A correct statement denoting the purpose of vitamin K administration to neonates is

Correct Answer: D

Rationale: The correct answer is D: All neonates need vitamin K for activation of thrombokinase. Vitamin K is essential for the synthesis of clotting factors in the liver, including thrombokinase, which plays a crucial role in blood clotting. In neonates, there is a deficiency of vitamin K due to limited transfer across the placenta and low levels in breast milk. Administering vitamin K at birth helps prevent hemorrhagic disease of the newborn. Choices A, B, and C are incorrect because vitamin K does not directly impact immunity, prevent jaundice, or promote normal gut bacteria growth in neonates.

Correct Answer: B

Rationale: The correct answer is B: His procedure has put him at significant risk for B12 absorption problems. Rationale: 1. Jejunum is primarily responsible for nutrient absorption, including B12. 2. Resection of a large portion of the jejunum can lead to malabsorption of B12. 3. B12 is essential for neurological function and red blood cell production. 4. Patients with significant jejunum resection are at high risk for B12 deficiency. 5. Monitoring B12 levels and potentially requiring supplementation is crucial for patients like Jake. Summary of other choices: A: Incorrect. Lifetime issues with diarrhea are not necessarily expected following jejunum resection. C: Incorrect. The ileum may assume some functions of the jejunum but cannot fully compensate. D: Incorrect. Enteral nutrition should not be delayed for months as it is essential for Jake's recovery and nutritional needs.

Correct Answer: A

Rationale: The correct answer is A: Pyuria. Pyuria is a common feature in acute pyelonephritis, as it indicates the presence of white blood cells in the urine due to the infection. Fever, CVA tenderness, and gross hematuria are all common features of acute pyelonephritis. Fever is a systemic response to infection, CVA tenderness indicates inflammation of the kidney, and gross hematuria is often seen due to inflammation and damage to the kidney tissue. Therefore, the absence of pyuria would be unexpected in a patient with suspected acute pyelonephritis.

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: B

Rationale: The correct answer is B: Captopril. Captopril is an angiotensin-converting enzyme (ACE) inhibitor that can lead to oligohydramnios in pregnant women due to its effect on reducing fetal renal function. This can result in decreased amniotic fluid levels. Diazepam (A) is a benzodiazepine used for anxiety and is not associated with oligohydramnios. Ampicillin (C) is an antibiotic commonly used during pregnancy and does not cause oligohydramnios. Pethidine (D) is an opioid analgesic with no known association with oligohydramnios in pregnancy.

Correct Answer: A

Rationale: The correct answer is A: There is a slightly higher risk of neurologic complications. Rationale: 1. Off-pump bypass grafting involves performing surgery on a beating heart without the use of a heart-lung machine. 2. The lack of cardiopulmonary bypass during off-pump surgery can lead to reduced blood flow to the brain, increasing the risk of neurologic complications. 3. This is why the AGACNP advises Mr. Nelson about the slightly higher risk of neurologic complications associated with off-pump bypass. 4. Choice B is incorrect as long-term results actually suggest similar or better patency rates for grafts in off-pump surgery. 5. Choice C is incorrect as the statement about the incidence increasing significantly in the last 10 years is not relevant to the risks of off-pump surgery. 6. Choice D is incorrect as off-pump surgery is not considerably more expensive and the correlation with better long-term outcomes is debatable.

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: 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: Cyclosporine. Cyclosporine is a first-line treatment for acute rejection following hepatic transplant due to its immunosuppressive properties. It inhibits T-cell activation and cytokine production, suppressing the immune response against the transplanted liver. This helps in preventing further damage caused by rejection. Azathioprine (B) and Sirolimus (D) are also immunosuppressants, but Cyclosporine is preferred as the initial treatment. Methylprednisolone (C) is a corticosteroid that can be used in combination with Cyclosporine for acute rejection to provide a more potent immunosuppressive effect.