While reviewing the head CT scan of a patient following a motor vehicle accident, the AGACNP appreciates a crescent-shaped fluid collection. This most likely represents

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: Placing client on Trendelenburg position. This helps prevent compression of the cord by moving the presenting part off the cord. Placing the client on all fours (choice A) may worsen cord compression. Application of fundal pressure (choice B) is contraindicated as it can further compress the cord. Labor augmentation with oxytocin (choice D) is not indicated in cord prolapse management as it does not address the immediate risk to the fetus. Trendelenburg position is the recommended intervention to alleviate cord compression and improve fetal oxygenation.

Correct Answer: B

Rationale: The correct answer is B: FALSE. Severe epigastric pain in preeclampsia is not associated with hyperacidity but is more likely due to complications such as HELLP syndrome or liver involvement. Preeclampsia is characterized by high blood pressure and proteinuria, not hyperacidity. Therefore, severe epigastric pain in preeclampsia should not be attributed to hyperacidity. Other choices are not applicable.

Correct Answer: A

Rationale: The correct answer is A: HELLP syndrome. This must be evaluated as a cause of abdominal pain in a pregnant patient because it is a serious condition characterized by hemolysis, elevated liver enzymes, and low platelet count. These abnormalities can lead to abdominal pain, especially in the right upper quadrant. Placental abruption (B) presents with vaginal bleeding and uterine tenderness, not specific abdominal pain. Spontaneous hepatic rupture (C) is rare and usually presents with sudden severe abdominal pain. Preterm labor (D) typically presents with regular uterine contractions and lower abdominal discomfort, not specific upper quadrant pain like in HELLP syndrome.

Correct Answer: D

Rationale: The correct answer is D: Compound presentation. This term refers to the situation where there is more than one part of the fetus on the pelvic brim at the onset of labor. This can include a hand or arm alongside the head or another body part. The other choices are incorrect because: A: Unstable lie refers to the fetus being in a transverse position. B: Fetal malpresentation indicates an abnormal presentation of the fetus, such as breech or transverse. C: Fetal malposition refers to the fetus being in a suboptimal position, like occiput posterior. Thus, the best choice is D as it specifically describes the scenario of multiple fetal parts on the pelvic brim.

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: Uterine apoplexy is the sudden rupture of blood vessels in the uterus, leading to severe hemorrhage. Placental abruption is the most likely cause due to the separation of the placenta from the uterine wall, resulting in bleeding. Incidental hemorrhage is not sudden or severe. Multiple pregnancy may increase the risk but doesn't directly cause uterine apoplexy. Placenta previa involves the placenta covering the cervix, leading to bleeding but not necessarily uterine rupture. Therefore, the correct answer is B.

Correct Answer: A

Rationale: Placenta praevia is more common in women with a history of multiple pregnancies (Grandmultiparity), as repeated stretching of the uterine wall can lead to abnormal placental implantation. Preeclampsia is a separate condition associated with hypertension in pregnancy. Placenta fenestrate and placenta increta are specific placental abnormalities but do not directly cause placenta praevia.

Correct Answer: D

Rationale: The correct answer is D because the term "carcinoma" specifically refers to neoplasms of epithelial origin. Epithelial cells line the surfaces and cavities of the body, so carcinomas originate from these tissues. This term does not describe internal structure (A), loss of growth regulation (B), or metaplastic adaptation (C). Carcinomas are the most common type of cancer and can occur in various organs such as the skin, lungs, breasts, and colon.