A client diagnosed with gestational diabetes at 24 weeks is scheduled for ANC care every

Correct Answer: C

Rationale: The correct answer is C: Four weekly up to 28 weeks. Gestational diabetes requires close monitoring of blood sugar levels and fetal well-being. ANC care every four weeks up to 28 weeks ensures proper management and early detection of any complications. Weekly or two weekly visits (options A and B) may be too frequent and unnecessary at this stage unless there are specific concerns. Three weekly visits (option D) may not provide adequate monitoring intervals. Therefore, option C is the most appropriate choice for the optimal management of gestational diabetes at this stage of pregnancy.

Correct Answer: C

Rationale: The correct answer is C: A rupture of the uterine wall confined to the tissue. Extra-peritoneal uterine rupture refers to a rupture that does not breach the peritoneal cavity, keeping the damage confined to the uterine tissue only. This is distinct from intra-peritoneal rupture which involves the peritoneum (choice B) and complete rupture of all uterine layers (choice D). Choice A is incorrect as it does not specify the location of the tear, and it does not necessarily imply that there is no organ damage.

Correct Answer: D

Rationale: The correct answer is D because the main aims of an exchange transfusion procedure are to control haemolysis (process of breaking down red blood cells) and restore hemoglobin levels. This procedure involves removing the baby's blood and replacing it with donor blood to prevent complications from severe jaundice or other conditions. Choice A is incorrect because exchange transfusion does not necessarily cure haemolysis, but it helps control it. Choice B is incorrect as the procedure focuses on managing specific issues rather than removing all toxic materials. Choice C is incorrect because it does not directly address the primary goals of an exchange transfusion.

Correct Answer: C

Rationale: The correct answer is C: Occipito-posterior. This position occurs when the baby's head is facing forward but towards the mother's spine. This position can cause intense back pain during labor because the baby's head puts pressure on the mother's lower back. Occipito-anterior (A) is the most common and ideal position for labor. Transverse position (B) is when the baby is lying sideways, which may cause prolonged labor but not necessarily intense back pain. Occipito-lateral (D) is a less common position where the baby's head is facing sideways, which may not specifically cause intense back pain.

Correct Answer: B

Rationale: It is important to monitor blood pressure in pregnant women to detect preeclampsia, a serious condition that can lead to complications for both the mother and the baby. Preeclampsia is characterized by high blood pressure and protein in the urine, and early detection is crucial for timely intervention. Regular monitoring allows healthcare providers to identify and manage preeclampsia promptly, reducing the risk of severe complications such as eclampsia and organ damage. Anemia, preterm labor, and gestational diabetes are important aspects of prenatal care but are not directly related to the need for regular blood pressure monitoring in pregnant women.

Correct Answer: D

Rationale: The correct answer is D: Serotonin. Serotonin is not a primary chemical mediator of hepatic encephalopathy. The main chemical mediators involved in hepatic encephalopathy are A: Gamma-aminobutyric acid (GABA), B: Ammonia, and C: False neurotransmitters. GABA plays a role in inhibiting neurotransmission, ammonia is a key factor in the pathogenesis of hepatic encephalopathy, and false neurotransmitters are produced due to altered amino acid metabolism in the liver. Serotonin is not a key player in the development of hepatic encephalopathy, hence it is the correct answer.

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.

Correct Answer: C

Rationale: The correct answer is C: Magnesium sulphate. It is the drug of choice in managing eclampsia due to its ability to prevent and control seizures. Magnesium sulfate is a central nervous system depressant that reduces neuronal excitability and neuromuscular transmission, thus preventing seizures. It also helps in lowering blood pressure and preventing complications. Phenobarbitone (A) is not the first-line treatment for eclampsia. Calcium gluconate (B) is used for calcium deficiency, not eclampsia. Sodium bicarbonate (D) is used to correct acidosis, not for managing eclampsia.

Correct Answer: A

Rationale: The engaging diameter in a face presentation is the sub-mento vertical diameter. This is the correct answer because it represents the distance from the tip of the chin (mentum) to the highest point on the skull (vertex), which is the most critical diameter for the face to descend through the pelvis during childbirth. Choice B (Sub-mento bregmatic diameter) is incorrect because it represents the distance from the tip of the chin to the anterior fontanelle, not the highest point on the skull. Choice C (Mento vertical diameter) is incorrect because it refers to the distance from the chin to the base of the skull, not the highest point on the skull. Choice D (Sub-occipito bregmatic diameter) is incorrect because it represents the distance from the base of the skull to the anterior fontanelle, not involving the chin.