Correct Answer: B

Rationale: The correct answer is 'headache.' While vancomycin can cause ototoxicity leading to symptoms like tinnitus, vertigo, and nausea, headaches are not typically associated with vancomycin use. Therefore, headache is the least concerning symptom in this scenario. Nausea, vertigo, and tinnitus are more likely to be related to vancomycin ototoxicity and should be closely monitored and reported. Headache is a common symptom that may not be directly linked to vancomycin use.

Correct Answer: A

Rationale: The correct answer is the closure of the posterior fontanel. By 10 months of age, the posterior fontanel should be closed. The anterior fontanel typically closes around 12-18 months of age. Overlapping of cranial bones is not a normal finding and may indicate craniosynostosis, a condition where the sutures close too early. Ossification of the sutures is also not a normal finding in a 10-month-old baby as the sutures should remain open to allow for the growth of the skull.

Correct Answer: B

Rationale: Male climacteric, also known as andropause, is a stage in a man's life characterized by a decline in testosterone levels and various physical and emotional changes. While men may experience symptoms like hot flashes, headaches, and heart palpitations during male climacteric, they do not typically lose their reproductive ability. Although fertility may decrease with age due to reduced testosterone production, men do not entirely lose the ability to reproduce. Therefore, the correct answer is 'loss of reproductive ability.' Choices A, C, and D are symptoms that can be associated with male climacteric, making them incorrect answers.

Correct Answer: A

Rationale: The correct answer is 'Hypoglycemia in diabetic women.' When educating a woman about hormone replacement therapy, it is important to discuss the possible side effects. It is true that monthly menses might return when taking combination hormones, as the progestin can cause this. Additionally, there is an increased risk of gallbladder disease associated with hormone replacement therapy. Furthermore, long-term use of hormone replacement therapy is linked to an increased risk of breast, cervical, and ovarian cancer. However, hypoglycemia is not a common side effect of hormone replacement therapy, especially in diabetic women. In fact, estrogen can have a positive impact on glucose control in some cases, so hypoglycemia would not be a typical concern.

Correct Answer: D

Rationale: When evaluating a kinetic family drawing, noting the omission of any family members is an effective action. It is crucial to observe and analyze all aspects of the drawing, including what is missing. This can provide valuable insights into the child's perception and relationships within the family. Asking the child to draw their family doing something (Choice A) is more related to initial instruction rather than evaluation. Offering specific suggestions (Choice B) can influence the child's drawing and should be avoided to maintain the authenticity of the representation. Discouraging the child from talking about the drawing (Choice C) is counterproductive as verbal expression can provide additional context and understanding.