A 42-year-old woman presents to the emergency department after being raped. The AGACNP examines her and realizes that the patients husband is the rapist. The patient does not want to press charges and wants to return home with her husband. The AGACNPs initial action should be to

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Question 1 of 5

A 42-year-old woman presents to the emergency department after being raped. The AGACNP examines her and realizes that the patients husband is the rapist. The patient does not want to press charges and wants to return home with her husband. The AGACNPs initial action should be to

Correct Answer: D

Rationale: The correct answer is D: Provide counseling to the patient regarding her options. The AGACNP's initial action should prioritize the patient's well-being and autonomy. Counseling allows the patient to understand her options, including legal, medical, and emotional support. Reporting to law enforcement (A) without the patient's consent violates her autonomy. Having the patient sign a release to go home with her husband (B) disregards the potential danger and trauma she may face. Consulting psychiatry for a psych hold (C) may not address the immediate emotional and physical needs of the patient.

Question 2 of 5

T. G. is a 48-year-old female who presents with biliary colic. She has had previous episodes but has resisted operation because she is afraid of anesthesia. Today her physical exam reveals a clearly distressed middle-aged female with right upper quadrant pain, nausea, and vomiting. Which of the following findings suggests a complication that requires a surgical evaluation?

Correct Answer: A

Rationale: The correct answer is A: A temperature of 101.5°F. A fever indicates an inflammatory response, which could be due to a complication like cholecystitis or cholangitis. Elevated leukocyte count (choice B) supports infection but is not as specific as a fever. Palpable gallbladder (choice C) may suggest inflammation but not necessarily a complication. A positive Murphy's sign (choice D) is indicative of gallbladder inflammation but does not directly indicate a complication requiring surgical evaluation.

Question 3 of 5

Lester R. is a 58-year-old male who is being evaluated for nocturia. He reports that he has to get up 2 to 3 times nightly to void. Additional assessment reveals urinary urgency and appreciable post-void dribbling. A digital rectal examination reveals a normal-sized prostate with no appreciable hypertrophy. The best approach to this patient includes

Correct Answer: D

Rationale: The correct answer is D: Assessment of nonprostate causes of nocturia. In this case, the patient's symptoms of nocturia, urinary urgency, and post-void dribbling are not indicative of prostate enlargement. Given that the digital rectal examination revealed a normal-sized prostate with no hypertrophy, it is essential to explore other potential causes of nocturia in this patient. By assessing non-prostate causes of nocturia, such as diabetes, urinary tract infection, medication side effects, or sleep disorders, a more accurate diagnosis and appropriate treatment plan can be developed. This approach will lead to better patient outcomes compared to focusing solely on prostate-related evaluations. Option A: Administration of the AUA Symptom Scale is not the best approach in this case because the patient's symptoms are not primarily related to prostate enlargement. Option B: Laboratory assessment to include a PSA is not necessary since the digital rectal examination already indicated a normal-sized prostate with no appreciable hypertrophy. Option C: Ordering a

Question 4 of 5

When counseling a patient about his surgical options for an ulcer that has been refractory to medical therapy, the AGACNP advises the patient that he will need

Correct Answer: D

Rationale: Correct Answer: D. Some form of vagotomy Rationale: 1. Vagotomy is a surgical procedure that involves cutting the vagus nerve to reduce acid production in the stomach, which can help in treating ulcers. 2. Vagotomy is often recommended when ulcers are refractory to medical therapy, making it an appropriate surgical option. 3. Lifelong vitamin D replacement (A) is not typically necessary for ulcer treatment. Excision of the ulcer (B) is not a common treatment and does not address the underlying cause. Eating smaller meals (C) may help manage symptoms but is not a surgical option for refractory ulcers.

Question 5 of 5

When evaluating a patient with acute pancreatitis, which of the following physical or diagnostic findings is an ominous finding that indicates a seriously illpotentially moribund patient?

Correct Answer: D

Rationale: The correct answer is D: Obturator sign. This finding indicates irritation of the peritoneum and is associated with a ruptured appendix, not acute pancreatitis. A: Severe epigastric pain with radiation to the back is a common presentation of acute pancreatitis, but not necessarily indicative of a seriously ill patient. B: Abdominal guarding and rigidity may suggest peritonitis but are not specific to acute pancreatitis. C: Grey Turner sign, bruising of the flanks, is associated with severe pancreatitis but does not necessarily indicate a seriously ill patient.

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