Based upon an understanding of the normal relationship between gastrin levels and acid secretion, the AGACNP recognizes that which of the following combinations is almost diagnostic of gastrinoma?

Correct Answer: A

Rationale: The correct answer is A: Hypogastrinemia and acid hyposecretion. Gastrinoma is a tumor that secretes excessive gastrin, leading to hypergastrinemia and increased acid secretion. However, due to a negative feedback mechanism, chronic exposure to high gastrin levels can cause downregulation of gastrin receptors on parietal cells, leading to decreased acid secretion. Therefore, in gastrinoma, despite high gastrin levels, acid secretion may be reduced due to this negative feedback loop. Choices B, C, and D are incorrect because they do not align with the expected relationship between gastrin levels and acid secretion in gastrinoma.

Correct Answer: B

Rationale: The correct answer is B: Turtle sign. This sign refers to the fetal head retracting against the perineum during delivery. It indicates shoulder dystocia, a complication where the baby's shoulders get stuck after the head is delivered. This can lead to serious complications for both the baby and the mother if not managed promptly. A: Gaskin sign is incorrect as it refers to a position where the mother is on her hands and knees during labor. C: Klumpke sign is incorrect as it is a neurological condition affecting the lower arm and hand. D: Chignon sign is incorrect as it is not a recognized medical term related to childbirth.

Correct Answer: C

Rationale: The correct answer is C: Truncus arteriosus. In this congenital heart defect, a single large blood vessel arises from the heart instead of the normal two separate vessels (aorta and pulmonary artery). This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygen supply to the body. This condition is incompatible with life, causing immediate death after birth. A: Pulmonary stenosis and B: Aortic coarctation are also congenital heart defects but do not typically result in immediate death after birth. Pulmonary stenosis obstructs blood flow to the lungs, while aortic coarctation causes narrowing of the aorta. D: Ductus arteriosus is a normal fetal blood vessel that connects the pulmonary artery and the aorta but usually closes shortly after birth. Failure of closure can lead to health issues, but it is not typically a cause of immediate death after birth.

Correct Answer: B

Rationale: Step-by-step rationale for why choice B is correct: 1. The ACCF/AHA recommends cardiac consultation before an operation for patients on antiplatelet therapy to assess the risk of bleeding versus thrombotic events. 2. Cardiac consultation helps determine the necessity of continuing, modifying, or stopping antiplatelet therapy. 3. This individualized approach ensures optimal perioperative management based on the patient's cardiovascular risk profile. 4. Choice A is incorrect as stopping antiplatelet therapy for 10 days can increase the risk of thrombotic events. 5. Choice C is incorrect as it oversimplifies the decision-making process without considering the patient's specific risks. 6. Choice D is incorrect because initiating antiplatelet therapy in all high-risk cardiac procedures may not be necessary for every patient.

Correct Answer: B

Rationale: The correct answer is B: Tachycardia. In the initial stage of shock, the body tries to compensate for decreased perfusion by increasing heart rate to maintain blood flow to vital organs. Cyanosis (A) is a late sign of shock due to inadequate oxygenation. Sweat beads (C) are a non-specific response and not a defining feature of shock. Hypotension (D) typically occurs in the later stages of shock as the body's compensatory mechanisms start to fail. Tachycardia is the earliest and most consistent sign of shock, reflecting the body's attempt to maintain cardiac output.

Correct Answer: D

Rationale: The correct answer is D because skin-to-skin contact after birth offers multiple benefits. Firstly, it helps stabilize the baby's temperature by utilizing the parent's body heat. Secondly, it promotes bonding between the parent and baby through physical closeness and touch. Finally, it can regulate the baby's heartbeat by providing a calming and reassuring environment. Therefore, all of the above choices are correct in highlighting the significance of skin-to-skin contact after birth.

Correct Answer: B

Rationale: Step 1: Family history of colon cancer is a significant risk factor for developing colon cancer. Step 2: By discussing with his parents, Mr. Costigan can determine if there is a family history of colon cancer. Step 3: Knowing this information can help assess his own risk and guide appropriate screening and preventive measures. Step 4: The primary danger for Mr. Costigan lies in potential genetic predisposition rather than the presence of inflammatory polyps. Step 5: Therefore, discussing with family members about any history of colon cancer is crucial for his overall risk assessment and management. Summary: - Choice A is incorrect as the frequency of colonoscopy should be individualized based on the patient's risk factors. - Choice C is incorrect as all polyps have the potential to become cancerous, especially inflammatory polyps. - Choice D is incorrect as consulting an oncologist at this stage is premature without first assessing family history.

Correct Answer: D

Rationale: The correct answer is D because the placenta performs multiple crucial roles in pregnancy. Firstly, it produces hormones essential for maintaining the pregnancy. Secondly, it provides nutrients and oxygen to the fetus for growth and development. Lastly, it removes waste products from the fetus to ensure a healthy environment. Choices A, B, and C individually do not cover all the functions of the placenta, making them incorrect. Selecting option D acknowledges the comprehensive functions of the placenta during pregnancy.

Correct Answer: A

Rationale: The correct answer is A: Immune globulin. Post bone marrow transplant, immune globulin is used to decrease the risk of graft-versus-host reaction by providing passive immunity. This helps in reducing the chances of the donor's immune cells attacking the recipient's tissues. Immune globulin does not suppress the immune system like cyclosporine (B) or systemic corticosteroids (D) do, which could increase the risk of infections post-transplant. Prophylactic antibiotics (C) are used to prevent infections but do not specifically target graft-versus-host reaction.