Correct Answer: B

Rationale: The correct answer is B: Threatened abortion. Vaginal spotting and abdominal cramps are common symptoms of a threatened abortion, which occurs when there is a risk of miscarriage but the pregnancy remains viable. This diagnosis is likely after a vaginal examination to assess the cervix and presence of fetal heartbeat. A: Eclampsia is characterized by seizures in pregnancy due to high blood pressure, not typically presenting with vaginal spotting and cramps. C: Placenta previa involves the placenta covering the cervix, leading to painless vaginal bleeding, not associated with cramps. D: Abruptio placenta is premature separation of the placenta from the uterus, manifesting as painful bleeding, not typically with vaginal spotting and cramps.

Correct Answer: C

Rationale: The correct answer is C: Umbilicus. The nurse begins assessing the uterine fundus at the level of the umbilicus as it is a standard reference point for postpartum fundal height measurement. This location allows for consistency and accuracy in tracking the descent of the uterus back into the pelvic cavity. Starting at the umbilicus also helps in monitoring the involution process and prevents potential errors in fundal height assessment. Symphysis pubis (A) is too low and not typically used as a reference point for uterine fundal assessment. Midline (B) is vague and does not provide a specific anatomical landmark. Sides of the abdomen (D) do not give a standardized starting point for measuring the uterine fundus, leading to potential variability in assessment.

Correct Answer: A

Rationale: The correct answer is A: Loss of self-tolerance. This is because autoimmune diseases result from a breakdown in the immune system's ability to distinguish between self and non-self antigens, leading to the production of antibodies against self-antigens. When self-tolerance is lost, immune cells mistakenly target the body's own tissues, causing tissue damage and inflammation. Choice B (Failure of innate immunity) is incorrect because autoimmune diseases are primarily driven by adaptive immunity rather than innate immunity. Choice C (Defective T cell activation) is incorrect as T cells play a critical role in the immune response to self-antigens in autoimmune diseases. Choice D (Impaired phagocytosis) is incorrect as phagocytosis is a mechanism primarily involved in the removal of pathogens, not in the development of autoimmune diseases.

Correct Answer: B

Rationale: The correct answer is B: Negligence. Negligence refers to the failure to exercise the care that a reasonably prudent person would under similar circumstances. In this case, administering the wrong dose of a vaccine indicates a lack of proper care or attention to detail, which constitutes negligence. A: Battery involves intentional harmful or offensive contact without consent, which is not applicable in this situation. C: Assault involves the threat of harm or unwanted physical contact, which is also not relevant here. D: Malpractice typically refers to professional misconduct or negligence by a healthcare provider, which could be a broader term but not specific to the situation described.

Correct Answer: C

Rationale: The correct action in this scenario is to choose option C: put a line across the sentence, make the correction over it, and sign. This method is recommended because it maintains the integrity of the original record by showing what was initially written and clearly indicating the correction. By crossing out the error, making the correction, and signing the entry, the nurse acknowledges and takes responsibility for the mistake while ensuring the accuracy and transparency of the documentation. Option A is incorrect as crossing the error many times can make the note illegible and may not clearly indicate the correction. Option B is incorrect because using correction fluid can make the note messy and may raise suspicions of tampering with the record. Option D is incorrect as erasing with a rubber eraser can damage the document and also raise concerns about the validity of the information. In summary, option C is the best choice as it allows for a clear and professional correction without compromising the integrity of the progress notes.