Mr. Costigan is a 50-year-old male patient who recently had a screening colonoscopy because it was recommended by his primary care provider as a screening measure. He received a report that noted inflammatory polyps. He is concerned because one of his friends had polyps that turned into cancer. While advising Mr. Costigan, the AGACNP tells him that

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 a client is declared fit for a vaginal birth after cesarean section if their previous delivery was via spontaneous vertex delivery. This indicates that the client has successfully given birth vaginally before, reducing the risk associated with a vaginal birth after cesarean section. A, B, and C are incorrect: A: Cephalopelvic disproportion was the reason for the previous C/S, indicating potential difficulty in vaginal delivery. B: Confirmation of a multiple pregnancy does not impact the client's eligibility for a vaginal birth after cesarean section. C: Previous cesarean section does not necessarily mean the client is fit for a vaginal birth after cesarean section.

Correct Answer: D

Rationale: The correct answer is D: Prevent excessive traction being applied. This is because in a breech delivery, excessive traction can lead to complications such as fetal injuries or umbilical cord prolapse. The midwife should avoid pulling on the baby's legs or body to prevent undue stress on the baby. The other choices are incorrect because: A: Ascertain the fetal wellbeing in utero - this is typically done through other means such as fetal monitoring. B: Allow enough room for the fetus to pass - this should be done by ensuring proper positioning and allowing natural descent. C: Allow gravitating descent of the fetus - this is not a recommended practice as it can cause complications.

Correct Answer: C

Rationale: The correct answer is C. In Cushing's syndrome, there is excess cortisol production leading to sodium retention, potassium loss, and increased protein breakdown. Low sodium and potassium levels along with high BUN are commonly seen in patients with Cushing's syndrome. A: Low potassium and high glucose are possible findings, but high white blood cell count is not typically associated with Cushing's syndrome. B: High sodium and polycythemia are not typical findings in Cushing's syndrome, and low BUN is not consistent with the protein breakdown seen in this condition. D: High sodium and high chloride levels can be seen, but high RBCs are not typically associated with Cushing's syndrome.

Correct Answer: C

Rationale: The correct answer is C: Premature rupture of membranes. Oligohydramnios is a condition characterized by low levels of amniotic fluid which can be caused by the premature rupture of membranes, leading to the leakage of amniotic fluid. This condition can result in various complications such as fetal growth restriction and compression of the umbilical cord. Maternal hypertension (choice A) is not a direct cause of oligohydramnios. Multiple gestations (choice B) may lead to polyhydramnios (excessive amniotic fluid) rather than oligohydramnios. Fetal macrosomia (choice D) is associated with increased amniotic fluid levels rather than decreased levels seen in oligohydramnios.

Correct Answer: A

Rationale: Rationale: Breech presentation increases risks during childbirth. Prolonged labor is common due to the position of the baby. Umbilical cord prolapse occurs when the cord slips through the cervix before the baby, leading to oxygen deprivation. Shoulder dystocia happens when the baby's shoulders get stuck during delivery. Choice A is correct as it directly relates to complications of breech presentation. Choices B, C, and D are incorrect as they do not specifically address the complications associated with breech presentation. Cesarean delivery is often recommended for breech presentation to avoid complications. Uterine rupture is a rare but severe complication that is not directly caused by breech presentation. Preeclampsia, gestational diabetes, and low birth weight are not commonly associated with breech presentation. Therefore, choice A is the correct answer.

Correct Answer: D

Rationale: The correct answer is D because in the context of neoadjuvant chemotherapy, a partial response means converting an unresectable tumor to a resectable one. This is crucial as it allows for successful surgical removal of the tumor. Choices A, B, and C do not accurately define partial response in the context of cancer therapy. A, stating 50% of patients demonstrating remission, is not specific to the change in resectability. B, mentioning 50% survival at 5 years, is more related to overall survival rather than the response to treatment. C, stating a reduction in tumor mass by >50%, does not necessarily imply a change in resectability status. Therefore, option D is the most appropriate definition of partial response in the given scenario.

Correct Answer: B

Rationale: The correct answer is B: Very severe anaemia. Productive cough, dyspnoea at rest, and generalized oedema are classic symptoms of very severe anaemia due to decreased oxygen-carrying capacity of the blood. Anemia leads to tissue hypoxia, causing shortness of breath and fluid retention. Folate deficiency (A) typically presents with megaloblastic anemia, not generalized edema. Mild iron deficiency (C) may lead to fatigue and weakness but not the severe symptoms described. Severe anemia (D) is too broad; very severe anemia specifically refers to the severity of the condition.

Correct Answer: C

Rationale: The correct answer is C: Extraplacental haemorrhage. Incidental antepartum haemorrhage refers to bleeding occurring outside the placenta, such as from the cervix or vaginal walls, before the onset of labor. This is not associated with the placenta itself (intraplacental - choice A). Similarly, it does not occur during labor (intrapartum - choice B) or specifically before term (preterm - choice D). Extraplacental haemorrhage captures the essence of bleeding unrelated to the placenta during the antepartum period.