When counseling a patient about his surgical options for an ulcer that has been refractory to medical therapy, the AGACNP advises the patient that he will need

Correct Answer: D

Rationale: Correct Answer: D. Some form of vagotomy Rationale: 1. Vagotomy is a surgical procedure that involves cutting the vagus nerve to reduce acid production in the stomach, which can help in treating ulcers. 2. Vagotomy is often recommended when ulcers are refractory to medical therapy, making it an appropriate surgical option. 3. Lifelong vitamin D replacement (A) is not typically necessary for ulcer treatment. Excision of the ulcer (B) is not a common treatment and does not address the underlying cause. Eating smaller meals (C) may help manage symptoms but is not a surgical option for refractory ulcers.

Correct Answer: D

Rationale: Step 1: Campylobacter jejuni is a bacteria commonly associated with foodborne illness, often found in undercooked poultry and unpasteurized milk. Step 2: The patient's symptoms and microbiological findings are consistent with Campylobacter infection. Step 3: Advising the patient that there is no readily identified food source of this bacteria is important for preventing future exposure and potential reinfection. Step 4: Choices A, B, and C are incorrect as they do not address the specific educational need related to food safety and prevention of Campylobacter infection.

Correct Answer: D

Rationale: The correct answer is D: Escherichia coli. E. coli is the most common causative organism of pyelonephritis due to its prevalence in the gastrointestinal tract. It has specific virulence factors that enable it to ascend the urinary tract and cause infection. Streptococcus faecalis, Proteus vulgaris, and Staphylococcus pyogene are less commonly associated with pyelonephritis compared to E. coli.

Correct Answer: B

Rationale: The correct answer is B: Within the first week of birth. Classical vitamin K deficiency bleeding typically occurs within the first week of birth due to low levels of vitamin K in newborns. During this time, infants are at a higher risk of bleeding complications if not supplemented with vitamin K. Choice A is incorrect because bleeding usually occurs after the first 24 hours. Choice C is incorrect as it does not specify a specific time frame within the neonatal stage. Choice D is incorrect as classical vitamin K deficiency bleeding is typically seen within the first week, not necessarily during the entire infancy stage.

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: Immediate caesarean section. In obstructed labor, prompt delivery is crucial to prevent harm to both the mother and the baby. A caesarean section is the most effective and timely intervention to safely deliver the baby and avoid complications such as fetal distress, maternal infection, and uterine rupture. Observation with pain relief (B) may delay necessary intervention, and manual repositioning of the fetus (C) is not sufficient in cases of obstructed labor. Choice D is incorrect because not all options are appropriate in this specific scenario.

Correct Answer: C

Rationale: Certainly! The correct answer is C: Hyperthermia neonatorum. Greatly reduced eliminations and a red rosy appearance of the face are indicative of hyperthermia, which is an elevated body temperature. This condition can lead to dehydration and other complications. A: Hypothermia neonatorum is characterized by low body temperature, not elevated. B: Hypoglycemia neonatorum refers to low blood sugar levels, not related to the symptoms mentioned. D: Hypocalcemia neonatorum is a deficiency of calcium in the blood, not associated with the given features. In summary, hyperthermia neonatorum is the correct answer due to the specific symptoms presented, while the other choices do not align with the described features.

Correct Answer: T

Rationale: Step-by-step rationale: 1. Puerperal psychosis is a severe mental health condition occurring postpartum. 2. Psychosocial adversities, such as stress or lack of social support, can trigger or exacerbate mental health issues. 3. Therefore, psychosocial adversities can be predisposing factors for puerperal psychosis. 4. Option A (TRUE) is correct as it aligns with the established relationship between psychosocial factors and mental health. Summary: Option A is correct because psychosocial adversities can indeed contribute to the development of puerperal psychosis, making it a relevant predisposing factor. Options B, C, and D are incorrect as they do not provide any rationale or evidence to support their validity.

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.