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: B

Rationale: The correct answer is B (500-1500 gm) because very low birth weight babies typically weigh less than 1500 grams at birth. This range encompasses the common weight range for these babies. Option A (1000-500 gm) is too narrow and excludes babies weighing below 500 grams. Option C (1001-1500 gm) is incorrect as it includes babies weighing over 1500 grams. Option D (1500-2000 gm) is incorrect as it includes babies above the typical weight range for very low birth weight babies.

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: 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: C

Rationale: The correct answer is C: Choanal atresia. The congenital abnormality of the respiratory tract with abnormal apical position is typically associated with choanal atresia, which is a blockage or narrowing of the back of the nasal passage. This condition can lead to respiratory distress in newborns due to difficulty breathing through the nose. Explanation: 1. Laryngeal stridor (Choice A) is a high-pitched noise during breathing and is not typically associated with abnormal apical position. 2. Diaphragmatic hernia (Choice B) is a defect in the diaphragm that allows abdominal organs to move into the chest cavity, but it is not related to abnormal apical position. 3. Tracheo-bronchi fistula (Choice D) is an abnormal connection between the trachea and bronchi, which is not associated with abnormal apical position. In summary, choanal atresia is the correct answer because it fits the description of

Correct Answer: A

Rationale: The correct answer is A (36 weeks gestation) because at this stage, the fetal lie should stabilize into a consistent position, typically longitudinal. Before 36 weeks, fetal movement and position can vary frequently. Choices B, C, and D are incorrect as they are past the point where fetal lie should have stabilized. At 42 weeks gestation (Choice B), the baby is considered post-term, and fetal lie should have already been established. Similarly, Choices C (38 weeks) and D (40 weeks) fall within the expected range for fetal lie stabilization.

Correct Answer: C

Rationale: The correct answer is C: Virilizing tumors in women are most often localized to the adrenal cortex. This is because virilizing tumors typically involve excessive production of androgens, which are male sex hormones, and are commonly associated with adrenal cortex disorders. A is incorrect because feminizing adrenal tumors can be either benign or malignant, not always carcinomas. B is incorrect because feminizing adrenal tumors are rare compared to virilizing tumors. D is incorrect because virilizing adrenal tumors are more likely to be benign rather than malignant in children. In summary, the correct answer highlights the common association of virilizing tumors with the adrenal cortex in women, while the other choices present incorrect information regarding the types and malignancy of adrenal tumors.

Correct Answer: A

Rationale: The correct answer is A: Pyuria. Pyuria is a common feature in acute pyelonephritis, as it indicates the presence of white blood cells in the urine due to the infection. Fever, CVA tenderness, and gross hematuria are all common features of acute pyelonephritis. Fever is a systemic response to infection, CVA tenderness indicates inflammation of the kidney, and gross hematuria is often seen due to inflammation and damage to the kidney tissue. Therefore, the absence of pyuria would be unexpected in a patient with suspected acute pyelonephritis.

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.