The type of heat loss that is prevented by keeping the NBU temperature warm & warm wrapping of the neonates is

Correct Answer: B

Rationale: The correct answer is B: Conduction. Conduction is the transfer of heat through direct contact. By keeping the neonatal unit warm and wrapping neonates in warm blankets, heat loss through direct contact with surfaces is minimized. Convection involves heat transfer through air or fluid movement, not relevant in this scenario. Evaporation is the process of heat loss through moisture evaporation from the skin, not applicable here. Radiation is heat transfer through electromagnetic waves, which can be prevented by warm wrapping but not the primary focus in this context.

Correct Answer: C

Rationale: The correct answer is C: Marked limitation of physical activity. In cardiac disease grading, grade III signifies marked limitation of physical activity. This indicates that the patient experiences symptoms with less than ordinary physical activity, such as shortness of breath or chest pain. This grade reflects significant impairment in daily activities due to cardiac issues. A: Patient is comfortable even at rest - This describes grade I, where patients are comfortable at rest. B: Patient is asymptomatic initially - This describes pre-symptomatic stages before any limitations in physical activity. D: Absolute limitation of physical activity - This is more severe and indicative of grade IV, where any physical activity causes discomfort or symptoms.

Correct Answer: D

Rationale: The correct answer is D: Hyperbaric oxygen. SSHL is a medical emergency that requires prompt intervention. Hyperbaric oxygen therapy increases oxygen delivery to the inner ear, potentially reversing the hearing loss. Acyclovir (A) is used for viral infections, not SSHL. Furosemide (B) is a diuretic used for treating fluid retention, not SSHL. Warfarin (C) is an anticoagulant and is not indicated for SSHL. In summary, hyperbaric oxygen is the appropriate choice for managing SSHL due to its potential to improve oxygen delivery to the inner ear.

Correct Answer: A

Rationale: The correct answer is A: External cephalic version. This procedure involves manually manipulating the baby from a breech position to a head-down position. It is recommended as a safe and effective way to manage breech presentations, reducing the need for a cesarean section. Immediate cesarean (B) is not always necessary and should be reserved for specific medical reasons. Pelvic X-ray (C) is not routinely recommended for managing breech presentations. Induction of labor (D) is not the primary strategy for managing breech presentations, as it does not address the positioning of the baby.

Correct Answer: C

Rationale: The correct answer is C: Gastric retention. Mrs. Coates' symptoms of persistent and progressive discomfort are not likely due to gastric retention because she underwent a duodenal resection for a bleeding ulcer, which would bypass the stomach. Therefore, gastric retention is not a possible cause. A: Colic due to return of peristalsis is a possible cause as peristalsis returning after surgery can cause discomfort. B: Leakage from the duodenal stump is a possible cause as it can lead to abdominal discomfort postoperatively. D: Hemorrhage is a possible cause given her history of bleeding ulcer and surgery.

Correct Answer: B

Rationale: The correct answer is B: Adjuvant therapies. Adjuvant therapies are additional treatments given after the primary treatment, usually surgery, to reduce the risk of cancer recurrence. In the context of fixed tumors, adjuvant therapies can help target any remaining cancer cells that may not have been completely removed during surgery, thus improving the chances of a successful outcome. En bloc resection (A) is important for complete tumor removal but may not always be feasible in fixed tumors. Neoadjuvant therapies (C) are given before surgery and are not typically used for fixed tumors. Elective lymph node dissection (D) may be necessary in some cases but is not the best approach for curative surgery in fixed tumors.

Correct Answer: D

Rationale: Rationale for Correct Answer (D: Atelectasis): 1. Ascorbic acid deficiency can lead to impaired collagen synthesis, affecting lung tissue integrity. 2. Anemia reduces oxygen-carrying capacity, increasing the risk of lung collapse. 3. Volume contraction can lead to decreased lung compliance, predisposing to atelectasis. Summary of Incorrect Choices: A: Prolonged intubation is more related to airway issues, not specifically affected by the mentioned risk factors. B: Thromboembolism is more linked to blood clotting issues rather than the mentioned risk factors. C: Delayed wound healing is more influenced by nutritional deficiencies and blood flow, not directly linked to lung complications like atelectasis.

Correct Answer: A

Rationale: The correct answer is A: Radiographs. Radiographs, specifically skull X-rays, are most useful in assessing for findings consistent with a history of abuse in this case. Radiographs can detect fractures, such as skull fractures or facial bone fractures, which are common in cases of physical abuse. These fractures may not always be clinically evident but can be identified on X-rays. Explanation of other choices: B: CT scan without contrast - While a CT scan can provide detailed imaging of the head, it may not be necessary in this case as the patient's neurologic examination is within normal limits. Also, radiographs are more cost-effective and can detect fractures effectively. C: MRI - MRI is not typically used as the first-line imaging modality for suspected head trauma due to its cost and time-consuming nature. Radiographs are more appropriate for initial evaluation. D: PET scan - PET scans are used to detect metabolic activity in tissues and are not typically indicated for assessing acute traumatic injuries like fractures associated with

Correct Answer: B

Rationale: The correct answer is B: Infuse albumin and fresh frozen plasma. Given Janet's post-hepatic resection status and abnormal lab values indicating liver dysfunction (elevated bilirubin, low albumin, prolonged prothrombin time, elevated AST and ALT), she is at risk for coagulopathy and hypoalbuminemia. Infusing albumin can help improve her oncotic pressure and fluid balance, while fresh frozen plasma can replenish clotting factors to address the prolonged prothrombin time. This intervention aims to stabilize her condition before transferring to the general medical floor. Canceling the transfer (Choice A) is not necessary if appropriate interventions can be taken. Repeating labs the next day (Choice C) delays potentially needed treatments. Preparing for reoperation (Choice D) is not indicated based on the information provided.