Correct Answer: A

Rationale: The correct answer is A because gestational diabetes can lead to macrosomia, which is excessive fetal growth due to high blood sugar levels in the mother. This occurs as the fetus receives excess glucose from the mother, resulting in increased fat deposition and larger birth weight. Congenital anomalies (B) are not directly caused by gestational diabetes but by genetic or environmental factors. Reduced fetal movements (C) are not a typical effect of gestational diabetes. While gestational diabetes can increase the risk of preterm birth (D), the primary impact on fetal development is macrosomia.

Correct Answer: B

Rationale: The correct answer is B: Grunting on expiration. In respiratory distress syndrome, the infant may exhibit grunting on expiration due to the difficulty in maintaining lung inflation during exhalation. This is a compensatory mechanism to increase functional residual capacity. Grunting on inspiration (choice A) may be seen in other respiratory conditions. Flaring of the nostrils (choice C) is a sign of increased work of breathing but is not specific to respiratory distress syndrome. Neonatal tachycardia (choice D) can be a nonspecific sign of distress and is not a specific feature of respiratory distress syndrome.

Correct Answer: A

Rationale: The presenting diameter in brow presentation is Submentobregmatic (choice A) because it refers to the distance from the submentum (chin) to the bregma (anterior fontanelle). This is the appropriate measurement for the brow presentation as the brow is the prominent part between the forehead and the chin. Choice B (Suboccipitofrontal) is incorrect because it refers to the distance from the subocciput to the frontal bone, which is not relevant to brow presentation. Choice C (Occipitalfrontal) is incorrect because it describes the distance from the occiput to the frontal bone, which again is not specific to brow presentation. Choice D (Mentovertical) is incorrect as it denotes the distance from the chin to the vertex, which is not the relevant measurement for brow presentation.

Correct Answer: C

Rationale: The correct answer is C: 4 hours. This is based on the definition of prolonged second stage in nulliparous women, which is labor lasting more than 4 hours. This duration is considered abnormal and may lead to increased risk of maternal and fetal complications. Choice A (1 hour) is too short and does not meet the criteria for prolonged second stage. Choice B (2 hours) is also insufficient based on the established timeframe. Choice D (8 hours) exceeds the duration for prolonged second stage, indicating a more advanced stage of labor. Therefore, the most appropriate and accurate timeframe for prolonged second stage in nulliparous women is 4 hours.

Correct Answer: A

Rationale: The correct answer is A: Submentovertival, bitemporal. In a face presentation, the presenting diameters are submentovertival (chin to vertex) and bitemporal (temple to temple). This is because the fetus is in a face-first position with the chin presenting first. Option B is incorrect because submentobregmatic is not a recognized presenting diameter in face presentation. Option C is incorrect as biparietal refers to the widest transverse diameter of the fetal head, not relevant in face presentation. Option D is incorrect as mentovertical is not a valid presenting diameter in face presentation.