Varneys Midwifery 6th Edition Test Bank

Varneys Midwifery 6th Edition Test Bank Related

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R. R. is a 61-year-old male patient who presents with a chief complaint of fever and urinary symptoms. He was in his usual state of good health when for no apparent reason he developed pain in his back and perineal region, as well as fever and chills. He presents as septic. He had urinary hesitancy and decreased stream but now reports that he has not passed urine in more than 12 hours. Palpation of the lower abdomen is consistent with bladder distention. The AGACNP knows that which of the following is contraindicated in this circumstance?

  • A. Digital prostate examination
  • B. Urinary catheterization
  • C. Fluoroquinolone antibiotics
  • D. Drainage of prostate abscess
Correct Answer: D

Rationale: In a patient with suspected prostatic abscess and urinary retention, urinary catheterization is contraindicated due to the risk of spreading infection and causing potential complications such as septicemia or worsening of the abscess. The introduction of a catheter can disrupt the abscess capsule, leading to dissemination of the infection. Therefore, other methods of decompression and treatment should be considered, such as drainage of the abscess or other appropriate interventions guided by a healthcare provider.

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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.

The AGACNP is counseling a patient about various methods of tumor biopsy. Which of the following is not an accurate statement?

  • A. Incisional biopsy is preferred to excisional biopsy when possible
  • B. Core needle biopsy has a higher rate of false positive than does fine needle aspiration
  • C. Fine needle aspiration does not allow grading of tumors
  • D. Core needle and incisional biopsies are virtually identical in terms of false results
Correct Answer: C

Rationale: Typically, excisional biopsy is preferred over incisional biopsy whenever feasible because it provides a more accurate representation of the tumor since the entire mass is removed. This benefits both the patient (by potentially preventing the need for a second procedure) and the medical team (by ensuring a more comprehensive evaluation of the tumor). It is important to remove the entire lesion during excisional biopsy to make an accurate diagnosis. Incisional biopsy, on the other hand, involves taking only a portion of the tumor for examination, which may lead to potential sampling error and inadequate representation of the tumor.

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.

Postmaturity is pregnancy equal to or more than

  • A. 38 completed weeks
  • B. 42 completed weeks
  • C. 40 completed weeks
  • D. 36 completed weeks
Correct Answer: B

Rationale: Postmaturity refers to pregnancies that last beyond 42 weeks.

Janice is a 32-year-old female who presents for evaluation of abdominal pain. She has no significant medical or surgical history and denies any history of ulcers, reflux, or gastritis. However, she is now in significant pain and is afraid something is really wrong. She describes what started out as a dull discomfort in the upper part of her stomach a few hours ago but has now become more profound and centered on the right side just under her ribcage. She has not vomited but says she feels nauseous. Physical exam reveals normal vital signs except for a pulse of 117 bpm. She is clearly uncomfortable, and palpation of the abdomen reveals tenderness with deep palpation of the right upper quadrant. The AGACNP orders which imaging study to investigate the likely cause?

  • A. Abdominal radiographs
  • B. CT scan of the abdomen with contrast
  • C. Right upper quadrant ultrasound
  • D. A HIDA scan
Correct Answer: A

Rationale: Given Janice's presentation of significant abdominal pain localized to the right upper quadrant with tenderness on deep palpation, the most appropriate initial imaging study to investigate the likely cause is a right upper quadrant ultrasound. This imaging modality is commonly used to evaluate the liver, gallbladder, bile ducts, and adjacent structures. It can help identify common causes of right upper quadrant pain such as gallstones, cholecystitis, or biliary duct obstruction. The non-invasive nature of ultrasound and its ability to provide real-time imaging make it a valuable tool in the initial assessment of patients with abdominal pain. Depending on the findings of the ultrasound, further imaging studies or interventions may be pursued. Abdominal radiographs may not provide sufficient detail of the biliary system, while a CT scan with contrast or a HIDA scan may be reserved for further evaluation if needed based on the ultrasound findings.

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