Midwifery Practice Questions

Correct Answer: A

Rationale: The correct answer is A because in cases of anteriorly situated placenta praevia, where the placenta partially or completely covers the cervix, a classical caesarean section is indicated to prevent severe bleeding during delivery. For choice B, a posteriorly situated placenta praevia does not necessitate a classical caesarean section. Choice C, gestation of more than 32 weeks, does not specifically indicate the need for a classical caesarean section. Choice D, aesthetic purpose on maternal request, is not a valid medical indication for a classical caesarean section.

Correct Answer: D

Rationale: The correct answer is D. A ruptured uterus can lead to fetal distress and necessitate a cesarean section. Failure of the cervix to dilate is indicative of a potential uterine rupture, as the uterus may not be able to contract effectively due to the rupture. Maternal dehydration (A), pyrexia (B), and oliguria (C) are not specific signs of a ruptured uterus and may be present in various other conditions. Therefore, failure of the cervix to dilate is the most relevant early sign in this scenario.

Correct Answer: A

Rationale: The correct answer is A. High-dose initial steroids are tapered off over a period of 4 to 6 weeks posttransplant. This is because corticosteroids are used initially to prevent rejection and then gradually tapered to minimize side effects. Choice B is incorrect as it states a general interest but does not address the specific protocol for corticosteroid use. Choice C is incorrect as there is no evidence suggesting better results in corticosteroid-free protocols for second-transplant recipients. Choice D is incorrect as there is no strong evidence supporting corticosteroid-free rejection protocols in posttransplant patients.

Correct Answer: D

Rationale: The correct answer is D, complete rupture of the uterus. This is an obstetric emergency due to the risk of severe bleeding and potential harm to both the mother and the fetus. A ruptured uterus can lead to life-threatening complications such as hemorrhage and shock. In contrast, options A, B, and C are not considered obstetric emergencies. Aftercoming head in breech, complete cephalic presentation, and complete breech presentation are normal variations in labor that do not typically require immediate intervention like a ruptured uterus does.

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.