ATI RN
Varneys Midwifery 6th Edition Test Bank Questions
Question 1 of 5
A patient being monitored post-heart transplant suffers a bradyarrhythmia. The AGACNP knows that which of the following medications is not indicated as part of emergency intervention for bradycardic abnormalities in a posttransplant patient?
Correct Answer: A
Rationale: Epinephrine is not indicated as part of emergency intervention for bradycardic abnormalities in posttransplant patients. Epinephrine is a medication usually used in cases of cardiac arrest or severe anaphylaxis, and it can potentially exacerbate bradycardia in patients with preexisting bradyarrhythmias. In this scenario, other options such as isoproterenol, external pacemaking, and atropine are more appropriate choices for managing bradyarrhythmias in a posttransplant patient.
Question 2 of 5
R. R. is a 61-year-old male patient who presents with a chief complaint of fever and urinary symptoms. He was in his usual state of good health when for no apparent reason he developed pain in his back and perineal region, as well as fever and chills. He presents as septic. He had urinary hesitancy and decreased stream but now reports that he has not passed urine in more than 12 hours. Palpation of the lower abdomen is consistent with bladder distention. The AGACNP knows that which of the following is contraindicated in this circumstance?
Correct Answer: D
Rationale: In a patient with suspected prostatic abscess and urinary retention, urinary catheterization is contraindicated due to the risk of spreading infection and causing potential complications such as septicemia or worsening of the abscess. The introduction of a catheter can disrupt the abscess capsule, leading to dissemination of the infection. Therefore, other methods of decompression and treatment should be considered, such as drainage of the abscess or other appropriate interventions guided by a healthcare provider.
Question 3 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: A leukocyte count of 18,000/µL suggests an elevated white blood cell count, which is indicative of an inflammatory or infectious process. In the context of biliary colic, an elevated white blood cell count could be a sign of complications such as cholecystitis (inflammation of the gallbladder) or choledocholithiasis (bile duct obstruction). These complications may require urgent surgical evaluation and intervention. The other options, although concerning, do not specifically suggest a complication that necessitates immediate surgical evaluation.
Question 4 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: C
Rationale: In this case, the best approach to the patient includes assessment of nonprostate causes of nocturia. Despite the lack of significant prostate hypertrophy on digital rectal examination, the patient is experiencing bothersome lower urinary tract symptoms such as nocturia, urinary urgency, and post-void dribbling. These symptoms suggest the need to consider alternative causes beyond prostate enlargement. Factors such as overactive bladder, urinary tract infections, diabetes, sleep apnea, medications, or other systemic conditions could be contributing to the patient's symptoms. Therefore, a comprehensive evaluation to identify potential nonprostate causes of the patient's nocturia is warranted before considering more invasive prostate-specific tests like PSA, ultrasound, or symptom scales.
Question 5 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: C
Rationale: When counseling a patient about surgical options for an ulcer that has been refractory to medical therapy, advising the patient that he will need some form of vagotomy is important. Vagotomy is a surgical procedure in which the vagus nerve is partially or completely severed. This procedure is commonly performed for patients with ulcers that have not responded to medical treatment. Vagotomy reduces the acid secretion in the stomach, which can help in the healing of the ulcer and prevent recurrence. It is an effective option for treating ulcers that have not responded to conservative medical management.