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: 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: A

Rationale: The correct answer is A: Increases risk of gestational diabetes. Maternal obesity can lead to insulin resistance, increasing the likelihood of developing gestational diabetes during pregnancy. This condition can have negative effects on both the mother and the baby. B: Miscarriage is not directly linked to maternal obesity but can be influenced by other factors. C: Maternal obesity is not a direct cause of anemia during pregnancy. Anemia is usually related to iron deficiency or other factors. D: Maternal obesity is actually associated with an increased risk of preterm labor, not a reduced chance. This is due to various complications such as hypertension and preeclampsia.

Correct Answer: D

Rationale: The correct answer is D because virilizing adrenal tumors are more likely to be malignant in children. This is due to the fact that virilizing tumors can be associated with conditions like adrenocortical carcinoma, which is a malignant tumor. In contrast, feminizing adrenal tumors are not always carcinomas (choice A) and are not the most common type of adrenal tumor (choice B). Additionally, virilizing tumors in women can be localized to different parts of the adrenal gland, not just the cortex (choice C). Therefore, choice D is the most accurate statement among the options provided.

Correct Answer: D

Rationale: The correct answer is D: His symptoms occur in 5 to 10% of people after ulcer surgery. This is the correct answer because the patient's symptoms of decreased capacity for intake and nausea after eating are common post-operative complications following ulcer surgery. By stating this fact to the patient, the AGACNP is providing reassurance that these symptoms are not unusual. Explanation for why the other choices are incorrect: A: Endoscopy is not necessary at this point since the symptoms described by the patient are known post-operative complications and do not indicate an urgent need for endoscopy. B: While gastroparesis can be a complication of ulcer surgery, there is no information in the case to suggest that the patient has chronic gastroparesis. C: Jumping to the conclusion that medication is unlikely to help and another surgery may be needed is premature and not supported by the information provided in the case.

Correct Answer: B

Rationale: Classical vitamin K deficiency bleeding occurs within the neonatal stage because newborns have low levels of vitamin K, which is essential for blood clotting. This deficiency typically manifests between 1-7 days after birth. Bleeding within the first 24 hours (choice A) is unlikely as it is too early for vitamin K deficiency to cause symptoms. Bleeding within infancy (choice C) is incorrect as it specifically refers to the neonatal stage. Bleeding within the first week of birth (choice D) is a close distractor, but the critical period for classical vitamin K deficiency bleeding is within the neonatal stage, which is slightly more specific than the first week of birth.

Correct Answer: B

Rationale: The correct answer is B: Retroperitoneal bleeding. The physical survey described focuses on assessing for internal bleeding within the retroperitoneal space following a serious motor vehicle accident. The rectovaginal examination, inspection of the urethral meatus, and palpation of pelvic landmarks help evaluate for signs of pelvic fracture and internal bleeding. These assessments help identify potential sources of retroperitoneal bleeding, which can be a life-threatening complication of trauma. Peritoneal bleeding (choice A) involves bleeding within the abdominal cavity, which is less likely in this scenario. Paresthesia (choice C) refers to abnormal sensations like tingling or numbness, which are not typically assessed through physical examination in this context. Pelvic fracture (choice D) is a possible outcome of trauma but does not directly assess for retroperitoneal bleeding.

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: 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.