A fetal associated risk of prolonged pregnancy includes

Correct Answer: A

Rationale: The correct answer is A: Fetal macrosomia. Prolonged pregnancy increases the risk of fetal macrosomia due to continued fetal growth beyond the normal term. This can lead to complications during delivery, such as shoulder dystocia and birth injuries. Placental dysfunction and cesarean section are possible outcomes of prolonged pregnancy but are not directly associated with fetal risks in this context. Shoulder dystocia is a potential complication of fetal macrosomia but is not a direct fetal risk of prolonged pregnancy.

Correct Answer: B

Rationale: The correct answer is B: Hypoglycaemia. Neonates born to diabetic mothers are at risk of hypoglycaemia due to high insulin levels in utero. Feeding the newborn within the first 15 minutes helps maintain blood glucose levels. Hypocalcaemia, hyponatraemia, and hypokalaemia are not typically immediate concerns in neonates born to diabetic mothers.

Correct Answer: B

Rationale: The correct answer is B: Low acidity levels which favor growth of candida albicans. During pregnancy, hormonal changes can lead to increased vaginal pH, creating a more alkaline environment that promotes the growth of candida albicans, causing vulvovaginitis. Choice A is incorrect as E. coli thrives in alkaline environments. Choice C, existing chronic hypertension, is unrelated to the development of vulvovaginitis. Choice D, lowered osmotic pressure, does not directly influence the growth of candida albicans.

Correct Answer: D

Rationale: The correct answer is D because Down syndrome is primarily caused by trisomy of chromosome 21. This means there is an extra copy of chromosome 21, leading to the characteristic features of the syndrome. Mosaicism and translocation of chromosome 21 can also result in Down syndrome, albeit less frequently. Option A includes deletion, which is not a common cause of Down syndrome. Option B lists duplication, which is not a typical mechanism for Down syndrome. Option C includes deletion and mosaicism, but trisomy is the main cause of Down syndrome, making option D the most accurate choice.

Correct Answer: B

Rationale: The correct answer is B: Pneumothorax. Respiratory distress syndrome is characterized by difficulty breathing due to immature lungs in premature infants. Pneumothorax, a condition where air leaks into the chest cavity, is a common complication as the fragile lungs are prone to air leaks. Cerebral palsy (A), epilepsy (C), and fractured ribs (D) are not direct complications of respiratory distress syndrome. Pneumothorax is the most likely and common complication due to the fragility of the premature infant's lungs.

Correct Answer: A

Rationale: The correct answer is A: External cephalic version. This procedure involves manually manipulating the baby from a breech position to a head-down position. It is recommended as a safe and effective way to manage breech presentations, reducing the need for a cesarean section. Immediate cesarean (B) is not always necessary and should be reserved for specific medical reasons. Pelvic X-ray (C) is not routinely recommended for managing breech presentations. Induction of labor (D) is not the primary strategy for managing breech presentations, as it does not address the positioning of the baby.

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: 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: D

Rationale: Rationale for Correct Answer (D: Atelectasis): 1. Ascorbic acid deficiency can lead to impaired collagen synthesis, affecting lung tissue integrity. 2. Anemia reduces oxygen-carrying capacity, increasing the risk of lung collapse. 3. Volume contraction can lead to decreased lung compliance, predisposing to atelectasis. Summary of Incorrect Choices: A: Prolonged intubation is more related to airway issues, not specifically affected by the mentioned risk factors. B: Thromboembolism is more linked to blood clotting issues rather than the mentioned risk factors. C: Delayed wound healing is more influenced by nutritional deficiencies and blood flow, not directly linked to lung complications like atelectasis.