Correct Answer: A

Rationale: The correct answer is A: Respiratory insufficiency. Chronic traumatic diaphragmatic hernias can lead to gradual compromise of respiratory function due to herniation of abdominal contents into the chest cavity, causing compression of the lungs and reduced lung capacity. This results in symptoms such as dyspnea, cough, and chest pain. Sepsis (B) is more commonly associated with acute traumatic diaphragmatic hernias. Bowel obstruction (C) is a possible complication but typically presents with acute symptoms like abdominal pain and distension. Anemia (D) is not a common presentation of diaphragmatic hernias.

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: Ammonia. Ammonia is a primary chemical mediator of hepatic encephalopathy. In patients with chronic liver disease, the liver's ability to detoxify ammonia is compromised, leading to its accumulation in the bloodstream and subsequent neurotoxic effects causing encephalopathy. Gamma-aminobutyric acid (GABA), false neurotransmitters, and serotonin are all implicated in the pathophysiology of hepatic encephalopathy. GABA is involved in neurotransmission, false neurotransmitters are substances that disrupt normal neurotransmission, and serotonin levels are altered in hepatic encephalopathy.

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: A

Rationale: The correct answer is A: Observation. As an AGACNP, observation is crucial for monitoring the progression of the condition before considering any invasive treatments. Hyperextension casting (B) and Jewett brace (C) are more specific interventions for spinal conditions and not typically indicated for this scenario. Surgical intervention (D) is typically considered only if conservative treatments fail, making it a last resort option. Therefore, observation allows for a conservative approach to assess the patient's response to initial management before considering more aggressive interventions.