The PRIORITY action to take when nursing a neonate on phototherapy is to

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.

Correct Answer: D

Rationale: In True cephalopelvic disproportion, the baby's head is too large to pass through the mother's pelvis. This condition often requires operative delivery (C-section) as a vaginal birth is not possible. Choice D is correct because operative delivery is indeed needed to safely deliver the baby. Choice A is incorrect as not all patients with cephalopelvic disproportion will necessarily require operative delivery. Choice B is also incorrect as the issue cannot generally be overcome during labor due to physical constraints. Choice C is incorrect as operative delivery is usually necessary in cases of true cephalopelvic disproportion to prevent complications.

Correct Answer: D

Rationale: Non-infective mastitis is associated with adenitis because it refers to inflammation of breast tissue without an infection. Adenitis specifically involves inflammation of the lymph nodes, which can be a common cause of non-infective mastitis. Cellulitis (A) is an infection of the skin and tissues beneath the skin, not specific to mastitis. Flat (B) and bifid (C) nipples are anatomical variations that do not directly relate to the inflammation of breast tissue.

Correct Answer: D

Rationale: The correct answer is D: A HIDA scan. A HIDA scan is the most appropriate imaging study for investigating the likely cause in this case because the patient's symptoms (abdominal pain centered on the right side just under the ribcage, tenderness in the right upper quadrant) are suggestive of a possible gallbladder issue, such as cholecystitis or biliary colic. A HIDA scan is specifically used to evaluate the gallbladder and biliary system. A: Abdominal radiographs would not provide detailed information about the gallbladder or biliary system, and are not the best choice in this scenario. B: A CT scan of the abdomen with contrast can be helpful in some situations, but it may not provide the specific information needed to evaluate the gallbladder and biliary system. C: Right upper quadrant ultrasound is a good initial imaging study for evaluating gallbladder disease, but a HIDA scan is more specific for functional assessment of

Correct Answer: D

Rationale: 1. Emotional counseling helps women cope with grief. 2. Explaining causes provides closure and understanding. 3. Supporting future pregnancies ensures better outcomes. 4. All options address different aspects of support needed after stillbirth. 5. Therefore, providing emotional counseling, explaining causes, and supporting future pregnancies collectively offer comprehensive care.

Correct Answer: A

Rationale: The correct answer is A: A complete blood count and RBC differential. In this case, Mr. Jefferson presents with severe abdominal pain, which could indicate various conditions like pancreatitis, a possible complication of his heavy drinking. A complete blood count (CBC) with RBC differential can help assess for signs of inflammation or infection, which may be elevated in conditions like pancreatitis. The RBC differential can also provide insights into potential causes of abdominal pain, such as anemia or other blood disorders. Summary: - B: Liver function enzymes may be affected in conditions like alcoholic liver disease, but in this case, the focus should be on investigating acute abdominal pain. - C: Serum amylase, lipase, and glucose are typically checked in cases of suspected pancreatitis, but a CBC with RBC differential would provide a more comprehensive initial assessment. - D: A basic metabolic panel may not directly address the underlying cause of the acute abdominal pain and is not the most appropriate test to anticipate

Correct Answer: C

Rationale: Correct Answer: C - Fine needle aspiration does not allow grading of tumors. Rationale: 1. Fine needle aspiration (FNA) collects cells for cytology evaluation, not tissue for grading. 2. Grading requires evaluation of tissue architecture, which is not possible with FNA. 3. FNA is useful for diagnosis but not for determining tumor grade. Summary: A: Incorrect - Excisional biopsy is preferred over incisional biopsy to obtain the entire tumor for diagnosis and grading. B: Incorrect - Core needle biopsy has a lower false positive rate compared to fine needle aspiration. D: Incorrect - Core needle and incisional biopsies differ in the amount of tissue sampled and potential for false results.

Correct Answer: A

Rationale: The correct answer is A: Submentovertival, bitemporal. In a face presentation, the presenting diameters are submentovertival (chin to vertex) and bitemporal (temple to temple). This is because the fetus is in a face-first position with the chin presenting first. Option B is incorrect because submentobregmatic is not a recognized presenting diameter in face presentation. Option C is incorrect as biparietal refers to the widest transverse diameter of the fetal head, not relevant in face presentation. Option D is incorrect as mentovertical is not a valid presenting diameter in face presentation.

Correct Answer: A

Rationale: The correct answer is A because gestational diabetes can lead to macrosomia, which is excessive fetal growth due to high blood sugar levels in the mother. This occurs as the fetus receives excess glucose from the mother, resulting in increased fat deposition and larger birth weight. Congenital anomalies (B) are not directly caused by gestational diabetes but by genetic or environmental factors. Reduced fetal movements (C) are not a typical effect of gestational diabetes. While gestational diabetes can increase the risk of preterm birth (D), the primary impact on fetal development is macrosomia.