Correct Answer: D

Rationale: In a patient with acute exacerbation of COPD who presents with hypercapnia and respiratory acidosis, the most appropriate ventilatory strategy is invasive mechanical ventilation with a lung protective strategy. This involves using lower tidal volumes and limiting plateau pressures to prevent ventilator-induced lung injury.

Correct Answer: D

Rationale: The best time to visit the clinic for the first prenatal care is during the first trimester of pregnancy, ideally before the 12th week. This is because early prenatal care is crucial for monitoring the health of both the mother and the developing baby, identifying any risk factors or complications early on, and initiating important interventions such as prenatal vitamins and screenings. By starting prenatal care early in the first trimester, potential issues can be identified and addressed promptly, leading to better pregnancy outcomes. It is important for pregnant women to seek early prenatal care to ensure a healthy pregnancy and delivery.

Correct Answer: D

Rationale: Coordinating with radiology or gastroenterology for procedural guidance is crucial to ensure the success of a percutaneous endoscopic gastrostomy (PEG) tube insertion. This procedure is typically performed under endoscopic guidance to ensure proper placement of the tube into the stomach through the abdominal wall. Radiology or gastroenterology professionals are trained to perform and guide the insertion procedure, making their involvement essential for a successful outcome. Additionally, their expertise helps minimize the risk of complications during and after the PEG tube placement.

Correct Answer: B

Rationale: The patient's presentation with sudden-onset severe lower abdominal pain, nausea, vomiting, inability to pass urine, suprapubic tenderness, and a palpable bladder is classic for acute urinary retention. Acute urinary retention is a urological emergency characterized by the sudden inability to pass urine due to the inability to empty the bladder completely. The palpable bladder on physical examination indicates significant bladder distension. This condition can be caused by multiple factors such as bladder outlet obstruction, neurogenic causes, or medications affecting bladder function. Prompt intervention is necessary to relieve the bladder distension, alleviate symptoms, and prevent complications like bladder rupture.

Correct Answer: B

Rationale: Guava leaves are recommended by the Department of Health as a remedy for cough due to their natural expectorant properties. The leaves contain compounds that help to loosen mucus and make it easier to expel, providing relief from cough and congestion. Guava leaves are commonly used in traditional medicine for respiratory conditions such as cough, bronchitis, and asthma. They help soothe the throat, reduce inflammation, and promote overall respiratory health. It is important to note that while guava leaves can be a helpful remedy for cough, they should be used in conjunction with other treatments as advised by healthcare professionals for best results.