In myelodysplastic syndromes, the primary indications for splenectomy include

Correct Answer: D

Rationale: The correct answer is D: Portal hypertension. In myelodysplastic syndromes, splenectomy is indicated primarily for portal hypertension due to extramedullary hematopoiesjson in the spleen, leading to increased blood flow and pressure in the portal vein. This can alleviate symptoms such as ascites and variceal bleeding. Choices A, B, and C are incorrect as major hemolysis, massive splenomegaly, and sustained leukocyte elevation are not primary indications for splenectomy in myelodysplastic syndromes.

Correct Answer: A

Rationale: The correct answer is A: Epidural hematoma. 1. Sudden rotational injuries can cause tearing of the middle meningeal artery, leading to an epidural hematoma. 2. The hematoma can compress the brain, disrupting the reticular activating system, causing altered consciousness. 3. Uncal herniation (B) involves herniation of the uncus, not rotation-related. 4. Concussion (C) is a mild traumatic brain injury, not directly related to rotational injuries. 5. Contrecoup injury (D) is when the brain impacts the opposite side of the skull due to sudden deceleration, not rotation-induced.

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: B

Rationale: Step 1: Postnatal clients with urinary tract trauma are at risk of dehydration due to increased fluid loss. Step 2: Encouraging plenty of fluids helps maintain hydration levels. Step 3: Proper hydration supports kidney function and aids in flushing out bacteria, reducing infection risk. Step 4: Adequate hydration also promotes tissue healing and prevents complications. Step 5: Therefore, the main aim of encouraging plenty of fluids is to keep the client well hydrated.

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.

Correct Answer: C

Rationale: The correct answer is C: Gastric retention. Mrs. Coates' symptoms of persistent and progressive discomfort are not likely due to gastric retention because she underwent a duodenal resection for a bleeding ulcer, which would bypass the stomach. Therefore, gastric retention is not a possible cause. A: Colic due to return of peristalsis is a possible cause as peristalsis returning after surgery can cause discomfort. B: Leakage from the duodenal stump is a possible cause as it can lead to abdominal discomfort postoperatively. D: Hemorrhage is a possible cause given her history of bleeding ulcer and surgery.

Correct Answer: A

Rationale: The correct answer is A: Frank breech, complete breech, footling breech. In a frank breech presentation, the baby's buttocks are aimed at the birth canal with legs flexed at the hips and extended at the knees. In a complete breech presentation, the baby's buttocks are aimed at the birth canal with legs flexed at the hips and knees. In a footling breech presentation, one or both of the baby's feet are positioned to come out first. These are the three main types of breech presentations. Choices B, C, and D do not accurately describe the different types of breech presentations, making them incorrect.

Correct Answer: A

Rationale: The correct answer is A (1000-500 gm) because extremely low birth weight babies are typically defined as those weighing less than 1000 grams (1kg) at birth. This range specifically includes weights below 1000 grams, making it the most accurate choice. Choice B (500-1500 gm) is incorrect because it includes weights above the threshold for extremely low birth weight (1000 gm). Choice C (1001-1500 gm) is incorrect because it excludes babies weighing less than 1000 gm, which are considered extremely low birth weight. Choice D (1500-2000 gm) is also incorrect as it includes weights above the range for extremely low birth weight babies.

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.