemia. Thiamine deficiency (Choice A) primarily affects the nervous system and does not directly cause diamorphic anemia. Liver enzymes deficiency (Choice D) does not directly lead to diamorphic anemia. Folic acid and thiamine deficiency (Choice C) can cause individual types of anemia but not diamorphic anemia.
The lie is defined as unstable when it keeps varying after
- A. 36 weeks gestation
- B. 42 weeks gestation
- C. 38 weeks gestation
- D. 40 weeks gestation
Correct Answer: A
Rationale: The correct answer is A (36 weeks gestation) because at this point in pregnancy, the fetus has reached a stable lie position. Before 36 weeks, fetal lie can vary due to the ample space in the uterus. After 36 weeks, the fetus tends to settle into a consistent head-down or breech position, making the lie stable. Choices B, C, and D are incorrect as they are past the point where the lie typically stabilizes, leading to less variability in fetal positioning.
Ms. Kweke’s possible complications (obstructed labour):
- A. Hemorrhage, uterine rupture
- B. Fetal distress, infection
- C. Preterm birth, asphyxia
- D. Both A and B
Correct Answer: D
Rationale: Rationale:
1. Obstructed labor can lead to prolonged pressure on the uterus, causing hemorrhage and uterine rupture (A).
2. Prolonged labor can result in fetal distress due to reduced oxygen supply and potential infection (B).
3. Therefore, both complications mentioned in A and B can occur in obstructed labor.
Summary:
A: Incorrect - Preterm birth and asphyxia are not directly related to obstructed labor.
B: Incorrect - Only fetal distress and infection are commonly associated with obstructed labor.
C: Incorrect - Both A and B are possible complications of obstructed labor, making D the correct choice.
Classical caesarean section is indicated for
- A. An anteriorly situated placenta praevia
- B. A posteriorly situated placenta praevia
- C. A gestation of more than 32 weeks
- D. Aesthetic purpose on maternal request
Correct Answer: A
Rationale: The correct answer is A because in cases of anteriorly situated placenta praevia, where the placenta partially or completely covers the cervix, a classical caesarean section is indicated to prevent severe bleeding during delivery. For choice B, a posteriorly situated placenta praevia does not necessitate a classical caesarean section. Choice C, gestation of more than 32 weeks, does not specifically indicate the need for a classical caesarean section. Choice D, aesthetic purpose on maternal request, is not a valid medical indication for a classical caesarean section.
The AGACNP knows that when evaluating a patient with suspected acute pyelonephritis, which of the following is not a common feature?
- A. Pyuria
- B. Fever
- C. CVA tenderness
- D. Gross hematuria
Correct Answer: A
Rationale: The correct answer is A: Pyuria. Pyuria is a common feature in acute pyelonephritis, as it indicates the presence of white blood cells in the urine due to the infection. Fever, CVA tenderness, and gross hematuria are all common features of acute pyelonephritis. Fever is a systemic response to infection, CVA tenderness indicates inflammation of the kidney, and gross hematuria is often seen due to inflammation and damage to the kidney tissue. Therefore, the absence of pyuria would be unexpected in a patient with suspected acute pyelonephritis.