Correct Answer: B

Rationale: The correct answer is B: Preservation of sensorineural hearing. In cholesteatoma, surgery aims to remove the lesion and prevent further damage to the ossicles and inner ear structures. Preserving sensorineural hearing is crucial to maintain auditory function post-surgery. A: Production of a dry ear is important to prevent recurrence, but not the primary goal. C: Debridement of infection is necessary, but the main aim is to address the cholesteatoma itself. D: Restoration of the tympanic membrane may be needed but is not the primary objective in cholesteatoma surgery.

Correct Answer: B

Rationale: The correct answer is B: Acute pancreatitis. The patient's sudden, severe upper abdominal pain, unaffected by food intake, along with guarding and elevated white blood cell count, are indicative of acute pancreatitis. The patient's positioning (knees to chest) suggests relief from pain, which is characteristic of pancreatitis. A dissecting aortic aneurysm (choice A) typically presents with tearing chest or back pain. Perforated peptic ulcer (choice C) would present with a history of chronic ulcer symptoms. Mallory-Weiss tear (choice D) presents with a history of recent vomiting. Therefore, based on the patient's presentation and findings, acute pancreatitis is the most likely diagnosis.

Correct Answer: C

Rationale: The correct answer is C: Rebound tenderness. Tenderness to percussion is similar to rebound tenderness because both involve assessing pain upon release of pressure. Rebound tenderness specifically evaluates pain when the examiner quickly removes pressure, indicating peritoneal inflammation. Tympany (A) refers to a drum-like sound upon percussion, not pain. Guarding (B) is involuntary muscle contractions in response to palpation, not percussion. Somatic pain (D) is localized pain arising from skin, muscles, or bones, not related to percussion tenderness.

Correct Answer: C

Rationale: The correct answer is C: Improve fetal oxygenation. Oxygen at 4 liters/minute is given to increase oxygen levels which can help improve oxygenation to the fetus during a cord prolapse scenario. This can be crucial in preventing fetal distress and hypoxia. Explanation for Incorrect Choices: A: Relieve maternal distress - Oxygen is primarily given in this scenario to benefit the fetus, not to relieve maternal distress. B: Promote her relative rest - Oxygen is not administered to promote rest, but to address the immediate concern of fetal oxygenation. D: Achieve the effect of tocolysis - Oxygen does not have a role in tocolysis, which is the inhibition of uterine contractions.

Correct Answer: C

Rationale: The correct answer is C because living wills typically are not always honored for cognitively impaired patients. Step-by-step rationale: A) Incorrect - A court can declare a patient incompetent if they are unable to make decisions. B) Incorrect - Impaired cognition can indeed make a person incompetent. D) Incorrect - A patient must have the capacity to understand information and make decisions to give informed consent.