You are called to assist a pregnant female in the 24th week gestation period according to her due date. The pale 26-year-old patient is found supine in bed, complaining of dizziness/weakness with extreme nausea. The patient denies vaginal bleeding, amniotic fluid leakage, or abdominal pain. There are no signs of imminent birth or active labor. She reports receiving normal prenatal care with no associated problems found during the pregnancy. Her heart rate is 126-130 beats per minute; her blood pressure is 80 mmHg systolic while her skin is cool and pale. Which of the following conditions is most likely to cause the patient's presentation?

Correct Answer: C

Rationale: The correct answer is C: Supine hypotension. When a pregnant woman lies flat on her back (supine position), the weight of the uterus can compress the inferior vena cava, reducing blood flow to the heart, leading to hypotension and decreased cardiac output. This can cause symptoms like dizziness, weakness, and nausea. In this case, the patient's symptoms of dizziness, weakness, and hypotension are consistent with supine hypotension due to compression of the vena cava. Choices A, B, and D are incorrect for this scenario because uterine rupture, spontaneous abortion, and placenta previa typically present with different symptoms and are not related to the patient's current presentation.

Correct Answer: D

Rationale: Rationale: 1. Mast cells play a key role in allergic reactions by releasing histamines and other inflammatory mediators. 2. When triggered by an allergen like a bee-sting, mast cells degranulate, releasing histamines and serotonin. 3. Histamines cause vasodilation and increased vascular permeability, leading to itching, hives, and urticaria. 4. Serotonin contributes to smooth muscle contraction and bronchoconstriction, leading to difficulty breathing. 5. Therefore, choice D is correct as it accurately describes the cellular events in an allergic reaction. Summary: A, B, and C are incorrect because they do not accurately depict the cellular processes involved in an allergic reaction. A does not mention degranulation, B focuses on a hypermetabolic state unrelated to allergies, and C refers to anaerobic metabolism which is not the primary mechanism in allergic reactions.

Correct Answer: D

Rationale: The correct answer is D: Initiate full resuscitation efforts including advanced cardiac life support, and contact medical control. In this scenario, the patient is found to be pulseless and apneic with CPR being performed by the family. The legal DNR order is not applicable in this situation as the patient does not have a terminal illness. Therefore, it is crucial to prioritize the patient's immediate need for resuscitation. Initiating full resuscitation efforts, including advanced cardiac life support, is necessary to maximize the chances of survival. Contacting medical control will ensure proper guidance and support during the resuscitation process. Choices A, B, and C are incorrect: A: Contacting medical control and waiting for approval before initiating full resuscitation could delay life-saving interventions. B: Stopping all resuscitation efforts based on the legal DNR order without considering the patient's current condition would be inappropriate. C: Advising the family to stop CPR and explaining the legal D

Correct Answer: C

Rationale: The correct next step is to perform endotracheal intubation (Choice C) in this scenario. Given the presentation of a motor vehicle crash with a GCS of 6, dilated pupil, and contralateral weakness, it indicates severe head trauma causing impending airway compromise and the need for airway protection. Intubation will secure the airway, ensure adequate oxygenation, and prevent the risk of aspiration. Choice A (CT-scan of head) is not the immediate priority as the patient's airway needs to be secured first. Choice B (Decadron) is not indicated for acute head trauma and may even worsen brain injury. Choice D (Mannitol) may help reduce intracranial pressure, but securing the airway takes precedence in this critical situation.

Correct Answer: C

Rationale: Correct Answer: C - Severe maxillofacial fractures Rationale: 1. Severe maxillofacial fractures can compromise the airway due to obstruction or displacement of structures. 2. Airway management is crucial in trauma patients to ensure adequate oxygenation and ventilation. 3. Maxillofacial fractures can lead to airway compromise rapidly, requiring a definitive airway intervention. 4. Other choices (A: Facial lacerations, B: Repeated vomiting, D: Sternal fracture) may not directly impact the airway to the same extent as severe maxillofacial fractures.