ATI RN
Midwifery Exam Questions and Answers PDF 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: C
Rationale: The correct answer is C: Decompression of the colon with rectal tube. This is the most appropriate intervention for a patient with acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome. In this condition, there is colonic distention without an actual mechanical obstruction, leading to symptoms like abdominal pain, distention, and high-pitched bowel sounds. Decompression with a rectal tube can help relieve the distention and prevent complications like perforation. Choice A (stimulant laxative) is incorrect because ACPO is not due to simple constipation, so laxatives would not be effective. Choice B (carcinoma of the bowel) is unlikely given the acute onset and lack of risk factors. Choice D (angiography for mesenteric ischemia) is not indicated in this case as there are no signs of acute ischemia. In summary, the correct choice is C because it directly addresses the underlying issue of colonic distention in
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: Correct Answer: C - Fine needle aspiration does not allow grading of tumors. Rationale: 1. Fine needle aspiration (FNA) collects cells for cytology evaluation, not tissue for grading. 2. Grading requires evaluation of tissue architecture, which is not possible with FNA. 3. FNA is useful for diagnosis but not for determining tumor grade. Summary: A: Incorrect - Excisional biopsy is preferred over incisional biopsy to obtain the entire tumor for diagnosis and grading. B: Incorrect - Core needle biopsy has a lower false positive rate compared to fine needle aspiration. D: Incorrect - Core needle and incisional biopsies differ in the amount of tissue sampled and potential for false results.
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: D
Rationale: Step 1: Campylobacter jejuni is a bacteria commonly associated with foodborne illness, often found in undercooked poultry and unpasteurized milk. Step 2: The patient's symptoms and microbiological findings are consistent with Campylobacter infection. Step 3: Advising the patient that there is no readily identified food source of this bacteria is important for preventing future exposure and potential reinfection. Step 4: Choices A, B, and C are incorrect as they do not address the specific educational need related to food safety and prevention of Campylobacter infection.
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: The correct answer is A: A complete blood count and RBC differential. In this case, Mr. Jefferson presents with severe abdominal pain, which could indicate various conditions like pancreatitis, a possible complication of his heavy drinking. A complete blood count (CBC) with RBC differential can help assess for signs of inflammation or infection, which may be elevated in conditions like pancreatitis. The RBC differential can also provide insights into potential causes of abdominal pain, such as anemia or other blood disorders. Summary: - B: Liver function enzymes may be affected in conditions like alcoholic liver disease, but in this case, the focus should be on investigating acute abdominal pain. - C: Serum amylase, lipase, and glucose are typically checked in cases of suspected pancreatitis, but a CBC with RBC differential would provide a more comprehensive initial assessment. - D: A basic metabolic panel may not directly address the underlying cause of the acute abdominal pain and is not the most appropriate test to anticipate
Question 5 of 5
The relationship between abdominal pain and vomiting typically can be characterized by saying
Correct Answer: D
Rationale: Step 1: The presence of bile in vomitus suggests that the vomit originated from the small intestine or stomach, indicating an obstruction in the pyloric region. Step 2: Pyloric stenosis is a condition characterized by narrowing of the opening from the stomach to the small intestine, leading to projectile vomiting with bile. Step 3: Therefore, the presence of bile in vomitus suggests pyloric stenosis, making option D the correct answer. Summary: Option A is incorrect because vomiting preceding pain does not necessarily indicate a surgical abdomen. Option B is incorrect as the severity of symptoms is not solely based on age. Option C is incorrect as some surgical abdomens can present with vomiting as a primary symptom.