Correct Answer: B

Rationale: The correct answer is B: Acute pancreatitis. The patient's sudden, severe upper abdominal pain, unaffected by food intake, along with guarding and elevated white blood cell count, are indicative of acute pancreatitis. The patient's positioning (knees to chest) suggests relief from pain, which is characteristic of pancreatitis. A dissecting aortic aneurysm (choice A) typically presents with tearing chest or back pain. Perforated peptic ulcer (choice C) would present with a history of chronic ulcer symptoms. Mallory-Weiss tear (choice D) presents with a history of recent vomiting. Therefore, based on the patient's presentation and findings, acute pancreatitis is the most likely diagnosis.

Correct Answer: D

Rationale: The correct answer is D (42 completed weeks) because a full-term pregnancy is considered to be around 40 weeks. Post maturity refers to a pregnancy that has exceeded the normal 40-week gestation period. At 42 weeks, the risk of complications such as stillbirth or issues with the placenta increases. Choice A (40 completed weeks) is incorrect because this is considered a full-term pregnancy. Choices B (38 completed weeks) and C (41 completed weeks) are incorrect as they do not meet the criteria for post maturity.

Correct Answer: B

Rationale: The correct answer is B (GCS of 3 to 8 and hypotension) because hypotension is not a specific indication for intracranial pressure (ICP) monitoring according to the Brain Trauma Foundation guidelines. The rationale is that hypotension is a systemic issue affecting overall perfusion, whereas ICP monitoring is specifically for assessing intracranial dynamics. A, C, and D are incorrect choices because they all involve conditions that could potentially indicate increased intracranial pressure and the need for monitoring. A) Abnormal head CT indicates structural brain injury, C) age > 40 is a risk factor for poor outcomes after traumatic brain injury, and D) bradycardia can be a sign of increased ICP affecting brainstem function. Therefore, these conditions warrant ICP monitoring according to guidelines.

Correct Answer: B

Rationale: The correct answer is B: Acute pancreatitis. The patient's sudden, severe upper abdominal pain, unaffected by food intake, along with guarding and elevated white blood cell count, are indicative of acute pancreatitis. The patient's positioning (knees to chest) suggests relief from pain, which is characteristic of pancreatitis. A dissecting aortic aneurysm (choice A) typically presents with tearing chest or back pain. Perforated peptic ulcer (choice C) would present with a history of chronic ulcer symptoms. Mallory-Weiss tear (choice D) presents with a history of recent vomiting. Therefore, based on the patient's presentation and findings, acute pancreatitis is the most likely diagnosis.

Correct Answer: D

Rationale: The correct answer is D: His symptoms occur in 5 to 10% of people after ulcer surgery. This is the correct answer because the patient's symptoms of decreased capacity for intake and nausea after eating are common post-operative complications following ulcer surgery. By stating this fact to the patient, the AGACNP is providing reassurance that these symptoms are not unusual. Explanation for why the other choices are incorrect: A: Endoscopy is not necessary at this point since the symptoms described by the patient are known post-operative complications and do not indicate an urgent need for endoscopy. B: While gastroparesis can be a complication of ulcer surgery, there is no information in the case to suggest that the patient has chronic gastroparesis. C: Jumping to the conclusion that medication is unlikely to help and another surgery may be needed is premature and not supported by the information provided in the case.