Midwifery Practice Questions

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: Aspiration and culture of fluid. Given Jasmine's history of injection drug use, neck pain, inability to turn her neck, elevated temperature, and foul breath, there is a high suspicion of a deep neck space infection. Aspiration and culture of fluid from the affected area will help identify the causative organism and guide appropriate antibiotic therapy. This procedure is essential for definitive diagnosis and management of deep neck infections. A: Anteroposterior neck radiography is not the most appropriate initial diagnostic test for evaluating deep neck space infections as it may not provide detailed information on the extent or nature of the infection. B: CT scan of the neck may provide valuable information regarding the extent of the infection, but aspiration and culture of fluid are crucial for identifying the causative organism. C: White blood cell (WBC) differential may show signs of inflammation, but it does not provide specific information on the causative organism of the infection.

Correct Answer: B

Rationale: The correct answer is B: CT urogram. This is the appropriate next step in the workup for Melanie's microscopic hematuria. A CT urogram can provide detailed imaging of the urinary tract to identify any structural abnormalities or causes of hematuria. A urology consultation (choice A) may be necessary after the imaging results. Upper urinary imaging (choice C) is not specific enough and may not provide a comprehensive evaluation. Cystoscopy (choice D) is invasive and typically reserved for cases where lower urinary tract issues are suspected, which is not indicated in Melanie's case without further evaluation.

Correct Answer: A

Rationale: The correct answer is A because high-volume liver resection is typically performed in individuals with significantly compromised hepatic function to ensure adequate liver remnant. Removing 50 to 75% of the liver in a patient with metastatic colon cancer may be necessary for tumor clearance but carries risks due to potential impairment of liver function postoperatively. Choices B and C provide inaccurate information regarding the timeline and extent of liver regeneration following resection. Choice D is incorrect as removing up to 95% of the liver would lead to severe consequences, such as liver failure. Hence, option A is the most appropriate advice given the patient's situation.

Correct Answer: B

Rationale: The correct answer is B: Acute epidural hematoma. A crescent-shaped fluid collection seen on a head CT scan following trauma is indicative of an epidural hematoma, which typically occurs due to an arterial bleed between the dura mater and the skull. This collection appears biconvex due to the restriction of the hematoma by the dura mater and is often associated with a lucid interval followed by rapid deterioration. Explanation for Incorrect Choices: A: Acute subdural hematoma typically presents as a crescent-shaped collection but is located between the dura mater and arachnoid mater, not between the dura mater and skull as seen in epidural hematomas. C: Acute uncal herniation involves displacement of the uncus of the temporal lobe, leading to compression of the brainstem, but it does not manifest as a crescent-shaped fluid collection. D: Acute brainstem compression does not typically present as a distinct crescent-shaped