Traumatic diaphragmatic hernias present in both acute and chronic forms. Patients with a more chronic form are most likely to be present with

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: Grade 1 cardiac disease refers to early-stage or mild heart conditions that are not yet severe. Choice A, "Organic disease," is the correct answer as it encompasses a broad category of structural heart abnormalities. Mitral stenosis (B) and ventricular failure (C) are specific conditions that can be present in cardiac disease but do not represent the general term for grade 1. Vascular disease (D) primarily refers to conditions affecting blood vessels, not the heart itself. In summary, choice A is correct because it is a comprehensive term that includes various structural heart abnormalities typically found in grade 1 cardiac disease, while the other choices are either too specific or unrelated to the concept of grade 1 cardiac disease.

Correct Answer: D

Rationale: The correct initial action for the AGACNP is to provide counseling to the patient regarding her options (Choice D). This is important to ensure the patient's safety, well-being, and autonomy. Counseling will allow the patient to explore her feelings, understand her options, and make an informed decision about her next steps. Reporting the physical assault to law enforcement (Choice A) should only be done with the patient's consent to respect her wishes. Having the patient sign a release to go home with her husband (Choice B) could potentially put the patient at risk of further harm. Consulting psychiatry for a psych hold (Choice C) may not be appropriate unless the patient is deemed a danger to herself or others.

Correct Answer: A

Rationale: The correct answer is A: Veracity and beneficence. Veracity refers to truthfulness, and the AGACNP is facing a conflict between being honest with the patient about the need for reintubation (veracity) and providing beneficence by ensuring the patient receives necessary medical care to prevent harm. The patient's autonomy and right to make decisions are not directly in conflict since the patient is conscious, and autonomy is respected by honoring the patient's wishes. Justice is also not in conflict here as it does not pertain to the immediate ethical dilemma of reintubation. Autonomy and beneficence are not in direct conflict as the patient's autonomy is being respected by allowing them to make an informed decision. Nonmalfeasance is not directly applicable in this scenario.

Correct Answer: B

Rationale: The correct answer is B: Placental insufficiency. Prolonged pregnancy can lead to decreased placental function, resulting in inadequate oxygen and nutrients for the fetus. This can lead to complications such as intra-uterine growth restriction and fetal distress. Option A (Intra-uterine oligohydramnios) is a consequence of decreased amniotic fluid levels but not directly associated with prolonged pregnancy. Option C (Fetal post-maturity syndrome) refers to the complications seen in a post-term newborn, not maternal risks. Option D (Large for gestational age baby) is a consequence of prolonged pregnancy but does not directly impact maternal health.

Correct Answer: B

Rationale: The correct answer is B: Severe asphyxia and prematurity. In eclampsia, maternal hypertension can lead to placental insufficiency, reducing oxygen and nutrient supply to the fetus, resulting in severe asphyxia and premature birth. This is due to the high risk of placental abruption and intrauterine growth restriction. Other choices are incorrect because cerebral hemorrhage and pneumonia (choice A) are not commonly associated with neonatal complications of eclampsia. Fractures and soft tissue trauma (choice C) are not typical complications of eclampsia in neonates. Respiratory distress and hypoglycemia (choice D) are more commonly seen in neonates born to mothers with gestational diabetes, not eclampsia.

Correct Answer: B

Rationale: The correct answer is B because reduced facial movement is a key clinical feature of facial palsy. This can lead to difficulty in making facial expressions, closing the eye on the affected side, and drooping of the mouth. Irritability may also occur due to discomfort or difficulty in communication. Choice A is incorrect because inability to feed and excessive cry are not typical features of facial palsy. Choice C is incorrect as excessively dry eyeball and feeding difficulties are not commonly associated with facial palsy. Choice D is incorrect as eyes being permanently open and no facial movement are not characteristic of facial palsy.

Correct Answer: D

Rationale: The correct answer is D because preeclampsia can lead to poor placental anchorage, which results in reduced blood flow to the placenta, leading to severe infarction. This can cause adverse effects on the fetus and the mother. Choice A is incorrect because infarcts and placental abruption are not specific effects of preeclampsia on the reproductive system. Choice B is incorrect because lowered vaginal discharge pH and hemorrhage are not typical effects of preeclampsia. Choice C is incorrect because congestive cardiac failure and fetal hypoxia are not direct effects of preeclampsia on the reproductive system.

Correct Answer: C

Rationale: The correct answer is C: Not more than two previous caesarean section scars. This is because a trial of scar refers to a trial of labor in a woman who has had previous cesarean sections. The guideline typically recommends that a trial of scar should be considered in women with no more than two previous cesarean section scars to reduce the risk of uterine rupture. Choices A, B, and D are incorrect because the estimated fetal weight, availability of a level one hospital, and pelvis size are not specific criteria used to determine eligibility for a trial of scar.