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: C

Rationale: The correct answer is C: Consideration of prophylactic therapy. A 12-mm induration in a healthcare worker is considered positive for PPD. In the absence of active TB on chest radiograph, the next step is to consider prophylactic therapy to prevent the development of active TB. This is based on the guidelines for the management of latent TB infection. Choice A is incorrect as a positive PPD warrants further evaluation regardless of the chest radiograph result. Choice B, the Quantiferon assay, is not the next step after a positive PPD and negative chest radiograph. Choice D, beginning therapy for pulmonary TB pending sputum cultures, is not indicated in this scenario as there is no evidence of active TB.

Correct Answer: A

Rationale: The correct answer is A because an estimated fetal weight below 3500 grams indicates a lower risk of complications during childbirth. Higher fetal weight increases the likelihood of shoulder dystocia and birth injuries. Maternal body mass index, gestational age, and maternal age do not directly impact the likelihood of a favorable outcome during a trial of scar.

Correct Answer: B

Rationale: Correct Answer: B (Managing as an outpatient case) Rationale: 1. Moderate pre-eclampsia indicates stable condition. 2. Outpatient management allows close monitoring without hospitalization. 3. Early intervention can prevent progression to severe pre-eclampsia. 4. Hospital admission is reserved for severe cases or complications (not moderate). 5. Encouraging fluids is important, but not the specific management for pre-eclampsia.

Correct Answer: A

Rationale: The correct answer is A: Six hours postnatally. Cephalohematoma is a collection of blood between a baby's skull and the periosteum. It typically appears several hours after birth due to trauma during delivery, causing bleeding under the periosteum. This allows time for the blood to accumulate and form a distinct swelling, making the onset around six hours postnatally. Choices B, C, and D are incorrect as they do not align with the typical timeline for the development of cephalohematoma.

Correct Answer: A

Rationale: The correct answer is A because occipito-posterior position can lead to prolonged labor due to poor fetal positioning, causing maternal back pain. This can result in fetal distress as the baby may have difficulty descending through the birth canal. Postpartum hemorrhage, uterine rupture, fetal death (choices B and C) are not typically associated with occipito-posterior position. Therefore, choice A is the most appropriate answer.

Correct Answer: A

Rationale: The correct answer is A because folic acid supplementation plays a crucial role in promoting spinal cord closure during fetal development, preventing neural tube defects. Folic acid helps in the formation of neural tube structures, ensuring proper closure and preventing defects like spina bifida. Choices B, C, and D are incorrect as preventing infections, enhancing fetal growth, and regulating blood sugar levels are not direct mechanisms through which folic acid prevents neural tube defects.

Correct Answer: A

Rationale: The correct answer is A because cord presentation occurs when the umbilical cord lies in front of the presenting part after the membranes have ruptured. This can lead to compression of the cord during labor, affecting fetal oxygenation. Option B is incorrect as it describes cord prolapse, where the cord lies in front of the presenting part before membrane rupture. Option C describes nuchal cord, where the cord is wrapped around the fetal neck. Option D describes cord abruption, where the cord detaches prematurely from the placenta.

Correct Answer: D

Rationale: The correct answer is D because placenta praevia can lead to life-threatening bleeding during labor due to the placenta partially or completely covering the cervix. This condition poses a high risk of morbidity and mortality to both the mother and the baby. A: Incorrect. Bleeding in placenta praevia is not related to the segment preparing for labor. B: Incorrect. While bleeding is due to placental issues, it is specifically due to the placenta's abnormal positioning, not a pathological process. C: Incorrect. Bleeding can occur before 37 weeks in cases of placenta praevia, and the timing of bleeding is not linked to gestational age.

Correct Answer: D

Rationale: The correct answer is D: All of the above. Ultrasound in monitoring fetal growth can detect fetal anomalies by visualizing the fetus in real-time. It can also monitor placental health by assessing blood flow and position. Additionally, ultrasound can assess amniotic fluid levels to ensure proper fetal development. Therefore, all the benefits mentioned in choices A, B, and C are valid reasons why ultrasound is essential in monitoring fetal growth.