The comprehensive serologic assessment of a patient with Cushings syndrome is likely to produce which constellation of findings?

Correct Answer: C

Rationale: The correct answer is C. In Cushing's syndrome, there is excess cortisol production leading to sodium retention, potassium loss, and increased protein breakdown. Low sodium and potassium levels along with high BUN are commonly seen in patients with Cushing's syndrome. A: Low potassium and high glucose are possible findings, but high white blood cell count is not typically associated with Cushing's syndrome. B: High sodium and polycythemia are not typical findings in Cushing's syndrome, and low BUN is not consistent with the protein breakdown seen in this condition. D: High sodium and high chloride levels can be seen, but high RBCs are not typically associated with Cushing's syndrome.

Correct Answer: D

Rationale: The correct answer is D because deep transverse arrest refers to a situation where the fetal head fails to rotate and descend in the pelvis due to the occiput and sinciput being at the same level. This leads to a prolonged labor. Choice A is incorrect because flexion can be inadequate in deep transverse arrest. Choice B is incorrect because it is not solely caused by uterine contractions but rather fetal malposition. Choice C is incorrect because a well-curved sacrum is not a defining factor in deep transverse arrest.

Correct Answer: D

Rationale: The correct diagnostic test for the patient is a barium enema. This test is commonly used to evaluate the colon and rectum for conditions such as colonic obstruction, inflammatory bowel disease, or colorectal cancer. In this case, the patient's presentation of left lower quadrant pain with a history of constipation and variable bowel habits suggests a possible colonic obstruction, which can be visualized through a barium enema. A CT scan with contrast may be helpful in some cases but may not provide as clear a view of the colon as a barium enema. CBC with WBC differential is a general blood test and would not directly aid in diagnosing colonic issues. Colonoscopy, while a valuable tool for evaluating the colon, may not be suitable for this patient initially due to the acute nature of the presentation and the need to first rule out a potential obstruction.

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: C

Rationale: The correct answer is C. In Cushing's syndrome, there is excess cortisol production leading to sodium retention, potassium loss, and increased protein breakdown. Low sodium and potassium levels along with high BUN are commonly seen in patients with Cushing's syndrome. A: Low potassium and high glucose are possible findings, but high white blood cell count is not typically associated with Cushing's syndrome. B: High sodium and polycythemia are not typical findings in Cushing's syndrome, and low BUN is not consistent with the protein breakdown seen in this condition. D: High sodium and high chloride levels can be seen, but high RBCs are not typically associated with Cushing's syndrome.

Correct Answer: B

Rationale: The correct answer is B: Magnesium sulphate. It is the drug of choice for managing eclampsia due to its ability to prevent and control seizures. Magnesium sulfate acts as a central nervous system depressant and smooth muscle relaxant, helping to prevent further seizures. Phenobarbitone (A) is not the first-line treatment for eclampsia. Calcium gluconate (C) is used to counteract calcium channel blocker toxicity, not for eclampsia. Sodium bicarbonate (D) is used to treat metabolic acidosis, not eclampsia.

Correct Answer: D

Rationale: The correct answer is D because a client is declared fit for a vaginal birth after cesarean section if their previous delivery was via spontaneous vertex delivery. This indicates that the client has successfully given birth vaginally before, reducing the risk associated with a vaginal birth after cesarean section. A, B, and C are incorrect: A: Cephalopelvic disproportion was the reason for the previous C/S, indicating potential difficulty in vaginal delivery. B: Confirmation of a multiple pregnancy does not impact the client's eligibility for a vaginal birth after cesarean section. C: Previous cesarean section does not necessarily mean the client is fit for a vaginal birth after cesarean section.

Correct Answer: A

Rationale: Rationale: Breech presentation increases risks during childbirth. Prolonged labor is common due to the position of the baby. Umbilical cord prolapse occurs when the cord slips through the cervix before the baby, leading to oxygen deprivation. Shoulder dystocia happens when the baby's shoulders get stuck during delivery. Choice A is correct as it directly relates to complications of breech presentation. Choices B, C, and D are incorrect as they do not specifically address the complications associated with breech presentation. Cesarean delivery is often recommended for breech presentation to avoid complications. Uterine rupture is a rare but severe complication that is not directly caused by breech presentation. Preeclampsia, gestational diabetes, and low birth weight are not commonly associated with breech presentation. Therefore, choice A is the correct answer.

Correct Answer: C

Rationale: Step-by-step rationale for choice C: 1. Progressive cervical dilatation indicates effective labor progress. 2. Stopping the syntocinon drops prematurely allows natural labor progression. 3. Prematurely stopping drops before reaching full dilation may hinder labor. 4. Achieving cervical dilatation is a crucial indicator for successful labor. Summary: A: Contractions should be strong, not just moderate. B: Maternal observations alone do not determine labor progress. D: Fetal-related observations are important but not the primary indicator for stopping drops.