Correct Answer: D

Rationale: The correct answer is D because additional nursing interventions are necessary to ensure an uncomplicated postpartum period. After an assisted vaginal delivery, the mother may experience increased pain, perineal trauma, and a higher risk of postpartum hemorrhage. Nursing interventions such as pain management, wound care, monitoring for signs of infection, and emotional support are crucial for the mother's recovery. A is incorrect because both vacuum extractors and forceps can cause trauma to the baby and mother's perineum, and the safety of one over the other depends on various factors. B is incorrect as the development of a cephalhematoma is not a normal expected outcome of assisted vaginal delivery and should be monitored and managed appropriately if it occurs. C is incorrect as the use of instruments during childbirth, while not as common as spontaneous vaginal deliveries, is not rare and can be necessary in certain situations to ensure the safety of the mother and baby.

Correct Answer: B

Rationale: The correct answer is B: By altering immune development. The maternal microbiome plays a crucial role in shaping the fetal immune system during pregnancy. Microbes in the mother's body can influence the development of the fetus's immune system through various mechanisms, such as immune cells crossing the placenta. This interaction helps the fetus develop tolerance to maternal antigens. Choice A (By increasing fetal weight) is incorrect because the maternal microbiome's influence is not primarily related to weight gain. Choice C (By reducing placental oxygen levels) is incorrect as it does not directly relate to the immune system development. Choice D (By enhancing amniotic fluid) is incorrect as the main influence is on the immune system rather than amniotic fluid enhancement.

Correct Answer: B

Rationale: Step 1: Feminizing adrenal tumors are not always carcinomas, so A is incorrect. Step 2: Virilizing tumors in women can originate from adrenal or extra-adrenal sites, so C is incorrect. Step 3: Virilizing adrenal tumors are usually benign, especially in children, so D is incorrect. Step 4: B is correct as feminizing adrenal tumors are rare but are the most common type of adrenal tumor causing gender symptoms.

Correct Answer: A

Rationale: The correct answer is A: Tympany. Tenderness to percussion is analogous to tympany as both indicate the presence of gas-filled structures. When a patient experiences tenderness to percussion in the abdomen, it suggests that there is gas or air present in the abdomen, leading to a hollow, drum-like sound upon percussion, which is characteristic of tympany. Guarding (B) is the involuntary contraction of abdominal muscles to protect the underlying organs, not related to percussion. Rebound tenderness (C) is the pain experienced when pressure is released during palpation, not percussion. Somatic pain (D) refers to pain originating from the skin, muscles, or bones, not related to percussion findings.

Correct Answer: B

Rationale: Step 1: Uterine contractions are a physiological process in labor causing pain due to muscle contractions. Step 2: Cervical dilatation involves the opening of the cervix, which can cause pain and discomfort. Step 3: Pelvic floor stretching occurs as the baby moves through the birth canal, leading to pain. Step 4: Socio-cultural norms do not directly cause physical pain in labor, making choice B the correct answer. Other choices directly relate to physical processes causing pain.