In the majority of cases, the first clinical manifestation of physiologic stress ulcer is

Correct Answer: C

Rationale: The correct answer is C: Fever. Physiologic stress ulcers are often associated with systemic stress response, leading to an increase in body temperature. Fever is an early sign of stress-related ulcers before other symptoms like epigastric pain or hemorrhage manifest. Change in mental status is more indicative of neurological issues rather than stress ulcers. Epigastric pain typically occurs after the ulcer has progressed, and hemorrhage is a severe complication of untreated stress ulcers.

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: A

Rationale: The correct answer is A: Erb’s palsy. Excessive traction and twisting of the neck during shoulder delivery can stretch or tear the brachial plexus nerves, leading to Erb’s palsy. This results in weakness or paralysis of the arm. Radial palsy (B) involves injury to the radial nerve, not typically caused by shoulder delivery. Torticollis (C) is a condition characterized by neck muscle contracture, not caused by excessive traction during delivery. Ecchymosis (D) refers to bruising and is not directly related to neck traction during delivery. In summary, Erb’s palsy is the correct choice due to the specific nerve injury pattern associated with excessive neck traction during shoulder delivery.

Correct Answer: D

Rationale: The correct answer is D because all the choices (A, B, and C) are risks associated with cesarean sections. Infection can occur at the incision site, blood loss is a common concern during surgery, and cesarean sections typically have a longer recovery time compared to vaginal delivery. Therefore, all of these risks are potential complications of undergoing a cesarean section. The other choices (A, B, and C) are incorrect individually because they only represent a subset of the risks associated with cesarean sections, while choice D encompasses all potential risks.

Correct Answer: B

Rationale: The correct answer is B: Delay in second stage of labor. Forceps delivery is indicated when there is a delay in the second stage of labor to expedite delivery and prevent maternal and fetal complications. This could be due to factors such as maternal exhaustion, fetal distress, or ineffective pushing. Inadequate pelvis size (A) may necessitate a C-section, unsuccessful vacuum extraction (C) may require alternative interventions, and fetal distress in the first stage of labor (D) may not necessarily indicate the need for forceps delivery immediately.