The MAIN clinical feature of puerperal psychosis is

Correct Answer: C

Rationale: The correct answer is C, major depression. Puerperal psychosis is a severe mental health condition that occurs in the postpartum period, characterized by symptoms such as hallucinations, delusions, and disorganized thinking. Major depression is a key clinical feature, often accompanied by mood disturbances and severe emotional distress. Rationale: - A: Episodic insomnia is a common symptom in various mental health disorders but not specific to puerperal psychosis. - B: Neglect of hygiene may occur in severe cases but is not the main clinical feature of puerperal psychosis. - D: Mild headache is not a characteristic symptom of puerperal psychosis, which is primarily marked by severe psychiatric symptoms.

Correct Answer: C

Rationale: The correct answer is C because neglected obstructed labor and high parity are well-established predisposing factors to uterine rupture. Neglected obstructed labor can cause prolonged pressure on the uterus, leading to weakening and potential rupture. High parity (having given birth multiple times) can also increase the risk of uterine rupture due to repeated stretching and strain on the uterine muscles. A, B, and D are incorrect because nulliparity (never given birth), breech presentation, multiple pregnancy, and obstetric maneuvers are not as strongly associated with uterine rupture as neglected obstructed labor and high parity. These factors may increase the risk of other complications during childbirth but are not primary predisposing factors for uterine rupture.

Correct Answer: D

Rationale: The correct answer is D: His symptoms occur in 5 to 10% of people after ulcer surgery. This is the correct answer because the patient's symptoms of decreased capacity for intake and nausea after eating are common post-operative complications following ulcer surgery. By stating this fact to the patient, the AGACNP is providing reassurance that these symptoms are not unusual. Explanation for why the other choices are incorrect: A: Endoscopy is not necessary at this point since the symptoms described by the patient are known post-operative complications and do not indicate an urgent need for endoscopy. B: While gastroparesis can be a complication of ulcer surgery, there is no information in the case to suggest that the patient has chronic gastroparesis. C: Jumping to the conclusion that medication is unlikely to help and another surgery may be needed is premature and not supported by the information provided in the case.

Correct Answer: C

Rationale: The correct answer is C: Magnesium sulphate. In eclampsia, magnesium sulphate is the drug of choice because it helps prevent seizures by reducing neuromuscular irritability and blocking peripheral neuromuscular transmission. It also has vasodilatory effects, improving uteroplacental blood flow. Phenobarbitone (A) is not recommended due to its sedative effects. Calcium gluconate (B) is used to treat hyperkalemia, not eclampsia. Sodium bicarbonate (D) is used for metabolic acidosis, not eclampsia. In summary, magnesium sulphate is preferred for its efficacy in preventing and managing seizures in eclampsia.

Correct Answer: C

Rationale: The correct answer is C: Seat belts. Flexion-distraction injuries of the thoracolumbar spine are commonly caused by seat belts due to the mechanism of injury during a motor vehicle accident. When a sudden deceleration occurs, the body is restrained by the seat belt while the spine continues to move forward, leading to hyperflexion of the spine. This results in distraction forces at the thoracolumbar junction, causing injury. Blunt trauma (choice A) can cause various types of spinal injuries but is not specifically associated with flexion-distraction injuries. Rotational injury (choice B) typically leads to injuries such as fractures or dislocations, not flexion-distraction injuries. Gunshot wounds (choice D) can cause direct spinal damage, but they do not typically result in flexion-distraction injuries.

Correct Answer: A

Rationale: The correct answer is A: Always of the same sex. Monozygotic twins develop from a single fertilized egg, so they have the same genetic material, making them always the same sex. This is due to the fact that the sex of an individual is determined by the chromosomes inherited from the parents. This is a fundamental principle of genetics. Choices B, C, and D are incorrect because monozygotic twins can have different fingerprints, blood groups, and superfetation (conception that occurs during an existing pregnancy) is not common in monozygotic twins.

Correct Answer: A

Rationale: The correct answer is A because congenital abnormalities and chorioangioma can lead to increased amniotic fluid accumulation, causing polyhydramnios. Congenital abnormalities can affect fetal swallowing and urine production, leading to fluid buildup. Chorioangioma is a vascular tumor in the placenta that can disrupt normal fluid dynamics. Choice B is incorrect as severe fetal hypoxia and multiple pregnancy are more likely to cause oligohydramnios, not polyhydramnios. Choice C is incorrect as uncontrolled diabetes mellitus and anemia are associated with macrosomia and not polyhydramnios. Choice D is incorrect because Rhesus D isoimmunisation and postdatism are not typically linked to polyhydramnios.

Correct Answer: D

Rationale: Maternal smoking during pregnancy can affect fetal development in multiple ways. Smoking can cause low birth weight by restricting oxygen and nutrients to the fetus, leading to growth issues. It can also increase the risk of preterm birth due to the harmful chemicals in cigarette smoke. Furthermore, smoking can affect lung development in the fetus, leading to respiratory issues. Therefore, the correct answer is D - All of the above, as maternal smoking can have a comprehensive impact on fetal development, including low birth weight, preterm birth, and lung development issues.

Correct Answer: B

Rationale: The correct answer is B: Hyperbaric oxygen. Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room, which can help reduce gas cysts in the gastrointestinal tract by increasing oxygen delivery to tissues. This promotes healing and reduces symptoms associated with pneumatosis. A: Several days of oxygen by face mask is not as effective as hyperbaric oxygen therapy in treating pneumatosis, as it does not provide the same level of pressurized oxygen delivery to tissues. C: Surgical resection may be considered in severe cases of pneumatosis where conservative treatments have failed, but it is not the first-line treatment option. D: Treatment of underlying disease is important in managing pneumatosis, but it may not directly address the gas cysts themselves. Hyperbaric oxygen therapy specifically targets the gas cysts to alleviate symptoms.