ATI RN
Varneys Midwifery Test Bank Questions
Question 1 of 5
The AGACNP knows that when managing a patient with acute cardiogenic shock after myocardial infarction, all of the following pharmacologic agents may be used except
Correct Answer: A
Rationale: Anticholinergics are not typically used in the management of acute cardiogenic shock after myocardial infarction. Anticholinergic medications may worsen tachycardia and exacerbate myocardial ischemia by increasing heart rate and myocardial oxygen demand. Therefore, the AGACNP should avoid using anticholinergics in this patient population.
Question 2 of 5
The AGACNP is treating a patient with ascites. After a regimen of 200 mg of spironolactone daily, the patient demonstrates a weight loss of 0.75 kgday. The best approach to this patients management is to
Correct Answer: B
Rationale: The best approach to managing the patient with ascites who has responded to spironolactone with weight loss is to add a loop diuretic to the current regimen. Spironolactone is an aldosterone antagonist that primarily works on the distal convoluted tubule, while loop diuretics, such as furosemide, act on the thick ascending limb of the loop of Henle. Combining these two diuretics can result in a synergistic effect, increasing diuresis and reducing fluid retention in patients with ascites. This combination therapy is often used in patients who do not respond adequately to spironolactone alone, and it is considered a common strategy in the management of ascites due to cirrhosis. Therefore, adding a loop diuretic to the spironolactone regimen is the most appropriate next step to optimize diuresis and fluid management in this patient.
Question 3 of 5
Justin F. is seen in the emergency department with an 8-cm jagged laceration on the dorsal surface of his right forearm. He says he was working with his brother-in-law yesterday morning building a deck on the back of his home. A pile of wooden planks fell on top of him, and he sustained a variety of cuts and superficial injuries. He cleaned the wound with soap and water but didnt want to go to the emergency room because he didnt want to risk being in the waiting room for hours. He wrapped up his arm and went back to work, and then took a normal shower and went to bed last night. This morning the cut on his arm was still flapping open, and he realized he needed sutures. The appropriate management of this patient includes
Correct Answer: D
Rationale: In this scenario, the patient presents with a jagged laceration on his forearm that is still open and requires sutures. The appropriate management for this patient involves local anesthesia to reduce pain, thorough cleansing of the wound to prevent infection, and wound exploration to assess for any foreign bodies that may be present. Suturing the wound is necessary to promote proper healing and reduce the risk of complications. Antibiotic therapy may be indicated if signs of infection are present, but it is not mentioned in the scenario as a primary management step. Tetanus prophylaxis should also be considered given the mechanism of injury involving a dirty object.
Question 4 of 5
Mrs. Maroldo is an 81-year-old female who presents for evaluation of pain in her left lower quadrant. She has had this pain before and says she usually takes antibiotics and it goes away. However, this time it seems worse, and she has had it for 4 days even though she says she started taking her leftover antibiotics from the last episode. She denies any nausea or vomiting but says she simply isnt hungry. She had a little diarrhea yesterday but no bowel movements today. She has a temperature of 100.9F and a pulse of 104 bpm, respirations of 20 breaths per minute, and a blood pressure of 9460 mm Hg. She has some discomfort to deep palpation in the left lower quadrant. The AGACNP suspects
Correct Answer: C
Rationale: Mrs. Maroldo's presentation with left lower quadrant pain, fever, elevated heart rate, history of previous episodes of similar pain that improved with antibiotics, and recent diarrhea are all concerning for diverticulitis. Diverticulitis is an infection or inflammation of small pouches that can form in the wall of the colon, known as diverticula. The symptoms typically include localized abdominal pain, fever, elevated heart rate, and changes in bowel habits such as diarrhea or constipation. The discomfort to deep palpation in the left lower quadrant indicates inflammation in that area. The presence of fever, elevated heart rate, and low blood pressure suggests an infectious process requiring urgent evaluation and treatment. Further diagnostic tests such as a CT scan may be ordered to confirm the diagnosis and assess the extent of the inflammation. Appendicitis can also present with abdominal pain, but the location of the pain in the left lower quadrant makes diverticul
Question 5 of 5
The AGACNP knows that which of the following must be evaluated as a cause of her abdominal pain?
Correct Answer: C
Rationale: Abdominal pain in pregnancy can be caused by various conditions, but spontaneous hepatic rupture is a rare but life-threatening cause that must be ruled out. Spontaneous hepatic rupture, also known as liver rupture, can occur in pregnancy, though it is extremely rare. It is associated with severe abdominal pain, hypovolemic shock, and can lead to significant maternal and fetal morbidity and mortality. Therefore, the AGACNP should evaluate this possibility when assessing a pregnant patient with abdominal pain to provide timely and appropriate management.HELLP syndrome, placental abruption, and preterm labor are important considerations in the differential diagnosis of abdominal pain in pregnancy but are not specific to the life-threatening nature of spontaneous hepatic rupture.