ATI RN
Varneys Midwifery 6th Edition Test Bank Questions
Question 1 of 5
R. S. is a 66-year-old female with Cushings syndrome due to an ACTH-producing pituitary tumor. The tumor is readily isolated by imaging, and the patient had an uneventful surgery. When seeing her in follow-up, the AGACNP anticipates
Correct Answer: A
Rationale: In patients with Cushing's syndrome due to an ACTH-producing pituitary tumor, removal of the tumor can result in a transient rebound release of remaining pituitary hormones. This occurs because the suppressed pituitary gland begins to recover and overproduce hormones in response to the sudden decrease in negative feedback from the removed tumor. As a result, patients may experience transient hormonal fluctuations before the pituitary gland establishes a new equilibrium. Therefore, when seeing the patient in follow-up after surgery, the AGACNP should anticipate a transient rebound release of remaining pituitary hormones rather than immediate and rapid reversal of symptoms or markedly improved test results. Additionally, hyponatremia and compensatory SIADH are less likely in this scenario unless there are other underlying factors contributing to it.
Question 2 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.
Question 3 of 5
The term persistent occipito-posterior position indicates that the occiput
Correct Answer: A
Rationale: Persistent occipito-posterior position means the occiput fails to rotate forward.
Question 4 of 5
There are no other abnormal findings. This suggests that Mr. Thornton
Correct Answer: D
Rationale: In the given scenario where there are no other abnormal findings, it suggests that Mr. Thornton is experiencing anterior wall ischemia. Ischemia occurs due to inadequate blood supply to the heart muscles, often caused by a partial blockage in the coronary arteries. The absence of abnormal findings, such as ST-segment elevation or specific changes on the electrocardiogram (ECG), indicates that the issue is more likely ischemia rather than infarction. Infarction, whether NSTEMI or STEMI, would typically be associated with specific ECG changes and significant abnormalities beyond just the absence of findings. In the absence of these features, the more likely diagnosis is anterior wall ischemia.
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.