Free BCEN Certified Emergency Nurse (CEN) Practice Question

The patient's presentation of sudden onset of severe abdominal pain, vaginal bleeding, a contracted uterus with a board-like abdomen and tenderness on palpation, and hypertensive vital signs are indicative of abruptio placenta (placental abruption). This condition occurs when the placenta prematurely separates from the uterus and can be life-threatening for both the mother and fetus. In contrast, placenta previa generally presents with painless vaginal bleeding, and uterine rupture would entail a history of intense contractions possibly following a trial of labor after cesarean (TOLAC) or traumatic delivery with a sudden cessation of contractions and a rapid change in fetal heart rhythm. Preeclampsia may include hypertension and proteinuria, but the absence of abdominal pain makes it less likely in this clinical scenario.