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: B

Rationale: The correct answer is B: Hyperbaric oxygen. Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room, which can help reduce gas cysts in the gastrointestinal tract by increasing oxygen delivery to tissues. This promotes healing and reduces symptoms associated with pneumatosis. A: Several days of oxygen by face mask is not as effective as hyperbaric oxygen therapy in treating pneumatosis, as it does not provide the same level of pressurized oxygen delivery to tissues. C: Surgical resection may be considered in severe cases of pneumatosis where conservative treatments have failed, but it is not the first-line treatment option. D: Treatment of underlying disease is important in managing pneumatosis, but it may not directly address the gas cysts themselves. Hyperbaric oxygen therapy specifically targets the gas cysts to alleviate symptoms.

Correct Answer: A

Rationale: The correct answer is A: Entonox. Entonox, a mixture of nitrous oxide and oxygen, is commonly used for inhalational analgesia during labor due to its fast-acting and safe properties. Nitrous oxide provides pain relief without affecting the baby's heart rate or causing sedation. Trilene (B) is not commonly used during labor due to potential side effects on the baby. Oxygen (C) is not an analgesic but is often used in conjunction with Entonox. Nitrous oxide (D) is the active component in Entonox and is the primary analgesic agent in this mixture.

Correct Answer: A

Rationale: The correct answer is A: Unstable lie. After 36 weeks of gestation, the fetal lie should typically be consistent. An unstable lie refers to a situation where the fetal lie keeps changing position, indicating a potential complication. This can lead to difficulties during labor and delivery. Summary: B: Compound lie - Refers to a situation where the fetus is in an abnormal position, such as breech or transverse, alongside another part of the body presenting first. C: Multiple lie - Not a recognized medical term. D: Transverse lie - Refers to a situation where the fetus is positioned horizontally across the uterus, which can complicate delivery.

Correct Answer: A

Rationale: The correct answer is A: Bradycardia. Hypothermia neonatorum is characterized by low body temperature in newborns, which can lead to bradycardia as the heart rate decreases in response to the cold stress. Bradycardia is a common physiological response to hypothermia as the body tries to conserve energy and maintain vital functions. Hyperglycemia, hypoventilation, and hyperventilation are not specific clinical features of hypothermia neonatorum. Hyperglycemia is more commonly associated with conditions like diabetes, hypoventilation could be a sign of respiratory distress, and hyperventilation is usually seen in response to metabolic acidosis or anxiety.

Correct Answer: B

Rationale: In the management of hypothermia neonatorum, the gradual rewarming process is aimed at preventing shock. Rapid rewarming can lead to vasodilation, causing a sudden drop in blood pressure and potentially leading to shock. Gradual rewarming helps the body adjust slowly to prevent this. Providing energy (Choice A) is not the primary goal of rewarming in hypothermia. Providing comfort (Choice C) is important but not the main purpose of the rewarming process. Preventing burns (Choice D) is not directly related to the rewarming process but is important to ensure the safety of the neonate during the rewarming process.

Correct Answer: C

Rationale: The correct answer is C: Fever. Physiologic stress ulcers are often associated with systemic stress response, leading to an increase in body temperature. Fever is an early sign of stress-related ulcers before other symptoms like epigastric pain or hemorrhage manifest. Change in mental status is more indicative of neurological issues rather than stress ulcers. Epigastric pain typically occurs after the ulcer has progressed, and hemorrhage is a severe complication of untreated stress ulcers.

Correct Answer: B

Rationale: Breech presentation refers to the bottom or feet-first position of the baby in the uterus. This is the correct answer (B) because it accurately defines breech presentation. Choice A (head-first presentation) is incorrect as it describes the typical vertex presentation. Choices C (oblique lie) and D (transverse lie) are also incorrect as they refer to other abnormal fetal positions that are different from breech presentation.

Correct Answer: B

Rationale: The correct answer is B: Acute pancreatitis. The patient's sudden, severe upper abdominal pain, unaffected by food intake, along with guarding and elevated white blood cell count, are indicative of acute pancreatitis. The patient's positioning (knees to chest) suggests relief from pain, which is characteristic of pancreatitis. A dissecting aortic aneurysm (choice A) typically presents with tearing chest or back pain. Perforated peptic ulcer (choice C) would present with a history of chronic ulcer symptoms. Mallory-Weiss tear (choice D) presents with a history of recent vomiting. Therefore, based on the patient's presentation and findings, acute pancreatitis is the most likely diagnosis.