The AGACNP recognizes that which of the following diagnostic studies is essential in all cases of acute abdomen?

Correct Answer: C

Rationale: The correct answer is C: Chest radiography. In cases of acute abdomen, a chest radiograph is essential to rule out conditions like pneumothorax, pleural effusion, or pneumonia which may present with similar symptoms. This helps in identifying potential causes of abdominal pain outside the abdomen. Abdominal radiograph (A) may not provide enough information for diagnosis. Contrast radiography (B) and ultrasonography (D) are not universally essential for all cases of acute abdomen and may not be appropriate in certain situations.

Correct Answer: D

Rationale: The correct answer is D: Fistula formation. Fistula formation is the most severe type of urinary tract trauma as it involves an abnormal connection between the urinary tract and another organ or the skin. This condition can lead to severe complications such as recurrent infections, incontinence, and even sepsis. Retention of urine (A) is a symptom of urinary tract obstruction, not necessarily the most severe type of trauma. Stress incontinence (B) is a common condition but is not indicative of severe trauma. Scalding sensation (C) can be a symptom of a urinary tract infection but does not necessarily indicate severe trauma like fistula formation.

Correct Answer: B

Rationale: The correct answer is B: Facilitation of weight gain. A thermal controlled environment for a low birth weight baby helps in maintaining the baby's body temperature, reducing energy expenditure, and promoting weight gain. This is crucial for the baby's growth and development. Incorrect choices: A: Prevention of infection - While a thermal controlled environment can indirectly help prevent infections by maintaining the baby's health, it is not the primary aim. C: Provision of quality care - Quality care involves multiple aspects beyond just thermal control, so this is not the primary aim. D: Provision of nutrition - Nutrition is important for weight gain, but the thermal controlled environment specifically focuses on regulating the baby's body temperature to support weight gain.

Correct Answer: A

Rationale: The correct answer is A (Low ACTH and low cortisol) because in patients with an adrenal tumor causing Cushing's syndrome, the tumor autonomously produces cortisol, leading to suppression of ACTH secretion from the pituitary. This results in low ACTH levels and high cortisol levels. Choices B, C, and D are incorrect because they do not reflect the characteristic hormone levels seen in patients with an adrenal tumor causing Cushing's syndrome.

Correct Answer: D

Rationale: The correct answer is D because precipitate delivery, characterized by rapid descent and delivery of the baby, can cause cervical lacerations due to the fast and forceful passage of the baby through the birth canal. This can result in tearing of the cervical tissue. Choice A is incorrect because uterine atony is not typically associated with precipitate delivery. Choice B is incorrect as puerperal sepsis is not directly related to the speed of delivery. Choice C is incorrect as the occurrence of precipitate delivery does not guarantee reduced risk of recurrence with prenatal monitoring.

Correct Answer: B

Rationale: The correct answer is B: Acute epidural hematoma. A crescent-shaped fluid collection seen on a head CT scan following trauma is indicative of an epidural hematoma, which typically occurs due to an arterial bleed between the dura mater and the skull. This collection appears biconvex due to the restriction of the hematoma by the dura mater and is often associated with a lucid interval followed by rapid deterioration. Explanation for Incorrect Choices: A: Acute subdural hematoma typically presents as a crescent-shaped collection but is located between the dura mater and arachnoid mater, not between the dura mater and skull as seen in epidural hematomas. C: Acute uncal herniation involves displacement of the uncus of the temporal lobe, leading to compression of the brainstem, but it does not manifest as a crescent-shaped fluid collection. D: Acute brainstem compression does not typically present as a distinct crescent-shaped

Correct Answer: C

Rationale: The correct answer is C because in obstructive shock due to a large pulmonary embolus, there is increased resistance to blood flow out of the right ventricle, leading to elevated right ventricular pressure. This causes a backup of blood into the pulmonary circulation, increasing left ventricular pressure. The increased left ventricular pressure results in decreased cardiac output as the left ventricle struggles to pump against the increased resistance. A: Elevated atrial and decreased ventricular pressures - This is incorrect as obstructive shock typically results in elevated ventricular pressures due to increased resistance. B: Elevated right-sided and decreased left-sided pressures - This is partially true, but C is a more complete answer that explains the consequences of these pressures on cardiac output. D: Elevated left ventricular pressure and decreased systemic vascular resistance - This is incorrect as obstructive shock leads to increased, not decreased, systemic vascular resistance due to the embolus obstructing blood flow.

Correct Answer: B

Rationale: The correct answer is B: Captopril. Captopril is an angiotensin-converting enzyme (ACE) inhibitor that can lead to oligohydramnios in pregnant women due to its effect on reducing fetal renal function. This can result in decreased amniotic fluid levels. Diazepam (A) is a benzodiazepine used for anxiety and is not associated with oligohydramnios. Ampicillin (C) is an antibiotic commonly used during pregnancy and does not cause oligohydramnios. Pethidine (D) is an opioid analgesic with no known association with oligohydramnios in pregnancy.

Correct Answer: C

Rationale: The correct answer is C: Placental insufficiency. Placental insufficiency can lead to decreased oxygen and nutrient supply to the fetus, causing fetal distress during labor. This can result in abnormal fetal heart rate patterns and potential complications. A: Umbilical cord prolapse can also cause fetal distress but is less common than placental insufficiency. B: Uterine rupture is a serious complication but typically presents with maternal symptoms rather than fetal distress. D: Fetal position can impact labor progress but is not typically the primary cause of fetal distress.