08-10-2006, 04:13 AM
14. Three days after being hospitalized for treatment of a hip fracture sustained in a fall, a 62-year-old woman becomes acutely short of breath and coughs up a small amount of blood-tinged sputum. She appears anxious. Her blood pressure is 110/70 mm Hg, pulse is 110/min, and respirations are 24/min. Examination shows no other abnormalities. Arterial blood gas analysis on 40% oxygen by face mask shows:
pH 7.40
PCO2 38 mm Hg
PO2 70 mm Hg
Ventilation-perfusion lung scans show multiple segmental areas of mismatch on the right. Which of the following is the most appropriate next step in management?
A ) Pulmonary angiography
B ) Dopamine therapy
C ) Heparin therapy
D ) Urokinase therapy
E ) Intubation
15. A 30-year-old woman, gravida 2, para 1, is brought to the emergency department in labor. An episiotomy is performed. Following delivery of the head, the shoulders do not follow with the usual traction and maternal pushing. Which of the following is the most appropriate next step in management?
A ) Flexing the woman's knees toward her shoulders
B ) More forceful traction and fundal pressure
C ) Delivering the posterior arm
D ) Rotating the head 180 degrees
E ) Symphysiotomy
pH 7.40
PCO2 38 mm Hg
PO2 70 mm Hg
Ventilation-perfusion lung scans show multiple segmental areas of mismatch on the right. Which of the following is the most appropriate next step in management?
A ) Pulmonary angiography
B ) Dopamine therapy
C ) Heparin therapy
D ) Urokinase therapy
E ) Intubation
15. A 30-year-old woman, gravida 2, para 1, is brought to the emergency department in labor. An episiotomy is performed. Following delivery of the head, the shoulders do not follow with the usual traction and maternal pushing. Which of the following is the most appropriate next step in management?
A ) Flexing the woman's knees toward her shoulders
B ) More forceful traction and fundal pressure
C ) Delivering the posterior arm
D ) Rotating the head 180 degrees
E ) Symphysiotomy