ATI RN
Varneys Midwifery 6th Edition Test Bank Questions
Question 1 of 5
Mr. Jefferson is a 59-year-old male who presents to the emergency department complaining of severe abdominal pain. His medical history is significant for dyslipidemia, and he takes 40 mgof simvastatin daily. He admits to drinking 6 to 10 bottles of beer nightly and to smoking 1 packs of cigarettes a day. He denies any history of chest pain or cardiovascular disease. He was in his usual state of good health until a couple of hours ago, when he developed this acute onset of severe pain in the upper abdomen. He says that he tried to wait it out at home but it was so bad he finally came in. His vital signs are as follows temperature 99.1F, pulse 129 bpm, respirations 22 breaths per minute, and blood pressure 13784 mm Hg. The abdomen is diffusely tender to palpation with some guarding but no rebound tenderness. The AGACNP anticipates that which of the following laboratory tests will be abnormal?
Correct Answer: A
Rationale: Given the patient's presentation of acute onset severe abdominal pain, the AGACNP anticipates abnormalities in serum amylase and lipase levels, as this can indicate pancreatitis. The presence of symptoms such as severe upper abdominal pain, along with the patient's risk factors such as heavy alcohol consumption, smoking, and dyslipidemia, increase suspicion for acute pancreatitis. Additionally, the evaluation of serum glucose levels is important to assess for potential hyperglycemia, which can be seen in acute pancreatitis. Liver function enzymes and basic metabolic panel may also be abnormal in the setting of pancreatitis; however, the most specific and sensitive tests for diagnosing acute pancreatitis are serum amylase and lipase levels.
Question 2 of 5
The AGACNP is managing a patient in the ICU who is being treated for a pulmonary embolus. Initially the patient was stable, awake, alert, and oriented, but during the last several hours the patient has become increasingly lethargic. At change of shift, the oncoming staff nurse appreciates a profound change in the patients mental status from the day before. Vital signs and hemodynamic parameters are as follows BP 8854 mm Hg Pulse 110 bpm Respiratory rate 22 breaths per minute SaO2 93 on a 50 mask Systemic vascular resistance (SVR) 1600 dynes seccm5 Cardiac index 1.3 Lmin Pulmonary capillary wedge pressure (PCWP) 8 mm Hg This clinical picture is most consistent with which shock state?
Correct Answer: B
Rationale: The patient's presentation with low blood pressure, tachycardia, tachypnea, decreased oxygen saturation, and altered mental status is most consistent with distributive shock. Distributive shock is characterized by systemic vasodilation and decreased systemic vascular resistance (SVR), leading to inadequate perfusion of tissues and organs despite normal or high cardiac output. In this case, the low SVR (1600 dynes ∙ sec/cm5) and low blood pressure indicate vasodilation. The patient's pulmonary capillary wedge pressure (PCWP) of 8 mm Hg is not consistent with cardiogenic shock, where elevated PCWP would be expected. Additionally, there are no signs of obstructive shock, such as a history of pulmonary embolism but rather clinical findings that suggest distributive shock. Hypovolemic shock would typically present with signs of volume depletion and would be less likely in this patient with stable mental status initially.
Question 3 of 5
The relationship between abdominal pain and vomiting typically can be characterized by saying
Correct Answer: B
Rationale: When the vomiting precedes pain, the likelihood of surgical abdomen increases appreciably. This statement is based on how the timing of symptoms can indicate the severity of the underlying condition. In cases where vomiting occurs before the onset of abdominal pain, it can be a sign of a more serious issue requiring urgent medical attention, such as a surgical abdomen. This sequence of symptoms suggests that there may be an obstruction or other critical issue in the gastrointestinal tract that is leading to the symptoms of vomiting and pain. Therefore, recognizing the relationship between the timing of symptoms like abdominal pain and vomiting is crucial in determining the urgency of intervention and appropriate medical management.
Question 4 of 5
Vitamin K prevents hemorrhagic disease of the neonate by
Correct Answer: B
Rationale: Vitamin K activates dormant clotting factors, preventing hemorrhagic disease in neonates.
Question 5 of 5
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
Correct Answer: D
Rationale: The described presentation of a round, smooth, flesh-colored tumor that is firm but not hard, with smooth borders, non-tender to palpation, and measuring 6 cm in diameter, fits the classic presentation of a lipoma. Lipomas are common noncancerous soft tissue tumors often found just beneath the skin, can occur anywhere on the body, including the chest wall. They are usually painless and slowly growing, with a characteristic appearance of being smooth, soft, and mobile under the skin. In this case, the absence of pain, redness, swelling, or other concerning signs, along with the appearance and characteristics of the lump, are highly suggestive of a lipoma.