Arrested active phase of labor in a multiparous wo

Question 1 of 5

Arrested active phase of labor in a multiparous woman denotes an abnormal labor pattern as characterized by

A. Cessation of cervical dilatation for more than 2 hours B. Cessation of cervical dilatation for more than 4 hours C. Duration of latent phase of labor lasting more than 8 hours D. Cessation of descent of the presenting part for more than 1 hour

Correct Answer: B

Rationale: Arrested active phase is characterized by cessation of cervical dilatation for more than 4 hours.

Question 2 of 5

The AGACNP is counseling a patient about various methods of tumor biopsy. Which of the following is not an accurate statement?

A. Incisional biopsy is preferred to excisional biopsy when possible B. Core needle biopsy has a higher rate of false positive than does fine needle aspiration C. Fine needle aspiration does not allow grading of tumors D. Core needle and incisional biopsies are virtually identical in terms of false results

Correct Answer: C

Rationale: Typically, excisional biopsy is preferred over incisional biopsy whenever feasible because it provides a more accurate representation of the tumor since the entire mass is removed. This benefits both the patient (by potentially preventing the need for a second procedure) and the medical team (by ensuring a more comprehensive evaluation of the tumor). It is important to remove the entire lesion during excisional biopsy to make an accurate diagnosis. Incisional biopsy, on the other hand, involves taking only a portion of the tumor for examination, which may lead to potential sampling error and inadequate representation of the tumor.

Question 3 of 5

Mr. Novello is an 81-year old male patient who presents with crampy abdominal pain in the hypogastrum and a vague history as to his last normal bowel movement. Physical examination reveals distention and high-pitched bowel sounds. The patient says he has never has this kind of problem before and denies any history of abdominal surgery. Abdominal radiographs reveal a frame pattern of colonic distention. The AGACNP considers

A. A stimulant laxative to relieve bowel contents B. Carcinoma of the bowel as a leading diagnosis C. Decompression of the colon with rectal tube D. Angiography to rule out mesenteric ischemia

Correct Answer: B

Rationale: The most appropriate step for the AGACNP to take in this scenario is to decompress the colon with a rectal tube. The patient's presentation, including crampy abdominal pain, distention, lack of bowel movements, and a frame pattern of colonic distention on radiographs, are suggestive of acute colonic pseudo-obstruction, also known as Ogilvie's syndrome. This condition is characterized by colonic distention without a mechanical obstruction, which can lead to significant complications such as perforation.

Question 4 of 5

Mrs. Coates is a 65-year-old female who is on postoperative day 1 following a duodenal resection for a bleeding ulcer. She had an uneventful immediate postoperative course, but throughout the course of day 1 she has complained of a mild abdominal discomfort that has progressed throughout the day. This evening the AGACNP is called to the bedside to evaluate the patient for persistent and progressive discomfort. Likely causes of her symptoms include all of the following except

A. Colic due to return of peristalsis B. Leakage from the duodenal stump C. Gastric retention D. Hemorrhage

Correct Answer: D

Rationale: In the scenario described, Mrs. Coates is a 65-year-old female who is on the first day postoperatively following a duodenal resection for a bleeding ulcer. Given her surgical history and the progression of her abdominal discomfort, the likely causes to consider are complications related to the surgery. Options B, C, and D are all potential postoperative complications following a duodenal resection: