ATI RN
Varneys Midwifery 6th Edition Test Bank Questions
Question 1 of 5
M. R. is a 52-year-old female who presents complaining of significant abdominal pain, which she rates as 8 to 9 on a 1 to 10 scale. The pain has been going on for a matter of hours, and she is afraid it wont go away on its own. She denies any nausea or vomiting, and she cannot remember precisely when her last bowel movement occurred probably it was a few days ago. She reports that she is always constipated. On physical examination, she is tachycardic but otherwise has normal vital signs her abdomen is tensely rigid, but no point tenderness to palpation is appreciated. The entire abdomen percusses as tympanicthere is no distinct dullness over the upper quadrants. Bowel sounds are present but hypoactive and intermittent. There is rebound tenderness to palpation. The AGACNP suspects
Correct Answer: B
Rationale: The patient's presentation with significant abdominal pain, tachycardia, tensely rigid abdomen, rebound tenderness, hypoactive and intermittent bowel sounds, and tympanic percussion of the entire abdomen is concerning for peritonitis. Peritonitis is inflammation of the peritoneum, which is the lining of the abdominal cavity. It is often caused by an infection or irritation, such as from a perforated bowel, which can lead to the leakage of bowel contents into the peritoneal cavity. The presentation of peritonitis includes severe abdominal pain, guarding, rebound tenderness, abdominal distension, and signs of systemic inflammation like tachycardia and fever. In this case, the lack of point tenderness to palpation and the absence of dullness over the upper quadrants make perforated bowel less likely, while the tense rigidity of the abdomen and rebound tenderness are more suggestive of diffuse peritonitis. Ischem
Question 2 of 5
How does maternal hypertension affect fetal development?
Correct Answer: D
Rationale: Maternal hypertension can restrict fetal growth, increase preterm birth risk, and lead to stillbirth.
Question 3 of 5
The AGACNP is evaluating a patient who reportedly fell down a flight of steps. Her history is significant for several emergency room visits, but she denies any significant medical conditions. Some documentation in her chart indicates that she may have been subjected to physical abuse. Today she presents with a periorbital ecchymosis of the left eye and swelling in the left side of the face. Her neurologic examination is within normal limits. Which head imaging study would be most useful in assessing for findings consistent with a history of abuse?
Correct Answer: A
Rationale: An MRI (Magnetic Resonance Imaging) would be the most useful head imaging study in assessing for findings consistent with a history of abuse in this patient. MRI is superior to CT in detecting subtle changes in the brain, such as small hemorrhages, edema, or shearing injuries, which may be present in cases of physical abuse. In cases of suspected abuse, it is important to evaluate for both acute and chronic changes that may not be clearly visible on other imaging modalities. While CT scans can detect acute hemorrhages or fractures, they may miss more subtle findings that can be seen on MRI. Therefore, an MRI would provide a more comprehensive evaluation of the brain and surrounding structures in this case.
Question 4 of 5
The AGACNP is counseling a patient about various methods of tumor biopsy. Which of the following is not an accurate statement?
Correct Answer: C
Rationale: Typically, excisional biopsy is preferred over incisional biopsy whenever feasible because it provides a more accurate representation of the tumor since the entire mass is removed. This benefits both the patient (by potentially preventing the need for a second procedure) and the medical team (by ensuring a more comprehensive evaluation of the tumor). It is important to remove the entire lesion during excisional biopsy to make an accurate diagnosis. Incisional biopsy, on the other hand, involves taking only a portion of the tumor for examination, which may lead to potential sampling error and inadequate representation of the tumor.
Question 5 of 5
Janice is a 32-year-old female who presents for evaluation of abdominal pain. She has no significant medical or surgical history and denies any history of ulcers, reflux, or gastritis. However, she is now in significant pain and is afraid something is really wrong. She describes what started out as a dull discomfort in the upper part of her stomach a few hours ago but has now become more profound and centered on the right side just under her ribcage. She has not vomited but says she feels nauseous. Physical exam reveals normal vital signs except for a pulse of 117 bpm. She is clearly uncomfortable, and palpation of the abdomen reveals tenderness with deep palpation of the right upper quadrant. The AGACNP orders which imaging study to investigate the likely cause?
Correct Answer: A
Rationale: Given Janice's presentation of significant abdominal pain localized to the right upper quadrant with tenderness on deep palpation, the most appropriate initial imaging study to investigate the likely cause is a right upper quadrant ultrasound. This imaging modality is commonly used to evaluate the liver, gallbladder, bile ducts, and adjacent structures. It can help identify common causes of right upper quadrant pain such as gallstones, cholecystitis, or biliary duct obstruction. The non-invasive nature of ultrasound and its ability to provide real-time imaging make it a valuable tool in the initial assessment of patients with abdominal pain. Depending on the findings of the ultrasound, further imaging studies or interventions may be pursued. Abdominal radiographs may not provide sufficient detail of the biliary system, while a CT scan with contrast or a HIDA scan may be reserved for further evaluation if needed based on the ultrasound findings.