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: 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.

Correct Answer: D

Rationale: The correct answer is D: All of the above. High-risk pregnancies are associated with various complications, including preterm birth, gestational diabetes, and preeclampsia. Preterm birth can lead to developmental issues for the baby. Gestational diabetes affects the mother's and baby's health. Preeclampsia can result in high blood pressure and organ damage. Choosing D as the correct answer encompasses all these complications, highlighting the comprehensive nature of risks in high-risk pregnancies. Choices A, B, and C alone do not cover all the potential complications, making them individually incorrect.

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: C

Rationale: The correct answer is C because neglected obstructed labor and high parity are well-established predisposing factors to uterine rupture. Neglected obstructed labor can cause prolonged pressure on the uterus, leading to weakening and potential rupture. High parity (having given birth multiple times) can also increase the risk of uterine rupture due to repeated stretching and strain on the uterine muscles. A, B, and D are incorrect because nulliparity (never given birth), breech presentation, multiple pregnancy, and obstetric maneuvers are not as strongly associated with uterine rupture as neglected obstructed labor and high parity. These factors may increase the risk of other complications during childbirth but are not primary predisposing factors for uterine rupture.

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: C

Rationale: The correct answer is C: Respiratory distress syndrome. Surfactant is essential for reducing surface tension in the alveoli, preventing their collapse. Inadequate levels of surfactant in a neonate result in respiratory distress syndrome. Meconium aspiration syndrome (A) is due to inhalation of meconium by the neonate. Intranatal pneumonia (B) is an infection acquired during birth. Congenital pneumothorax (D) is the presence of air in the pleural space, not directly related to surfactant levels.

Correct Answer: D

Rationale: The correct answer is D: Compound. In compound presentation, a hand or foot is alongside the presenting part, usually the head. This can complicate the delivery process. A: Footling presentation means the foot presents first. B: Transverse presentation is when the baby is lying sideways. C: Cephalic presentation is normal, with the head presenting first. In this scenario, D is the correct answer as it specifically describes the situation where a hand or foot is alongside the presenting part.

Correct Answer: D

Rationale: The correct answer is D: Hypergastrinemia and acid hypersecretion. Gastrinoma is a tumor that secretes excessive gastrin, leading to elevated gastrin levels. High gastrin levels stimulate acid secretion in the stomach, resulting in acid hypersecretion. Therefore, the combination of hypergastrinemia and acid hypersecretion is almost diagnostic of gastrinoma. A: Hypogastrinemia and acid hyposecretion is incorrect because gastrinoma leads to increased gastrin levels and subsequent acid hypersecretion. B: Hypergastrinemia and acid hyposecretion is incorrect because gastrinoma is associated with acid hypersecretion, not hyposecretion. C: Hypogastrinemia and acid hypersecretion is incorrect because gastrinoma causes elevated gastrin levels and acid hypersecretion, not hypogastrinemia. In summary, the correct answer D aligns with the pathophysiology of gastrinoma, while the

Correct Answer: D

Rationale: The correct answer is D because all the choices (A, B, and C) are risks associated with cesarean sections. Infection can occur at the incision site, blood loss is a common concern during surgery, and cesarean sections typically have a longer recovery time compared to vaginal delivery. Therefore, all of these risks are potential complications of undergoing a cesarean section. The other choices (A, B, and C) are incorrect individually because they only represent a subset of the risks associated with cesarean sections, while choice D encompasses all potential risks.