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: 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: Six hours postnatally. Cephalohematoma is a collection of blood between a baby's skull and the periosteum. It typically appears several hours after birth due to trauma during delivery, causing bleeding under the periosteum. This allows time for the blood to accumulate and form a distinct swelling, making the onset around six hours postnatally. Choices B, C, and D are incorrect as they do not align with the typical timeline for the development of cephalohematoma.

Correct Answer: B

Rationale: The correct answer is B: FALSE. In mild preeclampsia, the mother may have symptoms such as mild hypertension, proteinuria, and sometimes mild edema. This indicates that the mother does have complaints, albeit they may be mild. The other choices (A, C, D) are incorrect because in mild preeclampsia, the mother does have complaints, so option A is not true. Options C and D are not applicable as they do not provide any information.

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: Correct dehydration. Acute pyelonephritis can lead to dehydration due to fever, vomiting, and decreased fluid intake. High fluid intake helps correct dehydration by maintaining adequate fluid balance and preventing further complications. Increasing urine output (choice D) is a consequence of correcting dehydration. Promoting enough rest (choice A) is important but not the primary reason for advising high fluid intake. Relief of irritability (choice C) is not directly related to the management of acute pyelonephritis.

Correct Answer: C

Rationale: The correct answer is C: Majority are classified as secondary face presentation. In face presentation, the fetal head is hyperextended, presenting the face to the birth canal. Primary face presentation is rare. The bi-parietal diameter is not the presenting diameter in face presentation, as it is in vertex presentation. Locating the anterior fontanelle is not diagnostic of face presentation, as the fontanelles can be difficult to palpate during labor. Therefore, the correct statement is that the majority of face presentations are classified as secondary face presentation.

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: B

Rationale: The correct answer is B: FALSE. In mild preeclampsia, the mother may have symptoms such as mild hypertension, proteinuria, and swelling. This contradicts the statement that the mother has no complaints. Choice A is incorrect because it inaccurately states that the mother has no complaints. Choices C and D are not applicable as they do not provide any relevant information to address the question.