The appropriate order of steps in active management of the third stage of labor include:

Correct Answer: C

Rationale: The correct order of steps in active management of the third stage of labor includes: 1) Intramuscular injection of oxytocin to prevent postpartum hemorrhage, 2) Controlled cord traction with counter traction to the uterus to facilitate placental delivery, and 3) Uterine massage to aid in uterine contraction and reduce bleeding. Rationale for Correct Answer (C): - Intramuscular oxytocin is administered first to prevent excessive bleeding. - Controlled cord traction with counter traction assists in the gentle delivery of the placenta. - Uterine massage helps the uterus contract and reduce the risk of hemorrhage. Summary of Incorrect Choices: - A (Incorrect): Incorrect order of steps, ergometrine administration is not recommended. - B (Incorrect): Incorrect order, fundal massage should be done after cord traction. - D (Incorrect): Incorrect order, oxytocin should be administered before cord traction.

Correct Answer: B

Rationale: The correct answer is B: Soak in 0.5% chlorine solution for 30 minutes. This is the most effective method for handling contaminated instruments as it allows enough time for the chlorine solution to effectively disinfect the instruments and kill any pathogens present. Washing with soap and water alone may not be sufficient to completely sterilize the instruments. Soaking for a longer duration (30 minutes) ensures thorough disinfection. Options A and D are similar but do not provide an adequate soaking time, which may result in incomplete disinfection. Option C of boiling for 2 hours is unnecessary and may damage the instruments.

Correct Answer: A

Rationale: The correct answer is A: Drying the baby thoroughly immediately after birth. This is the first step for thermal protection as it helps prevent heat loss and hypothermia in the newborn. By drying the baby immediately after birth, any amniotic fluid on the skin is removed, allowing the baby's body temperature to stabilize. Covering the baby with a clean, dry cloth after drying would be the next step to maintain warmth. Choices B, C, and D are incorrect because they do not address the crucial initial step of drying the baby immediately after birth to prevent hypothermia.

Correct Answer: A

Rationale: The correct answer is A: Uterine atony. After birth, the uterus may not contract properly, leading to excessive bleeding known as postpartum hemorrhage. Uterine atony is the most common cause, as the uterus fails to remain contracted after delivery. This results in inadequate compression of blood vessels, leading to bleeding. Genital lacerations can cause bleeding but are less common than uterine atony. Abnormal clotting mechanisms and endometritis are less likely causes of immediate postpartum bleeding compared to uterine atony.