He has had 1 L of NSS infused by emergency medical services. His vital signs reveal a pulse of 128 bpm and a blood pressure of 8860 mm Hg. With respect to his hypotension, the AGACNP recognizes that

Correct Answer: C

Rationale: The correct answer is C: His blood pressure is likely a physiologic response to traumatic head injury. Rationale: 1. Physiologic response: Traumatic head injury can lead to autonomic dysregulation, causing increased sympathetic activity and elevated blood pressure to maintain cerebral perfusion. 2. Compensation mechanism: The body may increase blood pressure in response to hypotension to ensure vital organs receive adequate blood flow. 3. Treatment consideration: Understanding that elevated blood pressure can be a compensatory mechanism helps guide appropriate management strategies for traumatic head injury patients. Summary: A: Vasopressors can be used in traumatic head injury depending on the specific situation, and they are not always contraindicated. B: While hypotension can worsen outcomes in traumatic head injury, this choice overstates the risk without providing context. D: Identifying the cause of hypotension is crucial in managing traumatic head injury patients and should not be disregarded in favor of stabilizing the head injury.

Correct Answer: C

Rationale: The correct answer is C: Consideration of prophylactic therapy. A 12-mm induration in a healthcare worker is considered positive for PPD. In the absence of active TB on chest radiograph, the next step is to consider prophylactic therapy to prevent the development of active TB. This is based on the guidelines for the management of latent TB infection. Choice A is incorrect as a positive PPD warrants further evaluation regardless of the chest radiograph result. Choice B, the Quantiferon assay, is not the next step after a positive PPD and negative chest radiograph. Choice D, beginning therapy for pulmonary TB pending sputum cultures, is not indicated in this scenario as there is no evidence of active TB.

Correct Answer: A

Rationale: The presenting diameter in brow presentation is the submentobregmatic diameter. This is because in brow presentation, the fetal head is partially extended, causing the forehead (bregma) to be the presenting part. The submentobregmatic diameter is the distance between the chin (mentum) and the highest point of the forehead (bregma). This diameter is crucial for successful delivery in brow presentation as it is the smallest diameter that must pass through the maternal pelvis. Summary of other choices: B: Suboccipitofrontal - This diameter is not relevant in brow presentation as it involves the back of the head. C: Occipitalfrontal - This diameter is the distance between the back of the head and the forehead, also not relevant in brow presentation. D: Mentovertical - This diameter is the distance between the chin and the vertex of the head, not the forehead.

Correct Answer: A

Rationale: The correct answer is A: Symptom are absent and abnormal specific laboratory results. Chemical diabetes mellitus refers to a condition where there are abnormal specific laboratory results indicating diabetes without the presence of any symptoms. This classification is based on objective data from laboratory tests rather than subjective symptoms. Choices B, C, and D are incorrect as they do not align with the definition of chemical diabetes mellitus, which focuses on laboratory results rather than symptoms, congenital abnormalities, or pregnancy outcomes.

Correct Answer: D

Rationale: The correct answer is D (All of the above) because during pregnancy, UTI symptoms include painful urination, increased frequency of urination, and lower abdominal pain. Painful urination is a common symptom due to inflammation of the urinary tract. Increased frequency of urination is caused by the pressure of the growing uterus on the bladder. Lower abdominal pain can also occur due to the infection. Therefore, all these symptoms are indicative of a UTI during pregnancy. Other choices are incorrect as they do not encompass the comprehensive range of symptoms typically seen in a UTI during pregnancy.

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: 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: C

Rationale: The correct answer is C: Funic cord prolapse. Funic cord prolapse is characterized by the fetal umbilical cord being alongside the presenting part. This type of cord prolapse is a more specific term used to describe the exact position of the cord in relation to the presenting part. The other choices are incorrect because: - A: Occult umbilical cord prolapse refers to a hidden or concealed cord prolapse, where the cord is not visible externally. - B: Overt umbilical cord prolapse is when the cord is visible externally before the presenting part. - D: Complete cord prolapse implies that the entire cord has descended through the cervix before the presenting part, not just alongside it. Therefore, the correct choice is C as it accurately describes the specific positioning of the umbilical cord in relation to the presenting part during cord prolapse.

Correct Answer: B

Rationale: Correct Answer: B (Managing as an outpatient case) Rationale: 1. Moderate pre-eclampsia indicates stable condition. 2. Outpatient management allows close monitoring without hospitalization. 3. Early intervention can prevent progression to severe pre-eclampsia. 4. Hospital admission is reserved for severe cases or complications (not moderate). 5. Encouraging fluids is important, but not the specific management for pre-eclampsia.