Correct Answer: A

Rationale: The correct answer is A: There is a slightly higher risk of neurologic complications. Rationale: 1. Off-pump bypass grafting involves performing surgery on a beating heart without the use of a heart-lung machine. 2. The lack of cardiopulmonary bypass during off-pump surgery can lead to reduced blood flow to the brain, increasing the risk of neurologic complications. 3. This is why the AGACNP advises Mr. Nelson about the slightly higher risk of neurologic complications associated with off-pump bypass. 4. Choice B is incorrect as long-term results actually suggest similar or better patency rates for grafts in off-pump surgery. 5. Choice C is incorrect as the statement about the incidence increasing significantly in the last 10 years is not relevant to the risks of off-pump surgery. 6. Choice D is incorrect as off-pump surgery is not considerably more expensive and the correlation with better long-term outcomes is debatable.

Correct Answer: B

Rationale: The correct answer is B: His procedure has put him at significant risk for B12 absorption problems. Rationale: 1. Jejunum is primarily responsible for nutrient absorption, including B12. 2. Resection of a large portion of the jejunum can lead to malabsorption of B12. 3. B12 is essential for neurological function and red blood cell production. 4. Patients with significant jejunum resection are at high risk for B12 deficiency. 5. Monitoring B12 levels and potentially requiring supplementation is crucial for patients like Jake. Summary of other choices: A: Incorrect. Lifetime issues with diarrhea are not necessarily expected following jejunum resection. C: Incorrect. The ileum may assume some functions of the jejunum but cannot fully compensate. D: Incorrect. Enteral nutrition should not be delayed for months as it is essential for Jake's recovery and nutritional needs.

Correct Answer: A

Rationale: Step-by-step rationale for why choice A is correct: 1. Pregnancy can lead to severe anaemia due to increased demand for iron and folate. 2. Pregnancy-induced physiological changes can exacerbate malaria-related anaemia. 3. Severe jaundice may occur in pregnant women with malaria due to liver dysfunction. 4. These effects are common during pregnancy and can worsen with malaria infection. Summary of why other choices are incorrect: - Choice B: Blood smear positivity is not always guaranteed in malaria, and severe anaemia is not the only effect. - Choice C: Therapy limitations can occur, but the presence of few parasites in severe cases is not a defining feature. - Choice D: Loss of pregnancy can happen, but it is not a universal effect of malaria during pregnancy, and severity is not based on parasite count alone.

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: 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.