Varneys Midwifery Test Bank

Varneys Midwifery Test Bank Related

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K. W. is a 50-year-old woman who presents for surgical resection of the liver for treatment of metastatic colon cancer. Preoperatively, the surgeon tells her that he is planning to remove 50 to 75 of her liver. The patient is concerned that she will not be able to recover normal liver function with that much removed. The AGACNP counsels her that

  • A. Such a high-volume resection is utilized only in people with markedly compromised hepatic function
  • B. Major regeneration occurs within 10 days, and the process is complete by 5 weeks
  • C. Liver function will probably recover to 50% baseline, but that is enough for normal function
  • D. Up to 95% of the liver can be removed without any apparent consequence to the patient
Correct Answer: B

Rationale: The liver is known for its remarkable ability to regenerate. Major regeneration can occur within 10 days after partial hepatectomy (liver resection) as a compensatory mechanism. The process is typically complete within 5 weeks. This regenerative capacity allows for safe removal of a significant portion of the liver for procedures such as liver resection for cancer. The remaining liver tissue is able to rapidly proliferate and restore normal liver function. The patient should be reassured that even with 50 to 75% of her liver being removed, she can expect a significant amount of liver function recovery postoperatively.

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Placental parasitation is associated with

  • A. Malaria prenatally
  • B. Candidiasis prenatally
  • C. Tuberculosis prenatally
  • D. Multiple gestation
Correct Answer: A

Rationale: Placental parasitation is associated with malaria during pregnancy.

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

  • A. Opioids
  • B. Diuretics
  • C. Beta-adrenergic antagonists
  • D. Anticholinergics
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.

Which one of the following is a cause of oligohydramnios?

  • A. Absence of fetal urine production
  • B. Excessive fetal urine production
  • C. Blockage of the fetal gastro-intestinal tract
  • D. Dizygotic twinning thus twin to twin transfusion
Correct Answer: A

Rationale: Oligohydramnios can result from fetal kidney problems, leading to lack of urine production.

Melanie is a 31-year-old patient who is being evaluated following a routine urinalysis that revealed microscopic hematuria. She was between menses and has no other identifiable explanation for hematuria. She has no significant medical history and otherwise is without complaint. The AGACNP knows that workup for Melanie should include

  • A. A urology consultation
  • B. CT urogram
  • C. Upper urinary imaging
  • D. Cystoscopy
Correct Answer: D

Rationale: Upper urinary imaging is the appropriate next step in the workup for Melanie based on the presentation of microscopic hematuria with no other identifiable explanation. Upper urinary imaging, such as an ultrasound or CT scan, can help evaluate the upper urinary tract, including the kidneys and ureters, to investigate potential causes of hematuria. This step is commonly recommended before proceeding to invasive procedures like cystoscopy or consultation with a urologist. It allows for a non-invasive assessment of the upper urinary system to identify any potential abnormalities that may be causing the hematuria in the patient.

The AGACNP knows that when evaluating a patient with suspected acute pyelonephritis, which of the following is not a common feature?

  • A. Pyuria
  • B. Fever
  • C. CVA tenderness
  • D. Gross hematuria
Correct Answer: D

Rationale: While pyuria, fever, and CVA tenderness are common features of acute pyelonephritis, gross hematuria is less commonly associated with this condition. In acute pyelonephritis, the inflammatory process primarily affects the renal parenchyma and pelvis, leading to symptoms such as fever, chills, flank pain, pyuria (presence of pus in the urine), and CVA tenderness (tenderness over the costovertebral angle). Hematuria in acute pyelonephritis is more likely to be microscopic rather than gross.

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