The PRIORITY action to take when nursing a neonate on phototherapy is to

Correct Answer: D

Rationale: The correct answer is D: Check the neonate’s vital signs every 2-4 hourly. This is the priority action because neonates undergoing phototherapy are at risk for dehydration and temperature instability. Monitoring vital signs regularly helps to detect any signs of dehydration, such as decreased urine output or increased heart rate, and ensures timely intervention. Explanation for other choices: A: Turning the neonate every six hours routinely is important for preventing pressure ulcers but is not the priority when compared to monitoring vital signs for potential complications. B: Encouraging the mother to discontinue breastfeeding is incorrect as breastmilk provides essential nutrients and hydration, which are important for neonates, even during phototherapy. C: Notifying the physician if the skin turns bronze-colored is important to address a potential adverse reaction to phototherapy but does not take precedence over monitoring vital signs for immediate concerns.

Correct Answer: D

Rationale: Non-infective mastitis is associated with adenitis because it refers to inflammation of breast tissue without an infection. Adenitis specifically involves inflammation of the lymph nodes, which can be a common cause of non-infective mastitis. Cellulitis (A) is an infection of the skin and tissues beneath the skin, not specific to mastitis. Flat (B) and bifid (C) nipples are anatomical variations that do not directly relate to the inflammation of breast tissue.

Correct Answer: A

Rationale: The correct answer is A because cord presentation occurs when the umbilical cord lies in front of the presenting part after the membranes have ruptured. This can lead to compression of the cord during labor, affecting fetal oxygenation. Option B is incorrect as it describes cord prolapse, where the cord lies in front of the presenting part before membrane rupture. Option C describes nuchal cord, where the cord is wrapped around the fetal neck. Option D describes cord abruption, where the cord detaches prematurely from the placenta.

Correct Answer: A

Rationale: The correct answer is A because gestational diabetes can lead to macrosomia, which is excessive fetal growth due to high blood sugar levels in the mother. This occurs as the fetus receives excess glucose from the mother, resulting in increased fat deposition and larger birth weight. Congenital anomalies (B) are not directly caused by gestational diabetes but by genetic or environmental factors. Reduced fetal movements (C) are not a typical effect of gestational diabetes. While gestational diabetes can increase the risk of preterm birth (D), the primary impact on fetal development is macrosomia.

Correct Answer: A

Rationale: The correct answer is A: Immediate caesarean section. In obstructed labor, prompt delivery is crucial to prevent harm to both the mother and the baby. A caesarean section is the most effective and timely intervention to safely deliver the baby and avoid complications such as fetal distress, maternal infection, and uterine rupture. Observation with pain relief (B) may delay necessary intervention, and manual repositioning of the fetus (C) is not sufficient in cases of obstructed labor. Choice D is incorrect because not all options are appropriate in this specific scenario.

Correct Answer: B

Rationale: The correct answer is B: Myelomeningocele. McEwen sign refers to the characteristic scalloping of the frontal bones due to pressure from the expanding brain in individuals with myelomeningocele. This sign is specific to myelomeningocele and is not associated with hydrocephalus (A), microcephaly (C), or encephalocele (D), which have different clinical manifestations and imaging findings. Myelomeningocele is a neural tube defect where the spinal cord and its coverings protrude through an opening in the spine, leading to neurological deficits and associated signs like McEwen sign.

Correct Answer: D

Rationale: Step-by-step rationale for why D is correct: 1. Hyperemesis gravidarum is severe nausea and vomiting during pregnancy. 2. Prolonged vomiting can lead to electrolyte imbalances and nutritional deficiencies. 3. Vitamin B deficiency, specifically thiamine, can result in Wernicke’s encephalopathy. 4. Mallory-Weiss syndrome can occur due to repeated retching and vomiting. 5. Therefore, hyperemesis gravidarum can lead to both Wernicke’s encephalopathy and Mallory-Weiss syndrome. Summary: A: Placenta praevia is related to abnormal placental placement, not vomiting. B: Hypertensive disorders are associated with high blood pressure, not vomiting-related complications. C: Vitamin B deficiency can lead to Wernicke’s encephalopathy but is not directly caused by hyperemesis gravidarum.

Correct Answer: B

Rationale: The correct answer is B: Within the first week of birth. Classical vitamin K deficiency bleeding typically occurs within the first week of birth due to low levels of vitamin K in newborns. During this time, infants are at a higher risk of bleeding complications if not supplemented with vitamin K. Choice A is incorrect because bleeding usually occurs after the first 24 hours. Choice C is incorrect as it does not specify a specific time frame within the neonatal stage. Choice D is incorrect as classical vitamin K deficiency bleeding is typically seen within the first week, not necessarily during the entire infancy stage.

Correct Answer: D

Rationale: The correct answer is D: All of the above. Ultrasound in monitoring fetal growth can detect fetal anomalies by visualizing the fetus in real-time. It can also monitor placental health by assessing blood flow and position. Additionally, ultrasound can assess amniotic fluid levels to ensure proper fetal development. Therefore, all the benefits mentioned in choices A, B, and C are valid reasons why ultrasound is essential in monitoring fetal growth.