In the preoperative assessment of a patient for the likelihood of postoperative risk, ascorbic acid deficiency, anemia, and volume contraction are all risk factors for

Correct Answer: D

Rationale: Step-by-step rationale for why choice D (Atelectasis) is correct: 1. Ascorbic acid deficiency can lead to impaired lung function, increasing the risk of atelectasis. 2. Anemia can cause decreased oxygen-carrying capacity, contributing to atelectasis. 3. Volume contraction can lead to reduced lung expansion, further predisposing to atelectasis. Summary: - Choice A (Prolonged intubation): Intubation duration is more related to respiratory complications, not directly linked to the mentioned risk factors. - Choice B (Thromboembolism): Risk factors like immobility and hypercoagulability are more relevant to thromboembolism. - Choice C (Delayed wound healing): More associated with factors like malnutrition and impaired immune function rather than the mentioned risk factors.

Correct Answer: B

Rationale: Step 1: Post-splenectomy, platelet count typically drops temporarily, leading to a risk of bleeding. Step 2: To compensate, the body increases hemoglobin (Hgb) levels to maintain oxygen-carrying capacity. Step 3: Therefore, on postoperative day 2, an increased Hgb level is expected. Summary: A is incorrect because MCV is not typically affected in this scenario. C is incorrect because platelet count usually decreases post-splenectomy. D is incorrect as albumin levels are not directly impacted by splenectomy for ITP.

Correct Answer: B

Rationale: The correct answer is B: Hyperextension casting. The AGACNP knows that this treatment is appropriate for a condition that requires immobilization and support while allowing controlled movement. Hyperextension casting provides stability and support while promoting healing. Observation (A) would not provide adequate treatment for a condition requiring immobilization. Jewett brace (C) is typically used for spinal fractures, not for conditions that require hyperextension casting. Surgical intervention (D) would be considered if conservative measures like casting have failed.

Correct Answer: C

Rationale: The correct answer is C, Couvelaire uterus. This condition is characterized by a bruised and edematous appearance of the uterus due to severe placental abruption. The rationale is that a Couvelaire uterus specifically refers to this presentation, while the other choices do not. A: Wernicke's encephalopathy is a neurological disorder caused by thiamine deficiency. B: Uterine prolapse is the descent or herniation of the uterus into or beyond the vagina. D: Asherman's syndrome involves intrauterine adhesions leading to menstrual irregularities.

Correct Answer: C

Rationale: The correct answer is C: Four weekly up to 28 weeks. Gestational diabetes requires close monitoring of blood sugar levels and fetal well-being. ANC care every four weeks up to 28 weeks ensures proper management and early detection of any complications. Weekly or two weekly visits (options A and B) may be too frequent and unnecessary at this stage unless there are specific concerns. Three weekly visits (option D) may not provide adequate monitoring intervals. Therefore, option C is the most appropriate choice for the optimal management of gestational diabetes at this stage of pregnancy.

Correct Answer: D

Rationale: Step-by-step rationale for why choice D (Atelectasis) is correct: 1. Ascorbic acid deficiency can lead to impaired lung function, increasing the risk of atelectasis. 2. Anemia can cause decreased oxygen-carrying capacity, contributing to atelectasis. 3. Volume contraction can lead to reduced lung expansion, further predisposing to atelectasis. Summary: - Choice A (Prolonged intubation): Intubation duration is more related to respiratory complications, not directly linked to the mentioned risk factors. - Choice B (Thromboembolism): Risk factors like immobility and hypercoagulability are more relevant to thromboembolism. - Choice C (Delayed wound healing): More associated with factors like malnutrition and impaired immune function rather than the mentioned risk factors.

Correct Answer: C

Rationale: Rationale for choice C: 1. Excessive molding or abnormal stretching of the fetal head can indicate neonatal intracranial injury due to the trauma during birth. 2. This feature suggests possible compression or trauma to the baby's head during delivery. 3. It may lead to intracranial hemorrhage or other injuries, requiring close monitoring and medical intervention. Summary of other choices: A. An oedematous swelling resolving in 48 hours is likely a normal finding (cephalohematoma) and not specific to intracranial injury. B. Notable bleeding between the epicranial aponeurosis & periosteum may indicate cephalohematoma or caput succedaneum, not necessarily intracranial injury. D. Peripheral cyanosis is related to oxygenation and circulation, not specific to intracranial injury.

Correct Answer: D

Rationale: Rationale: 1. Hypoplastic left heart syndrome involves underdevelopment of the left ventricle, aortic valve, and aortic arch. 2. The left ventricle is essential for pumping oxygenated blood to the body. 3. Aortic valve controls blood flow from the left ventricle to the aorta. 4. Aortic arch connects the ascending and descending aorta. Summary: A - Incorrect, as it includes pulmonary veins not related to hypoplastic left heart syndrome. B - Incorrect, as it includes structures not primarily affected in this condition. C - Incorrect, as it does not involve structures related to the left side of the heart.

Correct Answer: C

Rationale: The correct answer is C: Occipito-posterior. This position occurs when the baby's head is facing forward but towards the mother's spine. This position can cause intense back pain during labor because the baby's head puts pressure on the mother's lower back. Occipito-anterior (A) is the most common and ideal position for labor. Transverse position (B) is when the baby is lying sideways, which may cause prolonged labor but not necessarily intense back pain. Occipito-lateral (D) is a less common position where the baby's head is facing sideways, which may not specifically cause intense back pain.