ATI RN
Varneys Midwifery Test Bank Questions
Question 1 of 5
A definitive indication for elective caesarean section includes
Correct Answer: C
Rationale: A major degree of placenta praevia is a definitive indication for elective cesarean section.
Question 2 of 5
A client is declared fit for vaginal birth after cesarean section if
Correct Answer: D
Rationale: Vaginal birth after cesarean section is possible if the previous delivery was via spontaneous vertex delivery
Question 3 of 5
The AGACNP is receiving report from the recovery room on a patient who just had surgical resection for pheochromocytoma. He knows that which class of drugs should be available immediately to manage hypertensive crisis, a possible consequence of physical manipulation of the adrenal medulla?
Correct Answer: C
Rationale: Surgical manipulation of the adrenal medulla during resection of a pheochromocytoma can result in the release of catecholamines leading to a hypertensive crisis. Alpha-adrenergic antagonists, such as phenoxybenzamine or prazosin, are the drugs of choice for managing hypertensive crisis in this situation. These medications block the alpha-adrenergic receptors, leading to vasodilation and lowering of blood pressure. Beta-adrenergic antagonists are contraindicated in this scenario due to the risk of unopposed alpha-adrenergic stimulation that could worsen the hypertension. Intravenous vasodilators and arteriolar dilators may be used as adjunctive therapy but alpha-adrenergic antagonists are the primary agents for managing hypertensive crisis in this context.
Question 4 of 5
The AGACNP is treating a patient with ascites. After a regimen of 200 mg of spironolactone daily, the patient demonstrates a weight loss of 0.75 kgday. The best approach to this patients management is to
Correct Answer: B
Rationale: The best approach to managing the patient with ascites who has responded to spironolactone with weight loss is to add a loop diuretic to the current regimen. Spironolactone is an aldosterone antagonist that primarily works on the distal convoluted tubule, while loop diuretics, such as furosemide, act on the thick ascending limb of the loop of Henle. Combining these two diuretics can result in a synergistic effect, increasing diuresis and reducing fluid retention in patients with ascites. This combination therapy is often used in patients who do not respond adequately to spironolactone alone, and it is considered a common strategy in the management of ascites due to cirrhosis. Therefore, adding a loop diuretic to the spironolactone regimen is the most appropriate next step to optimize diuresis and fluid management in this patient.
Question 5 of 5
The AGACNP knows that which of the following must be evaluated as a cause of her abdominal pain?
Correct Answer: C
Rationale: Abdominal pain in pregnancy can be caused by various conditions, but spontaneous hepatic rupture is a rare but life-threatening cause that must be ruled out. Spontaneous hepatic rupture, also known as liver rupture, can occur in pregnancy, though it is extremely rare. It is associated with severe abdominal pain, hypovolemic shock, and can lead to significant maternal and fetal morbidity and mortality. Therefore, the AGACNP should evaluate this possibility when assessing a pregnant patient with abdominal pain to provide timely and appropriate management.HELLP syndrome, placental abruption, and preterm labor are important considerations in the differential diagnosis of abdominal pain in pregnancy but are not specific to the life-threatening nature of spontaneous hepatic rupture.