On postoperative day 7 following hepatic transplant, the patient evidences signs and symptoms of acute rejection, confirmed by histologic examination. The AGACNP knows that first-line treatment of acute rejection consists of

Correct Answer: D

Rationale: The first-line treatment for acute rejection following hepatic transplant is high-dose corticosteroids, such as methylprednisolone. This is because corticosteroids have potent anti-inflammatory and immunosuppressive effects that can help suppress the immune response causing rejection. Cyclosporine, azathioprine, and sirolimus are also commonly used immunosuppressive medications in transplant patients, but in this case of acute rejection, the immediate treatment of choice is methylprednisolone.

Correct Answer: C

Rationale: Ultrasonography is considered essential in all cases of acute abdomen because it is a valuable tool in evaluating various abdominal organs non-invasively. It can quickly identify common causes of acute abdomen such as cholecystitis, pancreatitis, appendicitis, and other intra-abdominal pathologies. Ultrasonography also has the advantage of being radiation-free and can be performed rapidly at the bedside, making it a preferred initial diagnostic modality in the evaluation of acute abdominal pain. Abdominal radiograph, contrast radiography, and chest radiography may have limited utility in the evaluation of acute abdomen compared to ultrasonography.

Correct Answer: C

Rationale: Sodium bicarbonate is used to correct metabolic acidosis, not to influence carbon dioxide levels directly.

Correct Answer: A

Rationale: Vasa praevia occurs with a velamentous insertion of the umbilical cord.

Correct Answer: B

Rationale: Vitamin K activates clotting factors, thus preventing hemorrhagic disease of the neonate.