Varneys Midwifery 6th Edition Test Bank

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A patient being monitored post-heart transplant suffers a bradyarrhythmia. The AGACNP knows that which of the following medications is not indicated as part of emergency intervention for bradycardic abnormalities in a posttransplant patient?

  • A. Isoproterenol 0.2 to 0.6 mg IV bolus
  • B. External pacemaking
  • C. Atropine 0.5 mg IV
  • D. Epinephrine 1 mg IV
Correct Answer: A

Rationale: Epinephrine is not indicated as part of emergency intervention for bradycardic abnormalities in posttransplant patients. Epinephrine is a medication usually used in cases of cardiac arrest or severe anaphylaxis, and it can potentially exacerbate bradycardia in patients with preexisting bradyarrhythmias. In this scenario, other options such as isoproterenol, external pacemaking, and atropine are more appropriate choices for managing bradyarrhythmias in a posttransplant patient.

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An indication for forceps delivery is

  • A. Inadequate size of the pelvis
  • B. Delay in second stage of labor
  • C. Unsuccessful vacuum extraction
  • D. Fetal distress in first stage of labor
Correct Answer: B

Rationale: Forceps delivery is typically used in the second stage of labor when there is delay.

The AGACNP is evaluating a patient who reportedly fell down a flight of steps. Her history is significant for several emergency room visits, but she denies any significant medical conditions. Some documentation in her chart indicates that she may have been subjected to physical abuse. Today she presents with a periorbital ecchymosis of the left eye and swelling in the left side of the face. Her neurologic examination is within normal limits. Which head imaging study would be most useful in assessing for findings consistent with a history of abuse?

  • A. Radiographs
  • B. CT scan without contrast
  • C. MRI
  • D. PET scan
Correct Answer: A

Rationale: An MRI (Magnetic Resonance Imaging) would be the most useful head imaging study in assessing for findings consistent with a history of abuse in this patient. MRI is superior to CT in detecting subtle changes in the brain, such as small hemorrhages, edema, or shearing injuries, which may be present in cases of physical abuse. In cases of suspected abuse, it is important to evaluate for both acute and chronic changes that may not be clearly visible on other imaging modalities. While CT scans can detect acute hemorrhages or fractures, they may miss more subtle findings that can be seen on MRI. Therefore, an MRI would provide a more comprehensive evaluation of the brain and surrounding structures in this case.

Diabetes in pregnancy predisposes a mother to developing vulvo-vaginitis due to

  • A. High acidity levels which favor growth of Escherichia coli
  • B. Low acidity levels which favor growth of Candida albicans
  • C. Existing chronic hypertension
  • D. Lowered osmotic pressure
Correct Answer: B

Rationale: Diabetes in pregnancy alters vaginal pH, promoting Candida albicans growth.

Which of the following birth trauma results from damage of cervical nerve roots C8 & T1?

  • A. Erb’s palsy
  • B. Radial palsy
  • C. Brachial palsy
  • D. Facial palsy
Correct Answer: A

Rationale: Erb’s palsy results from damage to the C8 and T1 cervical nerve roots.

Vitamin K prevents hemorrhagic disease of the neonate by

  • A. Activating the white blood cells
  • B. Activating the dormant clotting factors
  • C. Adopting a fibrinogen sparing mechanism
  • D. Altering the red blood cells count
Correct Answer: B

Rationale: Vitamin K activates dormant clotting factors, preventing hemorrhagic disease in neonates.

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