Correct Answer: A

Rationale: Grade 1 cardiac disease refers to early-stage or mild heart conditions that are not yet severe. Choice A, "Organic disease," is the correct answer as it encompasses a broad category of structural heart abnormalities. Mitral stenosis (B) and ventricular failure (C) are specific conditions that can be present in cardiac disease but do not represent the general term for grade 1. Vascular disease (D) primarily refers to conditions affecting blood vessels, not the heart itself. In summary, choice A is correct because it is a comprehensive term that includes various structural heart abnormalities typically found in grade 1 cardiac disease, while the other choices are either too specific or unrelated to the concept of grade 1 cardiac disease.

Correct Answer: B

Rationale: The correct answer is B: Emergency cesarean section. Emergency cesarean sections can increase the risk of puerperal sepsis due to the urgency of the procedure, which may lead to inadequate sterilization or contamination. Other choices are less directly associated with puerperal sepsis: A may increase the risk of infection, but not specifically puerperal sepsis. C relates to general hygiene practices and D focuses on delays in seeking care, which may affect treatment outcomes but are not direct predisposing factors to puerperal sepsis.

Correct Answer: D

Rationale: The correct initial action for the AGACNP is to provide counseling to the patient regarding her options (Choice D). This is important to ensure the patient's safety, well-being, and autonomy. Counseling will allow the patient to explore her feelings, understand her options, and make an informed decision about her next steps. Reporting the physical assault to law enforcement (Choice A) should only be done with the patient's consent to respect her wishes. Having the patient sign a release to go home with her husband (Choice B) could potentially put the patient at risk of further harm. Consulting psychiatry for a psych hold (Choice C) may not be appropriate unless the patient is deemed a danger to herself or others.

Correct Answer: B

Rationale: The correct answer is B: A surgical procedure in which the cartilage of the pubic symphysis is divided. Pubiotomy involves cutting the pubic symphysis cartilage to widen the pelvic outlet during difficult childbirth. This procedure helps facilitate labor by increasing the pelvic diameter. Choices A, C, and D are incorrect because they do not accurately describe pubiotomy. Choice A refers to accessing the lower uterine segment, choice C involves ligating pubic bones for cancer, and choice D pertains to perineal tissue dissection during labor, which are unrelated to pubiotomy.

Correct Answer: C

Rationale: The correct answer is C because precipitate labor is defined as labor that is concluded in less than three hours. This rapid progression can lead to complications such as increased risk of tearing and fetal distress. Choice A is incorrect because it describes a different condition where the cervix fails to dilate despite good contractions. Choice B is incorrect as it contradicts the definition of precipitate labor. Choice D is incorrect as it describes a scenario where the cervix fails to dilate due to poor uterine contractions, which is not characteristic of precipitate labor. Therefore, choice C is the correct answer based on the definition and characteristics of precipitate labor.