The presenting diameter in brow presentation is

Correct Answer: A

Rationale: The presenting diameter in brow presentation is the submentobregmatic diameter. This is because in brow presentation, the fetal head is partially extended, causing the forehead (bregma) to be the presenting part. The submentobregmatic diameter is the distance between the chin (mentum) and the highest point of the forehead (bregma). This diameter is crucial for successful delivery in brow presentation as it is the smallest diameter that must pass through the maternal pelvis. Summary of other choices: B: Suboccipitofrontal - This diameter is not relevant in brow presentation as it involves the back of the head. C: Occipitalfrontal - This diameter is the distance between the back of the head and the forehead, also not relevant in brow presentation. D: Mentovertical - This diameter is the distance between the chin and the vertex of the head, not the forehead.

Correct Answer: T

Rationale: Step-by-step rationale: 1. Puerperal psychosis is a severe mental health condition occurring postpartum. 2. Psychosocial adversities, such as stress or lack of social support, can trigger or exacerbate mental health issues. 3. Therefore, psychosocial adversities can be predisposing factors for puerperal psychosis. 4. Option A (TRUE) is correct as it aligns with the established relationship between psychosocial factors and mental health. Summary: Option A is correct because psychosocial adversities can indeed contribute to the development of puerperal psychosis, making it a relevant predisposing factor. Options B, C, and D are incorrect as they do not provide any rationale or evidence to support their validity.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Cognitive ability is important for decision-making during surgery. 2. Functional status helps assess the patient's ability to recover post-surgery. 3. Competency assessment ensures the patient can consent to surgery. 4. Frailty score predicts surgical outcomes in geriatric patients. 5. Cognitive ability is not typically assessed preoperatively in the ACS/NSQIP guidelines. Summary: - A: Cognitive ability is not typically part of preoperative evaluation. - B: Functional status is important for post-surgery recovery. - C: Competency assessment is crucial for informed consent. - D: Frailty score helps predict surgical outcomes in geriatric patients.

Correct Answer: B

Rationale: The correct answer is B: Grunting on expiration. In respiratory distress syndrome, the infant may exhibit grunting on expiration due to the difficulty in maintaining lung inflation during exhalation. This is a compensatory mechanism to increase functional residual capacity. Grunting on inspiration (choice A) may be seen in other respiratory conditions. Flaring of the nostrils (choice C) is a sign of increased work of breathing but is not specific to respiratory distress syndrome. Neonatal tachycardia (choice D) can be a nonspecific sign of distress and is not a specific feature of respiratory distress syndrome.

Correct Answer: C

Rationale: The correct answer is C: Fluoroquinolone antibiotics. In this case, the patient presents with signs of sepsis and urinary retention, which are indicative of a possible prostatic abscess. Administering fluoroquinolone antibiotics could potentially mask the symptoms and delay further evaluation and treatment of the abscess. This can lead to worsening infection and sepsis. Therefore, the AGACNP should avoid prescribing fluoroquinolones until further evaluation is done to confirm or rule out a prostatic abscess. Incorrect choices: A: Digital prostate examination - This could help in assessing the prostate for abscess or other abnormalities. B: Urinary catheterization - Necessary to relieve bladder distention and assess urine output. D: Drainage of prostate abscess - If confirmed, drainage would be the appropriate intervention to address the abscess.

Correct Answer: A

Rationale: The correct answer is A: A temperature of 101.5°F. A fever indicates an inflammatory response, which could be due to a complication like cholecystitis or cholangitis. Elevated leukocyte count (choice B) supports infection but is not as specific as a fever. Palpable gallbladder (choice C) may suggest inflammation but not necessarily a complication. A positive Murphy's sign (choice D) is indicative of gallbladder inflammation but does not directly indicate a complication requiring surgical evaluation.

Correct Answer: C

Rationale: The correct answer is C: Consideration of prophylactic therapy. A 12-mm induration in a healthcare worker is considered positive for PPD. In the absence of active TB on chest radiograph, the next step is to consider prophylactic therapy to prevent the development of active TB. This is based on the guidelines for the management of latent TB infection. Choice A is incorrect as a positive PPD warrants further evaluation regardless of the chest radiograph result. Choice B, the Quantiferon assay, is not the next step after a positive PPD and negative chest radiograph. Choice D, beginning therapy for pulmonary TB pending sputum cultures, is not indicated in this scenario as there is no evidence of active TB.

Correct Answer: B

Rationale: Complete uterine rupture involves a full-thickness disruption of all uterine layers, including the serosa, myometrium, and endometrium. This leads to a complete separation of the uterine wall, potentially resulting in severe bleeding and fetal distress. Choice A is incorrect as it only involves the outermost layer of the uterus. Choice C is incorrect as uterine contractions are usually present during uterine rupture. Choice D is incorrect as the correct definition of complete uterine rupture involves the entire uterine layers being affected.

Correct Answer: D

Rationale: The correct answer is D: Check the neonate’s vital signs every 2-4 hourly. This is the priority action because neonates undergoing phototherapy are at risk for dehydration and temperature instability. Monitoring vital signs regularly helps to detect any signs of dehydration, such as decreased urine output or increased heart rate, and ensures timely intervention. Explanation for other choices: A: Turning the neonate every six hours routinely is important for preventing pressure ulcers but is not the priority when compared to monitoring vital signs for potential complications. B: Encouraging the mother to discontinue breastfeeding is incorrect as breastmilk provides essential nutrients and hydration, which are important for neonates, even during phototherapy. C: Notifying the physician if the skin turns bronze-colored is important to address a potential adverse reaction to phototherapy but does not take precedence over monitoring vital signs for immediate concerns.