The baby dies immediately after birth due to the presence of

Correct Answer: C

Rationale: The correct answer is C: Truncus arteriosus. In this congenital heart defect, a single large blood vessel arises from the heart instead of the normal two separate vessels (aorta and pulmonary artery). This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygen supply to the body. This condition is incompatible with life, causing immediate death after birth. A: Pulmonary stenosis and B: Aortic coarctation are also congenital heart defects but do not typically result in immediate death after birth. Pulmonary stenosis obstructs blood flow to the lungs, while aortic coarctation causes narrowing of the aorta. D: Ductus arteriosus is a normal fetal blood vessel that connects the pulmonary artery and the aorta but usually closes shortly after birth. Failure of closure can lead to health issues, but it is not typically a cause of immediate death after birth.

Correct Answer: B

Rationale: The correct answer is B: Cephalopelvic disproportion. This condition occurs when the baby's head is too large to pass through the mother's pelvis during labor. This leads to obstructed labor, causing complications for both the mother and the baby. Maternal exhaustion (A) may occur as a result of prolonged labor but is not the primary cause of obstructed labor. Microsomic fetus (C) refers to a small baby and would not typically cause obstructed labor. Fetal exsanguination (D) is the loss of blood from the fetus and is not a common cause of obstructed labor. Cephalopelvic disproportion is the most common reason for obstructed labor as it directly affects the passage of the baby through the birth canal.

Correct Answer: C

Rationale: Step 1: In normal labor, the cervix undergoes effacement and dilation. Step 2: A short and thin cervical canal indicates progression towards labor. Step 3: Long and thick cervical canal suggests a delay in labor progress. Step 4: Choice C, short and thin cervical canal, is indicative of abnormal labor. Summary: A, B, and D do not reflect changes in the cervix seen in labor, making them incorrect choices.

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: C

Rationale: Rationale for Correct Answer (C): 1. The patient's symptoms of decreased capacity for intake and nausea after eating suggest gastroparesis, a common complication post-ulcer surgery. 2. Given the history of complicated peptic ulcer disease and prior surgery, medication may be ineffective, necessitating potential reoperation. 3. The AGACNP advises that another surgery may be needed, indicating that medication alone may not suffice to address the issue. Summary of Incorrect Choices: A: Endoscopy is not necessary at this point as the symptoms are likely indicative of a functional issue rather than a structural problem. B: While gastroparesis can occur post-ulcer surgery, the patient's symptoms are more suggestive of gastroparesis rather than chronic gastroparesis as a known complication. D: The frequency of occurrence of symptoms after ulcer surgery is not relevant to the current management of the patient's symptoms.

Correct Answer: A

Rationale: The correct answer is A: Hypogastrinemia and acid hyposecretion. Gastrinoma is a tumor that secretes excessive gastrin, leading to hypergastrinemia and increased acid secretion. However, due to a negative feedback mechanism, chronic exposure to high gastrin levels can cause downregulation of gastrin receptors on parietal cells, leading to decreased acid secretion. Therefore, in gastrinoma, despite high gastrin levels, acid secretion may be reduced due to this negative feedback loop. Choices B, C, and D are incorrect because they do not align with the expected relationship between gastrin levels and acid secretion in gastrinoma.

Correct Answer: C

Rationale: The correct answer is C because establishing an intravenous line is essential for immediate access to administer fluids, medications, and blood products during the emergency cesarean section. This step ensures that the patient's vital signs can be supported, and any emergent interventions can be readily delivered. A: While informed consent is important, in an emergency situation, the priority is to ensure the patient's immediate medical needs are met. B: Inserting a Foley's catheter may be necessary during the procedure, but it is not the most critical assessment prior to the cesarean section. D: Shaving the perineal area is not a priority in an emergency situation and may be done during the preparation for surgery.

Correct Answer: D

Rationale: Placental parasitation is associated with Malaria prenatally because the Plasmodium parasite can infect the placenta through the bloodstream, leading to severe complications for both the mother and the fetus. This infection can result in low birth weight, preterm birth, and even stillbirth. Candidiasis, Tuberculosis, and Multiple gestation are not directly associated with placental parasitation. Candidiasis is a fungal infection, Tuberculosis is a bacterial infection, and Multiple gestation refers to carrying more than one fetus during pregnancy. Therefore, the correct answer is D, Malaria prenatally, due to the direct impact of Plasmodium parasite on the placenta and its implications on pregnancy outcomes.

Correct Answer: A

Rationale: The correct answer is A: Keep client well hydrated. Encouraging plenty of fluids helps prevent dehydration, maintain adequate urine output, and promote flushing of the urinary tract to prevent infections, all crucial for postnatal clients with urinary tract trauma. Proper hydration also supports overall health and aids in the healing process. B: Maintain proper fluid balance - While important, the main aim is to keep the client well hydrated to support healing. C: Facilitate proper healing - Proper hydration does facilitate healing, but the primary aim is to keep the client well hydrated. D: Control growth of organisms - While hydration can help in preventing infections, the main aim is to keep the client well hydrated.