Jennifer is an RN applicant for a staff nurse position in the surgical ICU. She has had a screening PPD and comes back in 48 hours to have it read. There is a 12-mm induration at the site of injection. A chest radiograph is negative. The AGACNP knows that the next step in Jennifers evaluation and management should include

Correct Answer: A

Rationale: The correct answer is A: No further care, because the chest radiograph is negative. In this scenario, Jennifer has a positive PPD test with a 12-mm induration but a negative chest radiograph, indicating latent TB infection. The negative chest radiograph rules out active TB disease. As a result, Jennifer does not require further evaluation or treatment for active TB. The positive PPD alone does not warrant further investigations such as Quantiferon assay (B) or prophylactic therapy (C) as these are not indicated for latent TB infection without active disease. Beginning therapy for pulmonary TB (D) is unnecessary and potentially harmful as Jennifer does not have active TB. Thus, the correct course of action is to provide no further care based on the negative chest radiograph.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Precipitate labor is defined as unusually rapid labor. 2. Option A states that it is concluded in less than three hours, aligning with the definition. 3. Option B talks about cervical dilation, which is not a defining factor of precipitate labor. 4. Option C contradicts the definition as it mentions a duration longer than three hours. 5. Option D mentions poor uterine contractions, which are not characteristic of precipitate labor. Summary: Option A is correct because it aligns with the definition of precipitate labor being rapid, while the other options are incorrect as they do not accurately describe the characteristics of precipitate labor.

Correct Answer: D

Rationale: The correct answer is D because both statements A and C are true. Older mothers have a higher risk of developing preeclampsia due to age-related complications. Additionally, advanced maternal age is associated with an increased likelihood of requiring a cesarean section due to factors like decreased uterine elasticity. Statement B is incorrect as younger mothers are not at higher risk of miscarriage compared to older mothers. This is because maternal age is not a significant factor in miscarriage risk.

Correct Answer: B

Rationale: The correct answer is B: Infuse albumin and fresh frozen plasma. Given Janet's post-hepatic resection status and abnormal lab values indicating liver dysfunction (elevated bilirubin, low albumin, prolonged prothrombin time, elevated AST and ALT), she is at risk for coagulopathy and hypoalbuminemia. Infusing albumin can help improve her oncotic pressure and fluid balance, while fresh frozen plasma can replenish clotting factors to address the prolonged prothrombin time. This intervention aims to stabilize her condition before transferring to the general medical floor. Canceling the transfer (Choice A) is not necessary if appropriate interventions can be taken. Repeating labs the next day (Choice C) delays potentially needed treatments. Preparing for reoperation (Choice D) is not indicated based on the information provided.

Correct Answer: D

Rationale: The correct answer is D because Down syndrome is primarily caused by trisomy of chromosome 21. This means there is an extra copy of chromosome 21, leading to the characteristic features of the syndrome. Mosaicism and translocation of chromosome 21 can also result in Down syndrome, albeit less frequently. Option A includes deletion, which is not a common cause of Down syndrome. Option B lists duplication, which is not a typical mechanism for Down syndrome. Option C includes deletion and mosaicism, but trisomy is the main cause of Down syndrome, making option D the most accurate choice.

Correct Answer: A

Rationale: The correct answer is A because signs of obstructed labor include a dry vagina due to prolonged pressure, oedema of the cervix due to prolonged contractions, and caput succedaneum which is swelling of the baby's scalp from prolonged pressure. Choice B is incorrect because plenty of amniotic fluid is not a sign of obstructed labor. A hot/dry vagina is not a typical sign of obstructed labor. Meconium-stained liquor can be a sign of fetal distress, but not specifically obstructed labor. Choice C is incorrect because meconium-stained liquor is a sign of fetal distress, not necessarily obstructed labor. A hot/dry vagina is not a typical sign of obstructed labor. Diluted urine is not a typical sign of obstructed labor. Choice D is incorrect because while caput succedaneum is a sign of obstructed labor, oedema of the cervix is more indicative of obstructed labor than plenty of amni

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: B

Rationale: The correct answer is B because reduced facial movement is a key clinical feature of facial palsy. This can lead to difficulty in making facial expressions, closing the eye on the affected side, and drooping of the mouth. Irritability may also occur due to discomfort or difficulty in communication. Choice A is incorrect because inability to feed and excessive cry are not typical features of facial palsy. Choice C is incorrect as excessively dry eyeball and feeding difficulties are not commonly associated with facial palsy. Choice D is incorrect as eyes being permanently open and no facial movement are not characteristic of facial palsy.

Correct Answer: D

Rationale: The correct answer is D: Hyperbaric oxygen. SSHL is a medical emergency that requires prompt intervention. Hyperbaric oxygen therapy increases oxygen delivery to the inner ear, potentially reversing the hearing loss. Acyclovir (A) is used for viral infections, not SSHL. Furosemide (B) is a diuretic used for treating fluid retention, not SSHL. Warfarin (C) is an anticoagulant and is not indicated for SSHL. In summary, hyperbaric oxygen is the appropriate choice for managing SSHL due to its potential to improve oxygen delivery to the inner ear.