The term used to describe the situation whereby there is the presence of more than one part of the fetus on the pelvic brim at the onset of labor is

Correct Answer: D

Rationale: The correct answer is D: Compound presentation. This term refers to the situation where there is more than one part of the fetus on the pelvic brim at the onset of labor. This can include a hand or arm alongside the head or another body part. The other choices are incorrect because: A: Unstable lie refers to the fetus being in a transverse position. B: Fetal malpresentation indicates an abnormal presentation of the fetus, such as breech or transverse. C: Fetal malposition refers to the fetus being in a suboptimal position, like occiput posterior. Thus, the best choice is D as it specifically describes the scenario of multiple fetal parts on the pelvic brim.

Correct Answer: A

Rationale: The correct answer is A: Pyuria. Pyuria is a common feature in acute pyelonephritis, as it indicates the presence of white blood cells in the urine due to the infection. Fever, CVA tenderness, and gross hematuria are all common features of acute pyelonephritis. Fever is a systemic response to infection, CVA tenderness indicates inflammation of the kidney, and gross hematuria is often seen due to inflammation and damage to the kidney tissue. Therefore, the absence of pyuria would be unexpected in a patient with suspected acute pyelonephritis.

Correct Answer: A

Rationale: The correct answer is A: Irritable bowel syndrome. Mrs. Maroldo's history of recurrent left lower quadrant pain that usually resolves with antibiotics suggests a chronic condition rather than an acute one like diverticulitis, appendicitis, or inflammatory bowel disease. Her lack of nausea, vomiting, and severe symptoms, along with the presence of diarrhea and no bowel movements, align more with irritable bowel syndrome. Additionally, her vital signs are not significantly elevated, ruling out acute conditions like appendicitis. Discomfort to deep palpation in the left lower quadrant is common in irritable bowel syndrome due to visceral hypersensitivity. Therefore, based on her chronic symptoms, lack of severe signs, and typical presentation, the most likely diagnosis is irritable bowel syndrome.

Correct Answer: A

Rationale: The correct answer is A: HELLP syndrome. This must be evaluated as a cause of abdominal pain in a pregnant patient because it is a serious condition characterized by hemolysis, elevated liver enzymes, and low platelet count. These abnormalities can lead to abdominal pain, especially in the right upper quadrant. Placental abruption (B) presents with vaginal bleeding and uterine tenderness, not specific abdominal pain. Spontaneous hepatic rupture (C) is rare and usually presents with sudden severe abdominal pain. Preterm labor (D) typically presents with regular uterine contractions and lower abdominal discomfort, not specific upper quadrant pain like in HELLP syndrome.

Correct Answer: D

Rationale: The correct answer is D (All of the above) because preeclampsia is characterized by high blood pressure, proteinuria, and symptoms like severe headaches. High blood pressure is a hallmark sign, proteinuria indicates kidney damage, and severe headaches can be a symptom of worsening preeclampsia. Therefore, all three signs are crucial for diagnosing preeclampsia. Choices A, B, and C are incorrect individually because they do not encompass all the key signs necessary for diagnosing preeclampsia.

Correct Answer: C

Rationale: The correct answer is C because in obstructive shock due to a large pulmonary embolus, there is increased resistance to blood flow out of the right ventricle, leading to elevated right ventricular pressure. This causes a backup of blood into the pulmonary circulation, increasing left ventricular pressure. The increased left ventricular pressure results in decreased cardiac output as the left ventricle struggles to pump against the increased resistance. A: Elevated atrial and decreased ventricular pressures - This is incorrect as obstructive shock typically results in elevated ventricular pressures due to increased resistance. B: Elevated right-sided and decreased left-sided pressures - This is partially true, but C is a more complete answer that explains the consequences of these pressures on cardiac output. D: Elevated left ventricular pressure and decreased systemic vascular resistance - This is incorrect as obstructive shock leads to increased, not decreased, systemic vascular resistance due to the embolus obstructing blood flow.

Correct Answer: B

Rationale: The correct answer is B: Tonic. During the tonic stage of eclampsia, the muscles go into a prolonged contraction leading to an arched back and tightly clenched teeth. This is due to sustained muscle rigidity. In contrast, the clonic stage involves rhythmic muscle contractions and relaxations, not sustained rigidity. The premonitory stage is characterized by warning signs like headaches and visual disturbances, not specific physical postures. Coma is a severe stage of unconsciousness, not associated with specific physical postures or muscle rigidity seen in the tonic stage of eclampsia.

Correct Answer: D

Rationale: Rationale: 1. Obstructed labor can lead to prolonged pressure on the uterus, causing hemorrhage and uterine rupture (A). 2. Prolonged labor can result in fetal distress due to reduced oxygen supply and potential infection (B). 3. Therefore, both complications mentioned in A and B can occur in obstructed labor. Summary: A: Incorrect - Preterm birth and asphyxia are not directly related to obstructed labor. B: Incorrect - Only fetal distress and infection are commonly associated with obstructed labor. C: Incorrect - Both A and B are possible complications of obstructed labor, making D the correct choice.

Correct Answer: C

Rationale: The Mauriceau-Smellie-Veit maneuver is the correct answer for delivering the head in a breech presentation. This maneuver involves applying pressure to the fetal head with the fingers in the mouth to flex the head, guiding it through the pelvis. This technique helps prevent hyperextension of the head and facilitates a safe delivery. The Lovset maneuver involves rotating the fetus to disengage the impacted shoulder, not for delivering the head. The Burns Marshall Method is used for delivering the aftercoming head in a breech presentation. The Reverse woodscrew maneuver is a technique to disimpact a shoulder dystocia, not for delivering the head in a breech presentation.