Choice A reason: IV supplies prepare for hydration or surgery, but assessing the obstruction’s extent via abdominal measurement is the first step to guide subsequent interventions.

Choice B reason: Anorectal manometry diagnoses anal function, but bilious vomiting suggests a higher obstruction (e.g., Hirschsprung’s); it’s not the initial assessment needed here.

Choice C reason: Measuring abdominal circumference assesses distension from potential obstruction (e.g., meconium ileus), the first action to evaluate severity and guide urgent care.

Choice D reason: Monitoring urinary output tracks hydration but doesn’t address the immediate gastrointestinal issue; abdominal assessment prioritizes identifying the obstruction’s impact first.

Choice A reason: Blow-by oxygen via cannula delivers supplemental oxygen but does not address apnea directly, as it relies on spontaneous breathing, which this neonate lacks despite stimulation, making it insufficient for immediate respiratory support.

Choice B reason: Assisting with intubation is a complex procedure requiring a neonatologist, but the nurse can act faster independently with positive pressure ventilation to address apnea, reserving intubation for persistent respiratory failure.

Choice C reason: Starting an IV infusion in a scalp vein addresses hydration or medication needs but does not correct the immediate life-threatening issue of apnea, which requires urgent respiratory intervention first.

Choice D reason: Positive pressure ventilation directly supports breathing by delivering air to the lungs, critical for an apneic neonate with a heart rate of 100 bpm, ensuring oxygenation and preventing further deterioration.

Choice A reason: Verifying the last menstrual cycle helps estimate gestational age but does not directly assess the current pregnancy status or cause of bleeding, which requires a more immediate diagnostic approach.

Choice B reason: Checking serum human chorionic gonadotropin levels quantitatively confirms pregnancy viability and detects abnormalities like miscarriage or ectopic pregnancy, critical for evaluating vaginal bleeding at 6 weeks gestation.

Choice C reason: Inquiring about the last intercourse provides context for pregnancy timing but offers no diagnostic insight into the bleeding’s cause, which needs objective hormonal or imaging assessment instead.

Choice D reason: Repeating a urine pregnancy test confirms pregnancy but lacks the precision of serum hCG to assess viability or progression, making it less useful for bleeding evaluation.

Choice A reason: Chickenpox, caused by varicella-zoster virus, is a viral infection with no established link to rheumatic fever, which is a post-streptococcal autoimmune condition, making it less relevant here.

Choice B reason: Influenza, a respiratory viral illness, can mimic some symptoms but lacks a direct causal relationship with rheumatic fever, which specifically follows group A streptococcal infection.

Choice C reason: Sore throat, often due to group A Streptococcus (e.g., strep throat), is a key precursor to rheumatic fever, triggering an autoimmune response affecting the heart and joints, making it highly significant.

Choice D reason: Mumps, a viral infection affecting salivary glands, has no association with rheumatic fever’s streptococcal etiology, rendering it insignificant in this health history context.

Choice A reason: A 2-pound weight gain at 34 weeks is within normal pregnancy ranges (0.5-1 kg/month), reflecting healthy maternal adaptation, not warranting immediate reporting to the HCP.

Choice B reason: Fundal height of 30 cm at 34 weeks is slightly below expected (typically 34 cm), but variations occur in multigravidas, so it’s not immediately alarming without other signs.

Choice C reason: 1+ edema in lower extremities is common in late pregnancy due to increased fluid volume and pressure, not typically urgent unless accompanied by hypertension or proteinuria.

Choice D reason: Fetal heart rate of 110 bpm is below the normal range (120-160 bpm), indicating potential fetal distress or bradycardia, requiring prompt reporting for further evaluation.

Choice A reason: Supervised parenteral antibiotics ensure effective PID treatment by delivering high-dose, bioavailable drugs directly into the bloodstream, critical for severe cases unresponsive to outpatient oral therapy, reducing complications.

Choice B reason: Jarisch-Herxheimer reaction occurs with spirochetal infections (e.g., syphilis), not typical PID pathogens, making early symptom detection irrelevant to her hospital stay for this condition.

Choice C reason: PID isn’t contagious via casual contact, so contact precautions are unnecessary; hospitalization focuses on treatment efficacy, not infection spread, which is irrelevant to her question.

Choice D reason: Serial anaerobic cultures monitor treatment response but aren’t the primary reason for admission; the focus is on delivering intensive antibiotic therapy, not just diagnostic sampling.

Choice A reason: Iron supports red blood cell production and prevents anemia in pregnancy but has no specific role in neural tube development, thus not preventing anencephaly directly.

Choice B reason: Vitamin D aids calcium absorption and bone health but lacks evidence linking it to neural tube defect prevention, making it irrelevant for anencephaly risk reduction.

Choice C reason: Folic acid is essential for neural tube closure in early fetal development; adequate intake (400-800 mcg daily) significantly reduces anencephaly risk, a severe neural tube defect.

Choice D reason: Calcium supports maternal and fetal bone health but does not influence neural tube formation, offering no protective effect against anencephaly during preconception or pregnancy.

Choice A reason: Encouraging clothing based on sexual maturity contradicts LHRH’s goal of delaying puberty, which suppresses physical changes to align her development with peers, not enhance it.

Choice B reason: LHRH treatment is temporary, halting precocious puberty until normal age; lifelong use isn’t required as the pituitary regulation normalizes by adolescence, making this incorrect.

Choice C reason: Birth control pills manage menstruation or contraception, not precocious puberty; LHRH suppresses gonadotropin release, delaying puberty without needing additional hormonal contraception.

Choice D reason: LHRH delays puberty progression, allowing peers to catch up by adolescence, reducing maturity differences within years, aligning with the treatment’s purpose of age-appropriate development.

Choice A reason: Palpating femoral pulses assesses proximal circulation but may miss distal issues like cast-related compression, which directly affects the foot’s perfusion in club foot correction.

Choice B reason: Monitoring capillary refill of the toes directly evaluates distal circulation and detects cast-induced neurovascular compromise, critical for preventing ischemia or nerve damage in the affected limb.

Choice C reason: Spontaneous movement indicates comfort but not circulation status; a child may move despite impaired blood flow, making it less reliable than capillary refill assessment.

Choice D reason: Comparing leg temperatures detects inflammation or circulation differences but is less specific than capillary refill for immediate neurovascular complications in a casted limb.

Choice A reason: Offering a pacifier supports oral stimulation and comfort but doesn’t ensure nutritional delivery critical for growth in a dehydrated, failure-to-thrive infant requiring enteral feeding.

Choice B reason: Sterile technique prevents infection but isn’t standard for enteral feedings, which use clean technique; it’s secondary to confirming tube placement for effective nutrition delivery.

Choice C reason: Ensuring nasogastric tube placement via x-ray confirms correct positioning for safe, effective enteral feeding, essential for delivering nutrients to support growth and reverse failure to thrive.

Choice D reason: Physical therapy aids motor development but doesn’t address immediate nutritional needs; enteral feeding’s success via proper tube placement is the priority for growth.