Which one of the following clinical features denotes cardiac disease grade III?

Correct Answer: C

Rationale: The correct answer is C: Marked limitation of physical activity. In cardiac disease grading, grade III signifies marked limitation of physical activity. This indicates that the patient experiences symptoms with less than ordinary physical activity, such as shortness of breath or chest pain. This grade reflects significant impairment in daily activities due to cardiac issues. A: Patient is comfortable even at rest - This describes grade I, where patients are comfortable at rest. B: Patient is asymptomatic initially - This describes pre-symptomatic stages before any limitations in physical activity. D: Absolute limitation of physical activity - This is more severe and indicative of grade IV, where any physical activity causes discomfort or symptoms.

Correct Answer: C

Rationale: The correct answer is C: Protein intake of 50 g daily. In hepatic encephalopathy, reducing protein intake is crucial to prevent ammonia accumulation. Protein breakdown in the body leads to ammonia production, which worsens encephalopathy symptoms. Limiting protein intake to 50g daily helps decrease ammonia formation. Lactulose (choice A) is used to reduce ammonia absorption in the gut. Spironolactone (choice B) is a diuretic used to treat fluid retention in liver disease. Zolpidem (choice D) is a sedative and not related to managing ammonia accumulation in hepatic encephalopathy. Therefore, choices A, B, and D are incorrect for long-term management of ammonia accumulation in hepatic encephalopathy.

Correct Answer: A

Rationale: The correct answer is A because Bishop's score assesses the readiness of the cervix for labor by evaluating descent (station of the fetal head), presentation (fetal position), and cervical dilatation, which are key indicators of cervical ripening and effacement. Descent shows the progress of the fetus through the birth canal, presentation indicates the fetal position for delivery, and cervical dilatation reflects the opening of the cervix for labor. Choices B, C, and D are incorrect as they do not encompass all the essential components of Bishop's score, which focuses on descent, presentation, and cervical dilatation.

Correct Answer: C

Rationale: The correct answer is C: Not more than two previous caesarean section scars. This is because a trial of scar refers to a trial of labor in a woman who has had previous cesarean sections. The guideline typically recommends that a trial of scar should be considered in women with no more than two previous cesarean section scars to reduce the risk of uterine rupture. Choices A, B, and D are incorrect because the estimated fetal weight, availability of a level one hospital, and pelvis size are not specific criteria used to determine eligibility for a trial of scar.

Correct Answer: B

Rationale: The correct answer is B: Assess fetal lung maturity. Amniotic fluid analysis measures the levels of substances like surfactant, which indicates lung maturity. This helps in determining if the fetus is ready for delivery. Other choices are incorrect because amniotic fluid analysis is not primarily used to detect fetal infections (A), determine fetal position (C), or assess placental health (D). These functions are typically achieved through other diagnostic tests or imaging techniques.

Correct Answer: A

Rationale: The correct answer is A: Observation. As an AGACNP, observation is crucial for monitoring the progression of the condition before considering any invasive treatments. Hyperextension casting (B) and Jewett brace (C) are more specific interventions for spinal conditions and not typically indicated for this scenario. Surgical intervention (D) is typically considered only if conservative treatments fail, making it a last resort option. Therefore, observation allows for a conservative approach to assess the patient's response to initial management before considering more aggressive interventions.

Correct Answer: C

Rationale: The correct answer is C because culture and level of education can significantly impact how women perceive and react to labor pain. Culture shapes beliefs, norms, and attitudes towards pain, influencing coping mechanisms. Education can enhance understanding of pain management techniques. Option A lacks specificity on how preparedness and fatigue affect perception. Option B oversimplifies by only considering culture and age. Option D overlooks the influence of education and focuses solely on anxiety and number of deliveries.

Correct Answer: C

Rationale: The correct answer is C: Diamorphine. Diamorphine is a non-pharmacological measure of pain relief in labor. It is a type of opioid analgesic that helps to reduce pain during labor. It works by binding to opioid receptors in the brain and spinal cord, altering the perception of pain. Rationale: 1. Diamorphine is a medication that directly targets pain relief. 2. It is a commonly used non-pharmacological measure in labor settings. 3. Diamorphine does not involve the use of any gases or inhalants like Entonox (A) or Cyclothane (B). 4. Homeopathy (D) is based on the principle of treating "like with like" using highly diluted substances and is not typically used for pain relief in labor. Summary: A: Entonox and B: Cyclothane are incorrect because they are pharmacological measures involving the use of gases or inhalants. D: Homeopathy is

Correct Answer: B

Rationale: The correct answer is B: A surgical procedure in which the cartilage of the pubic symphysis is divided. Pubiotomy involves cutting the pubic symphysis cartilage to widen the pelvic outlet during difficult childbirth. This procedure helps facilitate labor by increasing the pelvic diameter. Choices A, C, and D are incorrect because they do not accurately describe pubiotomy. Choice A refers to accessing the lower uterine segment, choice C involves ligating pubic bones for cancer, and choice D pertains to perineal tissue dissection during labor, which are unrelated to pubiotomy.