Correct Answer: B

Rationale: Step 1: Family history of colon cancer is a significant risk factor for developing colon cancer. Step 2: By discussing with his parents, Mr. Costigan can determine if there is a family history of colon cancer. Step 3: Knowing this information can help assess his own risk and guide appropriate screening and preventive measures. Step 4: The primary danger for Mr. Costigan lies in potential genetic predisposition rather than the presence of inflammatory polyps. Step 5: Therefore, discussing with family members about any history of colon cancer is crucial for his overall risk assessment and management. Summary: - Choice A is incorrect as the frequency of colonoscopy should be individualized based on the patient's risk factors. - Choice C is incorrect as all polyps have the potential to become cancerous, especially inflammatory polyps. - Choice D is incorrect as consulting an oncologist at this stage is premature without first assessing family history.

Correct Answer: D

Rationale: The correct answer is D because a client is declared fit for a vaginal birth after cesarean section if their previous delivery was via spontaneous vertex delivery. This indicates that the client has successfully given birth vaginally before, reducing the risk associated with a vaginal birth after cesarean section. A, B, and C are incorrect: A: Cephalopelvic disproportion was the reason for the previous C/S, indicating potential difficulty in vaginal delivery. B: Confirmation of a multiple pregnancy does not impact the client's eligibility for a vaginal birth after cesarean section. C: Previous cesarean section does not necessarily mean the client is fit for a vaginal birth after cesarean section.

Correct Answer: B

Rationale: The correct answer is B: Magnesium sulphate. It is the drug of choice for managing eclampsia due to its ability to prevent and control seizures. Magnesium sulfate acts as a central nervous system depressant and smooth muscle relaxant, helping to prevent further seizures. Phenobarbitone (A) is not the first-line treatment for eclampsia. Calcium gluconate (C) is used to counteract calcium channel blocker toxicity, not for eclampsia. Sodium bicarbonate (D) is used to treat metabolic acidosis, not eclampsia.

Correct Answer: C

Rationale: The correct answer is C because living wills are typically not honored for terminally ill patients with impaired cognition. Firstly, living wills require the patient to be of sound mind to make decisions. Secondly, in the case of a cognitively impaired patient, their ability to express their wishes and understand the implications may be compromised. Therefore, healthcare providers may not be able to honor the living will accurately. Choices A, B, and D are incorrect because A) competency can be determined by healthcare professionals, B) impaired cognition can lead to incompetence, and D) informed consent requires the patient to understand the decision-making process.

Correct Answer: C

Rationale: The correct answer is C. In myelodysplastic syndromes, splenectomy is indicated for sustained leukocyte elevation above 30,000 cells/µL to manage symptomatic splenomegaly and cytopenias. This is because an enlarged spleen can sequester and destroy blood cells, leading to low blood cell counts. Choices A, B, and D are incorrect as splenectomy is not typically indicated for major hemolysis unresponsive to medical management, severe symptoms of massive splenomegaly, or portal hypertension in the context of myelodysplastic syndromes.