Melanie is a 31-year-old patient who is being evaluated following a routine urinalysis that revealed microscopic hematuria. She was between menses and has no other identifiable explanation for hematuria. She has no significant medical history and otherwise is without complaint. The AGACNP knows that workup for Melanie should include

Correct Answer: B

Rationale: The correct answer is B: CT urogram. This is the appropriate next step in the workup for Melanie's microscopic hematuria. A CT urogram can provide detailed imaging of the urinary tract to identify any structural abnormalities or causes of hematuria. A urology consultation (choice A) may be necessary after the imaging results. Upper urinary imaging (choice C) is not specific enough and may not provide a comprehensive evaluation. Cystoscopy (choice D) is invasive and typically reserved for cases where lower urinary tract issues are suspected, which is not indicated in Melanie's case without further evaluation.

Correct Answer: D

Rationale: The use of bed cradle in leg thrombosis management is to promote venous drainage. Elevating the legs on a bed cradle helps improve blood flow back to the heart, reducing swelling and preventing blood clots. Keeping the legs straight (A) is not the main purpose. Preventing embolism (B) is important but not the direct purpose of a bed cradle. Controlling body temperature (C) is unrelated to the use of a bed cradle for leg thrombosis.

Correct Answer: A

Rationale: The correct answer is A: HELLP syndrome. This must be evaluated as a cause of abdominal pain in a pregnant patient because it is a serious condition characterized by hemolysis, elevated liver enzymes, and low platelet count. These abnormalities can lead to abdominal pain, especially in the right upper quadrant. Placental abruption (B) presents with vaginal bleeding and uterine tenderness, not specific abdominal pain. Spontaneous hepatic rupture (C) is rare and usually presents with sudden severe abdominal pain. Preterm labor (D) typically presents with regular uterine contractions and lower abdominal discomfort, not specific upper quadrant pain like in HELLP syndrome.

Correct Answer: D

Rationale: Rationale: 1. Obstructed labor can lead to prolonged pressure on the uterus, causing hemorrhage and uterine rupture (A). 2. Prolonged labor can result in fetal distress due to reduced oxygen supply and potential infection (B). 3. Therefore, both complications mentioned in A and B can occur in obstructed labor. Summary: A: Incorrect - Preterm birth and asphyxia are not directly related to obstructed labor. B: Incorrect - Only fetal distress and infection are commonly associated with obstructed labor. C: Incorrect - Both A and B are possible complications of obstructed labor, making D the correct choice.

Correct Answer: B

Rationale: The correct answer is B: FALSE. Severe epigastric pain in preeclampsia is not associated with hyperacidity but is more likely due to complications such as HELLP syndrome or liver involvement. Preeclampsia is characterized by high blood pressure and proteinuria, not hyperacidity. Therefore, severe epigastric pain in preeclampsia should not be attributed to hyperacidity. Other choices are not applicable.

Correct Answer: B

Rationale: The correct answer is B: Inadequate surfactant levels. Surfactant is a substance that reduces surface tension in the alveoli, preventing their collapse. In respiratory distress syndrome, premature infants have insufficient surfactant production, leading to collapsed alveoli and difficulty breathing. Choice A is incorrect because it focuses on quality rather than quantity of surfactant. Choice C is incorrect as rib cage underdevelopment is associated with congenital conditions like thoracic dystrophy, not RDS. Choice D is incorrect as gradual alveolar rupture is not a known cause of RDS.

Correct Answer: B

Rationale: The correct answer is B: Facilitation of weight gain. A thermal controlled environment for a low birth weight baby helps in maintaining the baby's body temperature, reducing energy expenditure, and promoting weight gain. This is crucial for the baby's growth and development. Incorrect choices: A: Prevention of infection - While a thermal controlled environment can indirectly help prevent infections by maintaining the baby's health, it is not the primary aim. C: Provision of quality care - Quality care involves multiple aspects beyond just thermal control, so this is not the primary aim. D: Provision of nutrition - Nutrition is important for weight gain, but the thermal controlled environment specifically focuses on regulating the baby's body temperature to support weight gain.

Correct Answer: A

Rationale: The correct answer is A. High-dose initial steroids are tapered off over a period of 4 to 6 weeks posttransplant. This is because corticosteroids are used initially to prevent rejection and then gradually tapered to minimize side effects. Choice B is incorrect as it states a general interest but does not address the specific protocol for corticosteroid use. Choice C is incorrect as there is no evidence suggesting better results in corticosteroid-free protocols for second-transplant recipients. Choice D is incorrect as there is no strong evidence supporting corticosteroid-free rejection protocols in posttransplant patients.

Correct Answer: B

Rationale: The correct answer is B: Iron and folic acid. Diamorphic anemia is characterized by the presence of both microcytic and macrocytic red blood cells, which can be caused by a deficiency in both iron and folic acid. Iron deficiency leads to microcytic anemia, while folic acid deficiency results in macrocytic anemia. Thiamine deficiency (Choice A) primarily affects the nervous system and does not directly cause diamorphic anemia. Liver enzymes deficiency (Choice D) does not directly lead to diamorphic anemia. Folic acid and thiamine deficiency (Choice C) can cause individual types of anemia but not diamorphic anemia.