The comprehensive serologic assessment of a patient with Cushings syndrome is likely to produce which constellation of findings?

Correct Answer: C

Rationale: The correct answer is C. In Cushing's syndrome, there is excess cortisol production leading to sodium retention, potassium loss, and increased protein breakdown. Low sodium and potassium levels along with high BUN are commonly seen in patients with Cushing's syndrome. A: Low potassium and high glucose are possible findings, but high white blood cell count is not typically associated with Cushing's syndrome. B: High sodium and polycythemia are not typical findings in Cushing's syndrome, and low BUN is not consistent with the protein breakdown seen in this condition. D: High sodium and high chloride levels can be seen, but high RBCs are not typically associated with Cushing's syndrome.

Correct Answer: A

Rationale: Rationale: A needle biopsy is appropriate for definitive diagnosis of hepatic hemangiomas, ruling out other liver lesions. It helps determine if they are benign or malignant. This will guide further management decisions. Summary: B: Annual ultrasound is unnecessary for benign hemangiomas. C: Surgery is not indicated for asymptomatic hepatic hemangiomas. D: Documenting the finding is important but not the appropriate next step in management.

Correct Answer: D

Rationale: The correct answer is D because additional nursing interventions are necessary to ensure an uncomplicated postpartum period. After an assisted vaginal delivery, the mother may experience increased pain, perineal trauma, and a higher risk of postpartum hemorrhage. Nursing interventions such as pain management, wound care, monitoring for signs of infection, and emotional support are crucial for the mother's recovery. A is incorrect because both vacuum extractors and forceps can cause trauma to the baby and mother's perineum, and the safety of one over the other depends on various factors. B is incorrect as the development of a cephalhematoma is not a normal expected outcome of assisted vaginal delivery and should be monitored and managed appropriately if it occurs. C is incorrect as the use of instruments during childbirth, while not as common as spontaneous vaginal deliveries, is not rare and can be necessary in certain situations to ensure the safety of the mother and baby.

Correct Answer: B

Rationale: Step 1: Puerperal pyrexia refers to fever occurring after childbirth. Step 2: Causes can be obstetric (infection) or non-obstetric (e.g., urinary tract infection). Step 3: Non-obstetric causes are also common postpartum. Step 4: Therefore, puerperal pyrexia is not entirely obstetrically related. Step 5: Hence, the correct answer is B (FALSE).

Correct Answer: C

Rationale: Rationale for Correct Answer (C): A trial of scar is indicated when a woman has had no more than two previous caesarean sections. This is because the risk of uterine rupture increases with each subsequent caesarean section due to scar tissue weakening. Limiting the number of previous scars reduces this risk. Therefore, option C is correct. Summary of Incorrect Choices: A: Estimated fetal weight is not a determining factor for a trial of scar. B: Availability of a level one hospital nearby is important for emergency situations but not a criteria for trial of scar. D: Adequate pelvis with true conjugate 10.5cm is important for vaginal delivery but not a specific requirement for a trial of scar.

Correct Answer: A

Rationale: The correct answer is A because the Brain Trauma Foundation recommends intracranial pressure monitoring for patients with traumatic brain injury and a GCS of 3 to 8, regardless of the head CT findings. Intracranial pressure monitoring helps in the management of elevated intracranial pressure, which can be life-threatening. Abnormal head CT findings may indicate the need for immediate intervention, but intracranial pressure monitoring is still recommended for all patients in this GCS range to guide treatment decisions. Choices B, C, and D are incorrect because hypotension, age > 40 years old, and bradycardia are not factors that would exclude a patient from needing intracranial pressure monitoring in the presence of a GCS of 3 to 8.

Correct Answer: C

Rationale: The correct answer is C: Extraplacental haemorrhage. Incidental antepartum haemorrhage refers to bleeding occurring outside the placenta, such as from the cervix or vaginal walls, before the onset of labor. This is not associated with the placenta itself (intraplacental - choice A). Similarly, it does not occur during labor (intrapartum - choice B) or specifically before term (preterm - choice D). Extraplacental haemorrhage captures the essence of bleeding unrelated to the placenta during the antepartum period.

Correct Answer: B

Rationale: The correct answer is B: Rotational injury. Flexion-distraction injuries of the thoracolumbar spine are often caused by rotational forces that occur during accidents such as motor vehicle collisions or falls. These forces lead to the spine being twisted, causing separation of the vertebrae. Blunt trauma (A) can cause various spinal injuries but is not specific to flexion-distraction injuries. Seat belts (C) are designed to prevent spinal injuries by restraining the body during a collision. Gunshot wounds (D) can cause spinal cord injuries but are not commonly associated with flexion-distraction injuries of the thoracolumbar spine.

Correct Answer: D

Rationale: The correct answer is D because in the context of neoadjuvant chemotherapy, a partial response means converting an unresectable tumor to a resectable one. This is crucial as it allows for successful surgical removal of the tumor. Choices A, B, and C do not accurately define partial response in the context of cancer therapy. A, stating 50% of patients demonstrating remission, is not specific to the change in resectability. B, mentioning 50% survival at 5 years, is more related to overall survival rather than the response to treatment. C, stating a reduction in tumor mass by >50%, does not necessarily imply a change in resectability status. Therefore, option D is the most appropriate definition of partial response in the given scenario.