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A patient with suspected Cushings syndrome is being evaluated to establish the diagnosis and cause. Patients with an adrenal tumor typically will demonstrate
- A. Low ACTH and low cortisol
- B. Low ACTH and high cortisol
- C. High ACTH and low cortisol
- D. High ACTH and high cortisol
Correct Answer: A
Rationale: The correct answer is A (Low ACTH and low cortisol) because in patients with an adrenal tumor causing Cushing's syndrome, the tumor autonomously produces cortisol, leading to suppression of ACTH secretion from the pituitary. This results in low ACTH levels and high cortisol levels. Choices B, C, and D are incorrect because they do not reflect the characteristic hormone levels seen in patients with an adrenal tumor causing Cushing's syndrome.
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Mrs. Maroldo is an 81-year-old female who presents for evaluation of pain in her left lower quadrant. She has had this pain before and says she usually takes antibiotics and it goes away. However, this time it seems worse, and she has had it for 4 days even though she says she started taking her leftover antibiotics from the last episode. She denies any nausea or vomiting but says she simply isnt hungry. She had a little diarrhea yesterday but no bowel movements today. She has a temperature of 100.9F and a pulse of 104 bpm, respirations of 20 breaths per minute, and a blood pressure of 9460 mm Hg. She has some discomfort to deep palpation in the left lower quadrant. The AGACNP suspects
- A. Irritable bowel syndrome
- B. Inflammatory bowel disease
- C. Diverticulitis
- D. Appendicitis
Correct Answer: A
Rationale: The correct answer is A: Irritable bowel syndrome. Mrs. Maroldo's history of recurrent left lower quadrant pain that usually resolves with antibiotics suggests a chronic condition rather than an acute one like diverticulitis, appendicitis, or inflammatory bowel disease. Her lack of nausea, vomiting, and severe symptoms, along with the presence of diarrhea and no bowel movements, align more with irritable bowel syndrome. Additionally, her vital signs are not significantly elevated, ruling out acute conditions like appendicitis. Discomfort to deep palpation in the left lower quadrant is common in irritable bowel syndrome due to visceral hypersensitivity. Therefore, based on her chronic symptoms, lack of severe signs, and typical presentation, the most likely diagnosis is irritable bowel syndrome.
Which of the following statements is true with respect to adrenal tumors that produce gender symptoms?
- A. Feminizing adrenal tumors are almost always carcinomas
- B. Feminizing adrenal tumors are the most common type of adrenal tumor
- C. Virilizing tumors in women are most often localized to the adrenal cortex
- D. Virilizing adrenal tumors are more likely to be malignant in children NURS 6560N Final Exam Answers 2024 NURS 6560 Final Exam Questions and Answers 2024
Correct Answer: C
Rationale: The correct answer is C: Virilizing tumors in women are most often localized to the adrenal cortex. This is because virilizing tumors typically involve excessive production of androgens, which are male sex hormones, and are commonly associated with adrenal cortex disorders.
A is incorrect because feminizing adrenal tumors can be either benign or malignant, not always carcinomas. B is incorrect because feminizing adrenal tumors are rare compared to virilizing tumors. D is incorrect because virilizing adrenal tumors are more likely to be benign rather than malignant in children.
In summary, the correct answer highlights the common association of virilizing tumors with the adrenal cortex in women, while the other choices present incorrect information regarding the types and malignancy of adrenal tumors.
Arched back and tightly clenched teeth are among the features of which stage of eclampsia:
- A. Clonic
- B. Tonic
- C. Premonitory
- D. Coma
Correct Answer: B
Rationale: The correct answer is B: Tonic. During the tonic stage of eclampsia, the muscles go into a prolonged contraction leading to an arched back and tightly clenched teeth. This is due to sustained muscle rigidity. In contrast, the clonic stage involves rhythmic muscle contractions and relaxations, not sustained rigidity. The premonitory stage is characterized by warning signs like headaches and visual disturbances, not specific physical postures. Coma is a severe stage of unconsciousness, not associated with specific physical postures or muscle rigidity seen in the tonic stage of eclampsia.
With respect to tumor nomenclature, the AGACNP knows that the term carcinoma describes
- A. Malignant neoplasms of internal structure
- B. Tumors that have lost normal growth regulation
- C. A dysfunctional metaplastic adaptation
- D. Neoplasms of epithelial origin
Correct Answer: D
Rationale: The correct answer is D because the term "carcinoma" specifically refers to neoplasms of epithelial origin. Epithelial cells line the surfaces and cavities of the body, so carcinomas originate from these tissues. This term does not describe internal structure (A), loss of growth regulation (B), or metaplastic adaptation (C). Carcinomas are the most common type of cancer and can occur in various organs such as the skin, lungs, breasts, and colon.
M. T. is a 71-year-old female who presents for evaluation of a lump on her chest. She denies any symptomsthere is no pain, erythema, edema, ecchymosis, or open areasit is just a lump. She has no idea how long it has been there and just noticed it a few weeks ago. Physical examination reveals a round, smooth, flesh-colored tumor. It is firm but not hard it has smooth borders. It measures 6 cm in diameter and is non-tender to palpation. The AGACNP suspects that this is a classic presentation of the most common chest wall tumor known as a
- A. Neurolemma
- B. Lipoma
- C. Hemangioma
- D. Lymphangioma
Correct Answer: B
Rationale: The correct answer is B: Lipoma. A lipoma is a common benign tumor made of fat cells. In this case, the patient's presentation of a painless, soft, round, flesh-colored lump with smooth borders is consistent with a lipoma. The absence of symptoms like pain, erythema, or tenderness further supports this diagnosis. Lipomas are usually non-tender to palpation and can grow to a significant size. The other choices (A, C, D) are not the correct answers because they do not align with the characteristics described in the patient's presentation. Neurolemma is associated with nerve sheath tumors, hemangioma with blood vessel tumors, and lymphangioma with lymphatic vessel tumors, none of which match the clinical findings in this case.