ATI RN
Midwifery Exam Practice Questions Questions
Question 1 of 5
When counseling a patient about treatment modalities for achalasia, the AGACNP advised that which of the following is the treatment of choice?
Correct Answer: A
Rationale: Rationale for choice A: Calcium channel antagonists are the treatment of choice for achalasia as they help relax the lower esophageal sphincter, improving swallowing. This is a non-invasive option that can provide symptom relief for many patients. Summary for other choices: B: Intrasphincter botulinum injection is a temporary solution and not considered the treatment of choice. C: Pneumatic dilation is another option for achalasia but is typically used if calcium channel antagonists are ineffective. D: Myotomy and partial fundoplication is a more invasive surgical option and usually considered if other treatments fail.
Question 2 of 5
A patient with suspected Cushings syndrome is being evaluated to establish the diagnosis and cause. Patients with an adrenal tumor typically will demonstrate
Correct Answer: A
Rationale: The correct answer is A: Low ACTH and low cortisol. In a patient with an adrenal tumor causing Cushing's syndrome, the tumor itself produces excess cortisol independently of ACTH regulation. Therefore, ACTH levels are low due to negative feedback from high cortisol levels. As a result, cortisol levels are high, while ACTH levels are low. Explanation for other choices: B: Low ACTH and high cortisol - This suggests primary adrenal insufficiency (Addison's disease), not Cushing's syndrome. C: High ACTH and low cortisol - This suggests secondary adrenal insufficiency, not Cushing's syndrome. D: High ACTH and high cortisol - This is contradictory and not physiologically possible in the context of an adrenal tumor causing Cushing's syndrome.
Question 3 of 5
K. T. presents for a routine wellness examination, and the review of systems is significant only for a markedly decreased capacity for intake and a vague sense of nausea after eating. K. T. denies any other symptoms the remainder of the GI review of systems is negative. His medical history is significant for complicated peptic ulcer disease that finally required resection for a perforated ulcer. The AGACNP advises the patient that
Correct Answer: C
Rationale: Rationale for Correct Answer (C): 1. The patient's symptoms of decreased capacity for intake and nausea after eating suggest gastroparesis, a common complication post-ulcer surgery. 2. Given the history of complicated peptic ulcer disease and prior surgery, medication may be ineffective, necessitating potential reoperation. 3. The AGACNP advises that another surgery may be needed, indicating that medication alone may not suffice to address the issue. Summary of Incorrect Choices: A: Endoscopy is not necessary at this point as the symptoms are likely indicative of a functional issue rather than a structural problem. B: While gastroparesis can occur post-ulcer surgery, the patient's symptoms are more suggestive of gastroparesis rather than chronic gastroparesis as a known complication. D: The frequency of occurrence of symptoms after ulcer surgery is not relevant to the current management of the patient's symptoms.
Question 4 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: C
Rationale: The correct answer is C: Local anesthesia, cleansing, and suture repair. 1. Local anesthesia is needed to numb the area before suturing. 2. Cleansing is necessary to prevent infection and remove debris. 3. Suture repair is required for a jagged laceration to promote proper wound healing and minimize scarring. Other choices are incorrect: A: Antibiotic therapy is not indicated for clean, non-infected wounds like this laceration. B: Wound exploration for foreign bodies is not necessary in this case as the mechanism of injury is known and there is no indication of foreign bodies. D: Tetanus prophylaxis is important but not directly related to the immediate management of the laceration.
Question 5 of 5
In the majority of cases, the first clinical manifestation of physiologic stress ulcer is
Correct Answer: C
Rationale: The correct answer is C: Fever. The first clinical manifestation of physiologic stress ulcer is often a fever due to the body's response to stress. This is because stress can trigger an inflammatory response, leading to an increase in body temperature. Epigastric pain (choice A) is more commonly associated with peptic ulcers. Change in mental status (choice B) is not a typical early symptom of physiologic stress ulcer. Hemorrhage (choice D) is a severe complication that can occur later in the course of the disease, but it is not typically the first clinical manifestation.