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Which one of the following statements is correct with regards to face presentation?
- A. Majority are classified as primary face presentation
- B. The presenting transverse diameter is the bi-parietal diameter
- C. Majority are classified as secondary face presentation
- D. Locating the anterior fontanelle is diagnostic of the presentation
Correct Answer: C
Rationale: The correct answer is C: Majority are classified as secondary face presentation. In face presentation, the fetal head is hyperextended, presenting the face to the birth canal. Primary face presentation is rare. The bi-parietal diameter is not the presenting diameter in face presentation, as it is in vertex presentation. Locating the anterior fontanelle is not diagnostic of face presentation, as the fontanelles can be difficult to palpate during labor. Therefore, the correct statement is that the majority of face presentations are classified as secondary face presentation.
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Cord presentation is when the
- A. Umbilical cord lies in front of the presenting part after the membranes have ruptured.
- B. Umbilical cord lies in front of the presenting part before membranes have ruptured
- C. Umbilical cord is tied around the fetal neck.
- D. Umbilical cord has prematurely been detached.
Correct Answer: A
Rationale: The correct answer is A because cord presentation occurs when the umbilical cord lies in front of the presenting part after the membranes have ruptured. This can lead to compression of the cord during labor, affecting fetal oxygenation. Option B is incorrect as it describes cord prolapse, where the cord lies in front of the presenting part before membrane rupture. Option C describes nuchal cord, where the cord is wrapped around the fetal neck. Option D describes cord abruption, where the cord detaches prematurely from the placenta.
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.
Vaginal delivery is possible in
- A. Brow presentation
- B. Face presentation
- C. Shoulder presentation
- D. Unstable lie
Correct Answer: B
Rationale: The correct answer is B: Face presentation. Vaginal delivery is possible in face presentation as the baby's head is extended, allowing for descent through the birth canal. Brow presentation (A) and shoulder presentation (C) may require cesarean delivery due to the atypical presentation of the baby. Unstable lie (D) refers to the baby being in a transverse position, which also necessitates a cesarean section. Face presentation is the only option where vaginal delivery may be possible due to the extended position of the baby's head.
The main feature of Hyperemesis gravidarum is
- A. Pallor or cyanosis of mucous membrane
- B. Inability to eat or retain food all through
- C. Weakness because of severe state of shock
- D. Smaller fundal height compared to dates
Correct Answer: B
Rationale: Step 1: Hyperemesis gravidarum is characterized by severe nausea and vomiting during pregnancy.
Step 2: Inability to eat or retain food all through is a hallmark feature due to excessive vomiting.
Step 3: This leads to dehydration, electrolyte imbalances, and weight loss.
Step 4: Pallor, cyanosis, weakness, and smaller fundal height are not specific to hyperemesis gravidarum.
Summary: Choice B is correct as it directly relates to the primary symptom of excessive vomiting in hyperemesis gravidarum, while the other choices are not specific to this condition.
Placenta praevia is also referred to as unavoidable haemorrhage because
- A. Bleeding results as the segment prepares for true labour
- B. Bleeding results from pathological processes of the placenta
- C. Bleeding always occurs after a gestation of 37 complete weeks
- D. Of the high morbidity and mortality rate to the mother and neonate
Correct Answer: D
Rationale: The correct answer is D because placenta praevia can lead to life-threatening bleeding during labor due to the placenta partially or completely covering the cervix. This condition poses a high risk of morbidity and mortality to both the mother and the baby.
A: Incorrect. Bleeding in placenta praevia is not related to the segment preparing for labor.
B: Incorrect. While bleeding is due to placental issues, it is specifically due to the placenta's abnormal positioning, not a pathological process.
C: Incorrect. Bleeding can occur before 37 weeks in cases of placenta praevia, and the timing of bleeding is not linked to gestational age.