A patient admitted for management of sepsis is critically ill and wants to talk with a hospital representative about donating her organs if she dies. She has a fairly complex medical history that includes traumatic brain injury, breast cancer, and dialysis-dependent renal failure. The patient is advised that she is ineligible to donate due to her

Correct Answer: D

Rationale: The correct answer is D: Breast cancer. The patient's breast cancer is the reason she is ineligible to donate organs. Breast cancer is a contraindication for organ donation due to the risk of cancer transmission to the recipient. Traumatic brain injury (choice B) and renal failure (choice A) are not absolute contraindications to organ donation. Gram-negative infection (choice C) may temporarily disqualify the patient but can be treated, unlike breast cancer. In summary, breast cancer poses the highest risk of organ recipient harm compared to the other medical conditions listed.

Correct Answer: D

Rationale: The correct answer is D: Breast cancer. The patient's breast cancer is the reason she is ineligible to donate organs. Breast cancer is a contraindication for organ donation due to the risk of cancer transmission to the recipient. Traumatic brain injury (choice B) and renal failure (choice A) are not absolute contraindications to organ donation. Gram-negative infection (choice C) may temporarily disqualify the patient but can be treated, unlike breast cancer. In summary, breast cancer poses the highest risk of organ recipient harm compared to the other medical conditions listed.

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.

Correct Answer: B

Rationale: The correct answer is B: Fetal head retracts against the perineum. This sign indicates possible shoulder dystocia as it suggests the baby's shoulders are impacted and unable to pass through the birth canal. The retraction of the fetal head against the perineum is a classic sign of shoulder dystocia, which requires specific maneuvers to dislodge the shoulders and facilitate delivery. A: Failure of internal rotation of the head is not specific to shoulder dystocia. C: Gentle traction should not be applied in cases of shoulder dystocia as it can worsen the situation. D: The occiput restituting towards the left side is not a sign of shoulder dystocia, as it refers to the rotation of the fetal head during delivery.

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 preeclampsia can lead to poor placental anchorage, which results in reduced blood flow to the placenta, leading to severe infarction. This can cause adverse effects on the fetus and the mother. Choice A is incorrect because infarcts and placental abruption are not specific effects of preeclampsia on the reproductive system. Choice B is incorrect because lowered vaginal discharge pH and hemorrhage are not typical effects of preeclampsia. Choice C is incorrect because congestive cardiac failure and fetal hypoxia are not direct effects of preeclampsia on the reproductive system.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Precipitate labor is defined as unusually rapid labor. 2. Option A states that it is concluded in less than three hours, aligning with the definition. 3. Option B talks about cervical dilation, which is not a defining factor of precipitate labor. 4. Option C contradicts the definition as it mentions a duration longer than three hours. 5. Option D mentions poor uterine contractions, which are not characteristic of precipitate labor. Summary: Option A is correct because it aligns with the definition of precipitate labor being rapid, while the other options are incorrect as they do not accurately describe the characteristics of precipitate labor.

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.