A maternal febrile condition noted within the first three weeks of postpartum is suggestive of

Correct Answer: C

Rationale: The correct answer is C: Puerperal pyrexia. Maternal febrile condition within the first three weeks postpartum is suggestive of puerperal pyrexia, which is defined as a fever of 38°C or higher occurring after the first 24 hours post-delivery. This condition is commonly caused by endometritis, a uterine infection following childbirth. Puerperal sepsis (choice A) is a more severe form of infection involving systemic symptoms, while puerperal thrombosis (choice B) refers to blood clot formation. Puerperal shock (choice D) is a life-threatening condition resulting from severe infection or hemorrhage, which may present with fever but is not the primary symptom.

Correct Answer: C

Rationale: The correct answer is C: Magnesium sulphate. In eclampsia, magnesium sulphate is the drug of choice because it helps prevent seizures by reducing neuromuscular irritability and blocking peripheral neuromuscular transmission. It also has vasodilatory effects, improving uteroplacental blood flow. Phenobarbitone (A) is not recommended due to its sedative effects. Calcium gluconate (B) is used to treat hyperkalemia, not eclampsia. Sodium bicarbonate (D) is used for metabolic acidosis, not eclampsia. In summary, magnesium sulphate is preferred for its efficacy in preventing and managing seizures in eclampsia.

Correct Answer: C

Rationale: The correct answer is C: Compound. When a hand or foot lies alongside the presenting part during childbirth, it is called a compound presentation. This can be a complication as it increases the risk of the presenting part not fitting through the birth canal properly. A: Footling presentation occurs when the baby's foot or feet are the first to emerge from the birth canal. B: Transverse presentation is when the baby is lying sideways in the uterus. D: Cephalic presentation is the ideal position for vaginal delivery, with the baby's head down and ready to be born.

Correct Answer: B

Rationale: The correct answer is B: Placental bed. Malaria parasites hide in the placental bed during pregnancy to avoid detection by the immune system. This location provides a safe haven for the parasites to survive and replicate without being cleared by the mother's immune response. The placental bed offers a rich blood supply and a favorable environment for the parasites to thrive. Incorrect choices: A: Bone marrow - Malaria parasites do not typically hide in the bone marrow during pregnancy. C: Fetal circulation - Malaria parasites do not hide in the fetal circulation; they primarily reside in the placental bed. D: Uterine muscle - Malaria parasites do not hide in the uterine muscle; the placental bed is the main site of sequestration during pregnancy.

Correct Answer: A

Rationale: The correct statement about shoulder dystocia is A: It’s an impaction of the anterior shoulder after delivery of the head. This is accurate as shoulder dystocia occurs when the anterior shoulder becomes impacted behind the maternal pubic symphysis. This can lead to difficulty delivering the shoulders after the head is delivered. B is incorrect as shoulder dystocia involves the anterior shoulder, not the posterior. C is incorrect as shoulder dystocia is not related to compound presentation. D is incorrect as shoulder dystocia is an obstetric emergency that requires prompt intervention to prevent complications for both the mother and the baby.

Correct Answer: C

Rationale: The correct answer is C: Place the client in knee-chest position. This helps relieve pressure on the cord and prevents further compression, ensuring adequate blood flow to the fetus. Pushing the cord back in (A) can worsen the situation. Covering the cord (B) does not address the urgent need to relieve pressure. Immediate vaginal delivery (D) may not be possible or safe at 32 weeks. Placing the client in the knee-chest position is the most immediate and effective action to manage cord prolapse.

Correct Answer: C

Rationale: The correct answer is C, major depression. Puerperal psychosis is a severe mental health condition that occurs in the postpartum period, characterized by symptoms such as hallucinations, delusions, and disorganized thinking. Major depression is a key clinical feature, often accompanied by mood disturbances and severe emotional distress. Rationale: - A: Episodic insomnia is a common symptom in various mental health disorders but not specific to puerperal psychosis. - B: Neglect of hygiene may occur in severe cases but is not the main clinical feature of puerperal psychosis. - D: Mild headache is not a characteristic symptom of puerperal psychosis, which is primarily marked by severe psychiatric symptoms.

Correct Answer: D

Rationale: The correct answer is D (>90%). Mr. Mettenberger had a reexpansion of his second spontaneous pneumothorax this year, indicating a high recurrence risk. Spontaneous pneumothorax recurrence rates are high, especially in young males. Factors such as smoking history, gender, and prior occurrences contribute to increased risk. Mr. Mettenberger's cessation of smoking reduces but does not eliminate the risk. Choices A, B, and C are too low, given his history and current situation. Choice D is the most appropriate due to the high likelihood of recurrence based on his medical history and risk factors.

Correct Answer: B

Rationale: The correct answer is B: Preservation of sensorineural hearing. In cholesteatoma, surgery aims to remove the lesion and prevent further damage to the ossicles and inner ear structures. Preserving sensorineural hearing is crucial to maintain auditory function post-surgery. A: Production of a dry ear is important to prevent recurrence, but not the primary goal. C: Debridement of infection is necessary, but the main aim is to address the cholesteatoma itself. D: Restoration of the tympanic membrane may be needed but is not the primary objective in cholesteatoma surgery.