Varneys Midwifery 6th Edition Test Bank

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When evaluating a patient with acute pancreatitis, which of the following physical or diagnostic findings is an ominous finding that indicates a seriously illpotentially moribund patient?

  • A. Severe epigastric pain with radiation to the back
  • B. Abdominal guarding and rigidity
  • C. Grey Turner sign
  • D. Obturator sign
Correct Answer: C

Rationale: The Grey Turner sign is characterized by bruising in the flanks and is a rare finding associated with acute pancreatitis. It indicates retroperitoneal bleeding and is considered an ominous finding that suggests a severe and potentially moribund state in patients with acute pancreatitis. The presence of the Grey Turner sign should prompt immediate intervention and close monitoring in a hospital setting. The other options, severe epigastric pain with radiation to the back, abdominal guarding and rigidity, and obturator sign, are indicative of pancreatitis but do not carry the same ominous implication as the Grey Turner sign.

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Which one of the following positions is SAFEST for a woman in labor with a cord prolapse?

  • A. Lithotomy
  • B. Trendelenburg
  • C. Fowler’s
  • D. Prone
Correct Answer: B

Rationale: The Trendelenburg position helps reduce pressure on the umbilical cord during prolapse.

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.

Match the conditions in column A with their correct description in column B

  • A. Torticollis
  • B. Damage to the sternomastoid muscles
  • C. Erb’s palsy
  • D. Damage to the upper brachial plexus
Correct Answer: A

Rationale: Torticollis is caused by damage to the sternomastoid muscles, while Erb’s palsy affects the upper brachial plexus.

R. S. is a 66-year-old female with Cushings syndrome due to an ACTH-producing pituitary tumor. The tumor is readily isolated by imaging, and the patient had an uneventful surgery. When seeing her in follow-up, the AGACNP anticipates

  • A. Rapid reversal of symptoms, with good pituitary function
  • B. Transient rebound release of remaining pituitary hormones
  • C. Markedly improved dexamethasone suppression test
  • D. Hyponatremia and compensatory SIADH
Correct Answer: A

Rationale: In patients with Cushing's syndrome due to an ACTH-producing pituitary tumor, removal of the tumor can result in a transient rebound release of remaining pituitary hormones. This occurs because the suppressed pituitary gland begins to recover and overproduce hormones in response to the sudden decrease in negative feedback from the removed tumor. As a result, patients may experience transient hormonal fluctuations before the pituitary gland establishes a new equilibrium. Therefore, when seeing the patient in follow-up after surgery, the AGACNP should anticipate a transient rebound release of remaining pituitary hormones rather than immediate and rapid reversal of symptoms or markedly improved test results. Additionally, hyponatremia and compensatory SIADH are less likely in this scenario unless there are other underlying factors contributing to it.

Mrs. Coates is a 65-year-old female who is on postoperative day 1 following a duodenal resection for a bleeding ulcer. She had an uneventful immediate postoperative course, but throughout the course of day 1 she has complained of a mild abdominal discomfort that has progressed throughout the day. This evening the AGACNP is called to the bedside to evaluate the patient for persistent and progressive discomfort. Likely causes of her symptoms include all of the following except

  • A. Colic due to return of peristalsis
  • B. Leakage from the duodenal stump
  • C. Gastric retention
  • D. Hemorrhage
Correct Answer: D

Rationale: In the scenario described, Mrs. Coates is a 65-year-old female who is on the first day postoperatively following a duodenal resection for a bleeding ulcer. Given her surgical history and the progression of her abdominal discomfort, the likely causes to consider are complications related to the surgery. Options B, C, and D are all potential postoperative complications following a duodenal resection:

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