What are the key indicators for cesarean section during labor?

Correct Answer: D

Rationale: The correct answer is D, as all three choices are key indicators for cesarean section during labor. Fetal distress indicates the baby is not tolerating labor well. Failure to progress may lead to complications for the mother or baby. Breech presentation increases the risk of complications during vaginal delivery. Therefore, all three indicators warrant consideration for a cesarean section to ensure the safety of both the mother and the baby.

Correct Answer: D

Rationale: The correct answer is D: Fistula formation. Fistula formation is the most severe type of urinary tract trauma as it involves an abnormal connection between the urinary tract and another organ or the skin. This condition can lead to severe complications such as recurrent infections, incontinence, and even sepsis. Retention of urine (A) is a symptom of urinary tract obstruction, not necessarily the most severe type of trauma. Stress incontinence (B) is a common condition but is not indicative of severe trauma. Scalding sensation (C) can be a symptom of a urinary tract infection but does not necessarily indicate severe trauma like fistula formation.

Correct Answer: D

Rationale: The correct answer is D: Non-pharmacological methods of pain relief. Homeopathy, music therapy, and hydrotherapy are all non-pharmacological approaches that do not involve the use of medication to manage pain. They focus on alternative techniques to alleviate pain, such as using natural remedies, music, or water-based therapies. These methods aim to address pain through holistic approaches that do not rely on traditional pharmaceutical interventions. A: Systemic methods of pain relief typically involve medications that affect the entire body, such as opioids. B: Regional analgesia methods target specific areas for pain relief, like nerve blocks. C: Inhalational analgesia involves administering pain relief medications through inhalation, such as nitrous oxide. In summary, the other choices are incorrect because they do not accurately describe the non-pharmacological nature of homeopathy, music therapy, and hydrotherapy in managing pain.

Correct Answer: D

Rationale: The correct answer is D because precipitate delivery, characterized by rapid descent and delivery of the baby, can cause cervical lacerations due to the fast and forceful passage of the baby through the birth canal. This can result in tearing of the cervical tissue. Choice A is incorrect because uterine atony is not typically associated with precipitate delivery. Choice B is incorrect as puerperal sepsis is not directly related to the speed of delivery. Choice C is incorrect as the occurrence of precipitate delivery does not guarantee reduced risk of recurrence with prenatal monitoring.

Correct Answer: A

Rationale: The correct answer is A (36 weeks gestation) because at this point in pregnancy, the fetus has reached a stable lie position. Before 36 weeks, fetal lie can vary due to the ample space in the uterus. After 36 weeks, the fetus tends to settle into a consistent head-down or breech position, making the lie stable. Choices B, C, and D are incorrect as they are past the point where the lie typically stabilizes, leading to less variability in fetal positioning.

Correct Answer: B

Rationale: The correct answer is B: FALSE. Severe epigastric pain in preeclampsia is not associated with hyperacidity but is more likely due to complications such as HELLP syndrome or liver involvement. Preeclampsia is characterized by high blood pressure and proteinuria, not hyperacidity. Therefore, severe epigastric pain in preeclampsia should not be attributed to hyperacidity. Other choices are not applicable.

Correct Answer: C

Rationale: The correct answer is C: Placental insufficiency. Placental insufficiency can lead to decreased oxygen and nutrient supply to the fetus, causing fetal distress during labor. This can result in abnormal fetal heart rate patterns and potential complications. A: Umbilical cord prolapse can also cause fetal distress but is less common than placental insufficiency. B: Uterine rupture is a serious complication but typically presents with maternal symptoms rather than fetal distress. D: Fetal position can impact labor progress but is not typically the primary cause of fetal distress.

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: A

Rationale: The correct answer is A (36 weeks gestation) because at this stage, the fetal lie should stabilize into a consistent position, typically longitudinal. Before 36 weeks, fetal movement and position can vary frequently. Choices B, C, and D are incorrect as they are past the point where fetal lie should have stabilized. At 42 weeks gestation (Choice B), the baby is considered post-term, and fetal lie should have already been established. Similarly, Choices C (38 weeks) and D (40 weeks) fall within the expected range for fetal lie stabilization.