Which of the following is highly associated with preterm babies?

Correct Answer: C

Rationale: The correct answer is C: Multiple gestation. Preterm birth is more common in multiple gestation pregnancies due to the increased strain on the mother's uterus and cervix. This can lead to early labor and delivery. Social habits (choice A) and genetic factors (choice B) may play a role in preterm birth but are not highly associated. Chronic conditions (choice D) can also contribute to preterm birth, but multiple gestation is a stronger predictor.

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: B

Rationale: The correct answer is B: Myelomeningocele. McEwen sign refers to the characteristic scalloping of the frontal bones due to pressure from the expanding brain in individuals with myelomeningocele. This sign is specific to myelomeningocele and is not associated with hydrocephalus (A), microcephaly (C), or encephalocele (D), which have different clinical manifestations and imaging findings. Myelomeningocele is a neural tube defect where the spinal cord and its coverings protrude through an opening in the spine, leading to neurological deficits and associated signs like McEwen sign.

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: D

Rationale: The correct answer is D: Assessment of nonprostate causes of nocturia. In this case, the patient's symptoms of nocturia, urinary urgency, and post-void dribbling are not indicative of prostate enlargement. Given that the digital rectal examination revealed a normal-sized prostate with no hypertrophy, it is essential to explore other potential causes of nocturia in this patient. By assessing non-prostate causes of nocturia, such as diabetes, urinary tract infection, medication side effects, or sleep disorders, a more accurate diagnosis and appropriate treatment plan can be developed. This approach will lead to better patient outcomes compared to focusing solely on prostate-related evaluations. Option A: Administration of the AUA Symptom Scale is not the best approach in this case because the patient's symptoms are not primarily related to prostate enlargement. Option B: Laboratory assessment to include a PSA is not necessary since the digital rectal examination already indicated a normal-sized prostate with no appreciable hypertrophy. Option C: Ordering a

Correct Answer: D

Rationale: The correct answer is D: Provide counseling to the patient regarding her options. The AGACNP's initial action should prioritize the patient's well-being and autonomy. Counseling allows the patient to understand her options, including legal, medical, and emotional support. Reporting to law enforcement (A) without the patient's consent violates her autonomy. Having the patient sign a release to go home with her husband (B) disregards the potential danger and trauma she may face. Consulting psychiatry for a psych hold (C) may not address the immediate emotional and physical needs of the patient.

Correct Answer: A

Rationale: The correct answer is A: A complete blood count and RBC differential. In this case, Mr. Jefferson presents with severe abdominal pain, which could indicate various conditions like pancreatitis, a possible complication of his heavy drinking. A complete blood count (CBC) with RBC differential can help assess for signs of inflammation or infection, which may be elevated in conditions like pancreatitis. The RBC differential can also provide insights into potential causes of abdominal pain, such as anemia or other blood disorders. Summary: - B: Liver function enzymes may be affected in conditions like alcoholic liver disease, but in this case, the focus should be on investigating acute abdominal pain. - C: Serum amylase, lipase, and glucose are typically checked in cases of suspected pancreatitis, but a CBC with RBC differential would provide a more comprehensive initial assessment. - D: A basic metabolic panel may not directly address the underlying cause of the acute abdominal pain and is not the most appropriate test to anticipate

Correct Answer: A

Rationale: The correct answer is A because cord presentation occurs when the umbilical cord lies in front of the presenting part after the membranes have ruptured. This can lead to compression of the cord during labor, affecting fetal oxygenation. Option B is incorrect as it describes cord prolapse, where the cord lies in front of the presenting part before membrane rupture. Option C describes nuchal cord, where the cord is wrapped around the fetal neck. Option D describes cord abruption, where the cord detaches prematurely from the placenta.

Correct Answer: C

Rationale: The correct answer is C: 4 hours. This is based on the definition of prolonged second stage in nulliparous women, which is labor lasting more than 4 hours. This duration is considered abnormal and may lead to increased risk of maternal and fetal complications. Choice A (1 hour) is too short and does not meet the criteria for prolonged second stage. Choice B (2 hours) is also insufficient based on the established timeframe. Choice D (8 hours) exceeds the duration for prolonged second stage, indicating a more advanced stage of labor. Therefore, the most appropriate and accurate timeframe for prolonged second stage in nulliparous women is 4 hours.