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: A

Rationale: The correct answer is A because inflammatory polyps are indeed considered precancerous, meaning they have the potential to develop into cancer over time. By having regular colonoscopies every 3 to 5 years, any new polyps can be detected early and removed before they have a chance to become malignant. This approach helps in preventing the progression of polyps to cancerous lesions, thus reducing the risk of developing colon cancer. Choice B is incorrect because while family history is a risk factor for colon cancer, the presence of inflammatory polyps in Mr. Costigan should not be overlooked or solely attributed to family history. Choice C is incorrect because all polyps have the potential to become cancerous, including inflammatory polyps. Ignoring their presence can lead to missed opportunities for early intervention. Choice D is incorrect because at this stage, the primary focus should be on surveillance and prevention through regular colonoscopies, rather than jumping into discussions about aggressive treatment options.

Correct Answer: C

Rationale: The correct answer is C: Truncus arteriosus. In this condition, there is a single large vessel arising from the heart that gives rise to the systemic, pulmonary, and coronary arteries. This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygenation of the body, causing immediate death after birth. A: Pulmonary stenosis and B: Aortic coarctation typically do not cause immediate death after birth. D: Ductus arteriosus is a normal fetal structure that closes shortly after birth and its presence would not directly cause immediate death.

Correct Answer: B

Rationale: The correct answer is B, Gestational diabetes mellitus. This condition is diagnosed when a pregnant woman exhibits symptoms of diabetes and has elevated fasting blood sugar and abnormal oral glucose tolerance test results. This specific combination of symptoms and test results during pregnancy points towards gestational diabetes mellitus. A: Potential diabetes mellitus - Incorrect. The symptoms combined with abnormal test results suggest an active condition, not potential. C: Clinical diabetes mellitus - Incorrect. While the symptoms and test results indicate diabetes, the context of pregnancy suggests gestational diabetes. D: Chemical diabetes mellitus - Incorrect. This term is not commonly used in medical practice and does not specifically address the condition in the given scenario.

Correct Answer: A

Rationale: The correct answer is A: Erb’s palsy. Excessive traction and twisting of the neck during shoulder delivery can stretch or tear the brachial plexus nerves, leading to Erb’s palsy. This results in weakness or paralysis of the arm. Radial palsy (B) involves injury to the radial nerve, not typically caused by shoulder delivery. Torticollis (C) is a condition characterized by neck muscle contracture, not caused by excessive traction during delivery. Ecchymosis (D) refers to bruising and is not directly related to neck traction during delivery. In summary, Erb’s palsy is the correct choice due to the specific nerve injury pattern associated with excessive neck traction during shoulder delivery.

Correct Answer: B

Rationale: The correct answer is B (3000 ml) because polyhydramnios is defined as an excessive amount of amniotic fluid, typically exceeding 2000-2500 ml. A level of 3000 ml is commonly used as a cutoff point for clinical diagnosis. Choices A, C, and D are incorrect because they fall below the threshold typically considered diagnostic for polyhydramnios. Answer A (1500 ml) is too low, while choices C (1900 ml) and D (2500 ml) are below or at the lower end of the range typically associated with polyhydramnios. Therefore, the most appropriate threshold for diagnosing polyhydramnios is when the amount of amniotic fluid exceeds 3000 ml.

Correct Answer: A

Rationale: Rationale for correct answer (A): At 36 weeks, the baby has enough room to move, reducing risks of complications during external cephalic version. Earlier intervention also allows for possible repeat attempts if needed. This timing aligns with guidelines for optimal success rates. Summary of other choices: B: 38 weeks may be too late as the baby may have less space to turn. C: 42 weeks is post-term and poses risks for both the baby and the mother. D: 40 weeks is close to full term and may not allow for adequate time for successful version.

Correct Answer: D

Rationale: The correct answer is D (42 completed weeks) because a full-term pregnancy is considered to be around 40 weeks. Post maturity refers to a pregnancy that has exceeded the normal 40-week gestation period. At 42 weeks, the risk of complications such as stillbirth or issues with the placenta increases. Choice A (40 completed weeks) is incorrect because this is considered a full-term pregnancy. Choices B (38 completed weeks) and C (41 completed weeks) are incorrect as they do not meet the criteria for post maturity.

Correct Answer: A

Rationale: Step 1: Transient tachypnea of the newborn is characterized by rapid respirations due to delayed reabsorption of fetal lung fluid. Step 2: Rapid respirations of up to 120/minute is a common clinical feature seen in newborns with transient tachypnea. Step 3: This rapid breathing pattern distinguishes it from other conditions. Step 4: Marked recession of the rib cage is more indicative of respiratory distress syndrome. Step 5: Transient tachypnea can occur in both normal and cesarean deliveries, so choice C is incorrect. Step 6: Diminished respirations of less than 40/minute would not be expected in transient tachypnea. Summary: Choice A is correct because rapid respirations are a key clinical feature of transient tachypnea, while the other choices do not align with its characteristic presentation.

Correct Answer: D

Rationale: Step-by-step rationale for why D is correct: 1. Arteriolar dilators such as sodium nitroprusside are used to manage hypertensive crisis by rapidly reducing blood pressure. 2. Pheochromocytoma surgery can result in catecholamine release, causing severe hypertension. 3. Arteriolar dilators act directly on blood vessels to lower blood pressure quickly. 4. Alpha-adrenergic antagonists (A) can worsen hypotension, beta-adrenergic antagonists (B) can lead to unopposed alpha-adrenergic effects, and intravenous vasodilators (C) may not act rapidly enough.