ATI RN
Varneys Midwifery 6th Edition Test Bank Questions
Question 1 of 5
Mr. Novello is an 81-year old male patient who presents with crampy abdominal pain in the hypogastrum and a vague history as to his last normal bowel movement. Physical examination reveals distention and high-pitched bowel sounds. The patient says he has never has this kind of problem before and denies any history of abdominal surgery. Abdominal radiographs reveal a frame pattern of colonic distention. The AGACNP considers
Correct Answer: B
Rationale: The most appropriate step for the AGACNP to take in this scenario is to decompress the colon with a rectal tube. The patient's presentation, including crampy abdominal pain, distention, lack of bowel movements, and a frame pattern of colonic distention on radiographs, are suggestive of acute colonic pseudo-obstruction, also known as Ogilvie's syndrome. This condition is characterized by colonic distention without a mechanical obstruction, which can lead to significant complications such as perforation.
Question 2 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 3 of 5
A patient presents with a 2-day history of abdominal pain, fever, vomiting, and diarrhea. A surgical abdomen is ruled out, and radiography demonstrates inflammation of the small bowel and colon. Microscopy supports a diagnosis of Campylobacter jejuni, and the patient is prepared for discharge from the emergency room. Important patient education includes advising her that
Correct Answer: B
Rationale: Campylobacter jejuni is a common bacterial cause of gastroenteritis, typically transmitted through contaminated food, water, or contact with infected animals. Patient education regarding Campylobacter jejuni infection should include advising the patient that the bacteria may be spread for as long as she has diarrhea. It is important for the patient to practice good hand hygiene and take precautions to prevent spreading the infection to others. While most cases of Campylobacter infection are self-limiting and resolve on their own without the need for antibiotics, proper hygiene practices help prevent the spread of the bacteria to others.
Question 4 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 5 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.