Correct Answer: D

Rationale:
Step 1: Atony of the uterus is the most common cause of primary postpartum hemorrhage due to inadequate uterine contractions.

Step 2: Trauma of the genital tract can lead to bleeding but is not as common as atony of the uterus in postpartum hemorrhage.

Step 3: Blood coagulation disorder can contribute to excessive bleeding but is not the primary cause of postpartum hemorrhage.

Step 4: Prolonged 3rd stage can result in postpartum hemorrhage but is typically secondary to uterine atony.

Correct Answer: A

Rationale: The correct answer is A: Acute mitral valve regurgitation. The presence of a grade VVI systolic murmur that radiates to the midaxillary line suggests mitral valve involvement. Mitral regurgitation leads to acute onset of symptoms such as dyspnea and pulmonary congestion, indicated by coarse rales on auscultation. The murmur is loudest at the point of maximal impulse due to eccentric regurgitation jet. Acute aortic valve regurgitation (
B) typically presents with a diastolic murmur. Acute cardiac tamponade (
C) would present with Beck's triad and pulsus paradoxus. Acute pulmonary embolus (
D) would present with sudden onset dyspnea and pleuritic chest pain.

Correct Answer: D

Rationale: The correct answer is D (All of the above) because during pregnancy, UTI symptoms include painful urination, increased frequency of urination, and lower abdominal pain. Painful urination is a common symptom due to inflammation of the urinary tract. Increased frequency of urination is caused by the pressure of the growing uterus on the bladder. Lower abdominal pain can also occur due to the infection.
Therefore, all these symptoms are indicative of a UTI during pregnancy. Other choices are incorrect as they do not encompass the comprehensive range of symptoms typically seen in a UTI during pregnancy.

Correct Answer: T

Rationale:
Step-by-step rationale:
1. Puerperal psychosis is a severe mental health condition occurring postpartum.
2. Psychosocial adversities, such as stress or lack of social support, can trigger or exacerbate mental health issues.
3.
Therefore, psychosocial adversities can be predisposing factors for puerperal psychosis.
4. Option A (TRUE) is correct as it aligns with the established relationship between psychosocial factors and mental health.
Summary: Option A is correct because psychosocial adversities can indeed contribute to the development of puerperal psychosis, making it a relevant predisposing factor. Options B, C, and D are incorrect as they do not provide any rationale or evidence to support their validity.

Correct Answer: C

Rationale: The correct answer is C: Homeopathy. Homeopathy involves using highly diluted substances to stimulate the body's natural healing processes. In labor, homeopathy can help manage pain and support relaxation. Entonox (
A) and Diamorphine (
D) are pharmacological measures, while Cyclothane (
B) is not a recognized pain relief option in labor. Homeopathy aligns with non-pharmacological approaches, making it the most suitable choice for pain relief in labor.