Varneys Midwifery Test Bank

Varneys Midwifery Test Bank Related

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Jake is a 32-year-old patient who is recovering from major abdominal surgery and organ resection following a catastrophic motor vehicle accident. Due to the nature of his injuries, a large portion of his jejunum had to be resected. In planning for his recovery and nutritional needs, the AGACNP considers that

  • A. He will probably be able to transition to oral nutrition but will have lifetime issues with diarrhea
  • B. His procedure has put him at significant risk for B12 absorption problems
  • C. Most jejunum absorption functions will be assumed by the ileum
  • D. Enteral nutrition will need to be delayed for 3 to 6 months to facilitate adaptation
Correct Answer: B

Rationale: The jejunum is the primary site for absorption of nutrients, including vitamin B12. Resection of a large portion of the jejunum can lead to malabsorption of vitamin B12, as this nutrient is primarily absorbed in the distal ileum but also partially absorbed in the jejunum. Thus, Jake is at significant risk for B12 absorption problems following his surgery, and close monitoring and potential supplementation may be needed to address this issue.

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A circumscribed swelling on the newborn’s scalp is indicative of

  • A. Caput succedaneum
  • B. Subgaleal hemorrhage
  • C. Intracranial injury
  • D. Neonatal cephalhematoma
Correct Answer: D

Rationale: Neonatal cephalhematoma is a circumscribed swelling on the newborn’s scalp due to pressure during delivery.

How does a water birth benefit labor?

  • A. Reduces labor pain
  • B. Lowers risk of tearing
  • C. Enhances relaxation
  • D. All of the above
Correct Answer: D

Rationale: Water birth can reduce pain, lower tearing risks, and improve relaxation during labor.

Complications of deep venous thrombosis include:

  • A. Pulmonary embolism, varicosity
  • B. Moist gangrene, secondary postpartum hemorrhage
  • C. Hydronephrosis, hematoma formation
  • D. Prolonged labor, disseminated intravascular coagulopathy
Correct Answer: A

Rationale: Pulmonary embolism and varicosity are common complications of deep venous thrombosis.

Uterus hypotonicity is likely to lead to prolonged labor due to

  • A. Incoordination of the uterus muscle fibers during a contraction
  • B. Maternal exhaustion because of improper preparation for labor
  • C. Weak receptors thus not strong enough to signal enough contraction
  • D. Inadequate pelvis thus not able to stimulate enough uterine contractions
Correct Answer: A

Rationale: Uterus hypotonicity results in poor coordination of muscle fibers, leading to ineffective contractions.

P. T. is a 58-year-old female who is admitted with chest pain and shortness of breath and is found to have a large pulmonary embolus. Her systolic blood pressure is falling, and a diagnosis of obstructive shock is made. Cardiac pressure would likely demonstrate

  • A. Elevated atrial and decreased ventricular pressures
  • B. Elevated right-sided and decreased left-sided pressures
  • C. Elevated left ventricular pressure and decreased cardiac output
  • D. Elevated left ventricular pressure and decreased systemic vascular resistance
Correct Answer: B

Rationale: Obstructive shock, such as in this case of a large pulmonary embolus causing obstructive shock, results in a sudden increase in right ventricular afterload due to obstruction of blood flow. This leads to right heart failure and decreased left ventricular preload, ultimately resulting in decreased cardiac output. The elevated right-sided pressures will be reflected by elevated right atrial and ventricular pressures, while the left ventricular pressures will be decreased due to decreased preload. This commonly leads to a situation known as acute cor pulmonale, where the right heart becomes dilated and dysfunctional in response to the increased afterload.

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