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: A

Rationale: The correct answer is A: Rheumatic heart disease. This is because rheumatic heart disease is a known risk factor for cardiac complications during pregnancy due to the strain pregnancy places on the heart. Choice B, notable peripheral edema, is a symptom of heart failure but not a predisposing factor. Choice C, easy fatiguability, is a non-specific symptom and not a direct predisposing factor. Choice D, basal crepitation, is a sign of possible lung pathology and not directly related to cardiac disease in pregnancy. Therefore, the correct answer is A as it directly relates to an increased risk of cardiac issues during pregnancy.

Correct Answer: A

Rationale: The correct answer is A because in Cushing's syndrome, there is excess cortisol production leading to hyperglycemia (high glucose) and hypokalemia (low potassium). The high white blood cell count is due to the immunosuppressive effects of cortisol. Option B is incorrect as polycythemia is not typically seen in Cushing's syndrome. Option C is incorrect as low sodium and low potassium are not common findings in Cushing's syndrome. Option D is incorrect as high sodium, high chloride, and high RBCs are not typical features of Cushing's syndrome.

Correct Answer: B

Rationale: The correct answer is B: reduce serum sodium concentration by infusing a 0.45% sodium chloride solution. In hyponatremic hyperosmolality, the primary goal is to correct the low serum sodium levels. A 0.45% sodium chloride solution is hypotonic, which helps to slowly correct the serum sodium concentration without causing rapid shifts in osmolality. Infusing a hypotonic solution will gradually increase the serum sodium levels, addressing the underlying issue. Choices A, C, and D are incorrect because they do not directly address the low serum sodium levels, which is essential in treating hyponatremic hyperosmolality. Infusing a 5% dextrose in 0.2% sodium chloride solution (Choice A) or a 5% dextrose in water solution (Choice D) would not correct the low sodium levels. Replenishing volume with a 0.9% sodium chloride solution (Choice C) would not directly

Correct Answer: D

Rationale: Mallory-Weiss syndrome is caused by severe vomiting leading to tears in the esophagus. Hyperemesis gravidarum is severe nausea and vomiting during pregnancy, which can result in Mallory-Weiss syndrome. Placenta praevia, cardiac disease, and postpartum hemorrhage are not directly associated with Mallory-Weiss syndrome.

Correct Answer: A

Rationale: The correct answer is A: Always of the same sex. Monozygotic twins develop from a single fertilized egg, so they have the same genetic material, making them always the same sex. This is due to the fact that the sex of an individual is determined by the chromosomes inherited from the parents. This is a fundamental principle of genetics. Choices B, C, and D are incorrect because monozygotic twins can have different fingerprints, blood groups, and superfetation (conception that occurs during an existing pregnancy) is not common in monozygotic twins.

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: 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: 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