The AGACNP is receiving report from the recovery room on a patient who just had surgical resection for pheochromocytoma. He knows that which class of drugs should be available immediately to manage hypertensive crisis, a possible consequence of physical manipulation of the adrenal medulla?

Correct Answer: C

Rationale: Surgical manipulation of the adrenal medulla during resection of a pheochromocytoma can result in the release of catecholamines leading to a hypertensive crisis. Alpha-adrenergic antagonists, such as phenoxybenzamine or prazosin, are the drugs of choice for managing hypertensive crisis in this situation. These medications block the alpha-adrenergic receptors, leading to vasodilation and lowering of blood pressure. Beta-adrenergic antagonists are contraindicated in this scenario due to the risk of unopposed alpha-adrenergic stimulation that could worsen the hypertension. Intravenous vasodilators and arteriolar dilators may be used as adjunctive therapy but alpha-adrenergic antagonists are the primary agents for managing hypertensive crisis in this context.

Correct Answer: B

Rationale: Occipito-posterior position occurs when the baby faces the mother's back with the head down.

Correct Answer: C

Rationale: Ultrasonography is considered essential in all cases of acute abdomen because it is a valuable tool in evaluating various abdominal organs non-invasively. It can quickly identify common causes of acute abdomen such as cholecystitis, pancreatitis, appendicitis, and other intra-abdominal pathologies. Ultrasonography also has the advantage of being radiation-free and can be performed rapidly at the bedside, making it a preferred initial diagnostic modality in the evaluation of acute abdominal pain. Abdominal radiograph, contrast radiography, and chest radiography may have limited utility in the evaluation of acute abdomen compared to ultrasonography.

Correct Answer: A

Rationale: Caput succedaneum is caused by bleeding between the epicranial aponeurosis and the periosteum.

Correct Answer: A

Rationale: Achalasia is a motility disorder characterized by the inability of the lower esophageal sphincter to relax, resulting in difficulty swallowing and impaired movement of food from the esophagus into the stomach. Patients with achalasia have an increased risk of developing squamous cell carcinoma of the esophagus. This risk is due to chronic inflammation, stasis of food in the esophagus, and increased exposure of esophageal mucosa to irritants, all of which can contribute to the development of cancer over time. Gastroesophageal reflux disease (Choice B) is less likely to be associated with achalasia because the impaired esophageal motility in achalasia results in decreased, rather than increased, reflux of stomach contents into the esophagus. Esophageal atrophy (Choice C) and malabsorption syndromes (Choice D) are not directly related to achalasia.