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 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: C

Rationale: The correct answer is C, major depression. Puerperal psychosis is a severe mental health condition that occurs in the postpartum period, characterized by symptoms such as hallucinations, delusions, and disorganized thinking. Major depression is a key clinical feature, often accompanied by mood disturbances and severe emotional distress. Rationale: - A: Episodic insomnia is a common symptom in various mental health disorders but not specific to puerperal psychosis. - B: Neglect of hygiene may occur in severe cases but is not the main clinical feature of puerperal psychosis. - D: Mild headache is not a characteristic symptom of puerperal psychosis, which is primarily marked by severe psychiatric symptoms.

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: 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.