Congenital retraction of the prepuce, so that the glans is permanently exposed, is known as

Correct Answer: B

Rationale: Congenital retraction of the prepuce, leading to permanent glans exposure, describes paraphimosis. This condition occurs when the foreskin is pulled back and cannot return to its normal position, causing pain and swelling. Phimosis (A) is the inability to retract the foreskin over the glans. Hypospadias (C) is a urethral opening on the underside of the penis. Hermaphroditism (D) is a rare condition of having both male and female reproductive organs. Paraphimosis (B) is the specific term for the given scenario.

Correct Answer: D

Rationale: Step-by-step rationale: 1. External examination can reveal the position of the baby's head. 2. Ultrasound can confirm the baby's position accurately. 3. Physical exam and pelvic exam findings can provide additional information. 4. Combining both methods (A and B) ensures a comprehensive assessment for accurate diagnosis. Summary: - Choice A alone may not provide sufficient information. - Choice B alone may not be as accurate as combined with ultrasound. - Choice C is not specific to diagnosing occipito-posterior position. - Choice D is correct as it combines external examination, ultrasound, and physical exam for accurate diagnosis.

Correct Answer: D

Rationale: The correct answer is D: Prevent excessive traction being applied. This is because in a breech delivery, excessive traction can lead to complications such as fetal injuries or umbilical cord prolapse. The midwife should avoid pulling on the baby's legs or body to prevent undue stress on the baby. The other choices are incorrect because: A: Ascertain the fetal wellbeing in utero - this is typically done through other means such as fetal monitoring. B: Allow enough room for the fetus to pass - this should be done by ensuring proper positioning and allowing natural descent. C: Allow gravitating descent of the fetus - this is not a recommended practice as it can cause complications.

Correct Answer: D

Rationale: The correct answer is D because additional nursing interventions are necessary to ensure an uncomplicated postpartum period. After an assisted vaginal delivery, the mother may experience increased pain, perineal trauma, and a higher risk of postpartum hemorrhage. Nursing interventions such as pain management, wound care, monitoring for signs of infection, and emotional support are crucial for the mother's recovery. A is incorrect because both vacuum extractors and forceps can cause trauma to the baby and mother's perineum, and the safety of one over the other depends on various factors. B is incorrect as the development of a cephalhematoma is not a normal expected outcome of assisted vaginal delivery and should be monitored and managed appropriately if it occurs. C is incorrect as the use of instruments during childbirth, while not as common as spontaneous vaginal deliveries, is not rare and can be necessary in certain situations to ensure the safety of the mother and baby.

Correct Answer: C

Rationale: Rationale for Correct Answer (C): A trial of scar is indicated when a woman has had no more than two previous caesarean sections. This is because the risk of uterine rupture increases with each subsequent caesarean section due to scar tissue weakening. Limiting the number of previous scars reduces this risk. Therefore, option C is correct. Summary of Incorrect Choices: A: Estimated fetal weight is not a determining factor for a trial of scar. B: Availability of a level one hospital nearby is important for emergency situations but not a criteria for trial of scar. D: Adequate pelvis with true conjugate 10.5cm is important for vaginal delivery but not a specific requirement for a trial of scar.