The AGACNP recognizes that which of the following diagnostic studies is essential in all cases of acute abdomen?

Correct Answer: C

Rationale: The correct answer is C: Chest radiography. In cases of acute abdomen, a chest radiograph is essential to rule out conditions like pneumothorax, pleural effusion, or pneumonia which may present with similar symptoms. This helps in identifying potential causes of abdominal pain outside the abdomen. Abdominal radiograph (A) may not provide enough information for diagnosis. Contrast radiography (B) and ultrasonography (D) are not universally essential for all cases of acute abdomen and may not be appropriate in certain situations.

Correct Answer: B

Rationale: Uterine apoplexy is the sudden rupture of blood vessels in the uterus, leading to severe hemorrhage. Placental abruption is the most likely cause due to the separation of the placenta from the uterine wall, resulting in bleeding. Incidental hemorrhage is not sudden or severe. Multiple pregnancy may increase the risk but doesn't directly cause uterine apoplexy. Placenta previa involves the placenta covering the cervix, leading to bleeding but not necessarily uterine rupture. Therefore, the correct answer is B.

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: C

Rationale: The correct answer is C: Chest radiography. In cases of acute abdomen, a chest radiograph is essential to rule out conditions like pneumothorax, pleural effusion, or pneumonia which may present with similar symptoms. This helps in identifying potential causes of abdominal pain outside the abdomen. Abdominal radiograph (A) may not provide enough information for diagnosis. Contrast radiography (B) and ultrasonography (D) are not universally essential for all cases of acute abdomen and may not be appropriate in certain situations.

Correct Answer: A

Rationale: Rationale for Correct Answer (A): 1. Previous C-section and uterine scars weaken the uterine wall. 2. Fetal macrosomia (large baby) increases pressure on the uterus. 3. Trauma can cause direct injury to the uterus. 4. Prolonged labor can lead to uterine overdistension and fatigue, increasing rupture risk. Summary of Incorrect Choices: B: Malpresentation, premature rupture of membranes, obesity, malnutrition, anemia are not direct factors for uterine rupture. C: Uterine fibroids, excessive weight gain, smoking, poor prenatal care can contribute to complications but not primary causes of uterine rupture. D: Not all factors in choices B and C are predisposing factors for uterine rupture, making this choice incorrect.

Correct Answer: D

Rationale: The correct answer is D: Compound presentation. This term refers to the situation where there is more than one part of the fetus on the pelvic brim at the onset of labor. This can include a hand or arm alongside the head or another body part. The other choices are incorrect because: A: Unstable lie refers to the fetus being in a transverse position. B: Fetal malpresentation indicates an abnormal presentation of the fetus, such as breech or transverse. C: Fetal malposition refers to the fetus being in a suboptimal position, like occiput posterior. Thus, the best choice is D as it specifically describes the scenario of multiple fetal parts on the pelvic brim.

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: 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.

Correct Answer: C

Rationale: The correct answer is C: Choanal atresia. The congenital abnormality of the respiratory tract with abnormal apical position is typically associated with choanal atresia, which is a blockage or narrowing of the back of the nasal passage. This condition can lead to respiratory distress in newborns due to difficulty breathing through the nose. Explanation: 1. Laryngeal stridor (Choice A) is a high-pitched noise during breathing and is not typically associated with abnormal apical position. 2. Diaphragmatic hernia (Choice B) is a defect in the diaphragm that allows abdominal organs to move into the chest cavity, but it is not related to abnormal apical position. 3. Tracheo-bronchi fistula (Choice D) is an abnormal connection between the trachea and bronchi, which is not associated with abnormal apical position. In summary, choanal atresia is the correct answer because it fits the description of