ATI RN
Varneys Midwifery Test Bank Questions
Question 1 of 5
Mechanism of labour in left Sacro-anterior position (breech):
Correct Answer: A
Rationale: In the left sacro-anterior position of breech presentation during labor, the correct sequence of the mechanism of labor is flexion, internal rotation, extension, and external rotation (Option A). This sequence is crucial for the successful delivery of the baby in breech presentation. Flexion allows the fetal head to descend through the maternal pelvis. Internal rotation helps the baby's head align with the maternal pelvis to facilitate passage. Extension allows the head to be born, followed by external rotation to deliver the shoulders and body. Option B (descent, engagement, flexion, internal rotation) is incorrect because engagement and descent typically occur earlier in the labor process, before the specific mechanism related to breech presentation. Option C (flexion, external rotation, descent, expulsion) is incorrect as it does not follow the typical mechanism seen in breech presentation. Option D (extension, flexion, engagement, delivery) is incorrect as the sequence is not in alignment with the specific requirements of breech presentation during labor. Understanding the mechanisms of labor in different presentations is essential for midwives and healthcare providers to provide safe and effective care during childbirth. By knowing the correct sequence, midwives can anticipate and manage potential complications that may arise during breech deliveries.
Question 2 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 3 of 5
Ms. Carpenter is a 28-year-old female who presents in significant pain she indicates that the discomfort is in the right lower quadrant. The discomfort is colicky in nature and has the patient in tears. Which of the following associated findings increases the index of suspicion for ureteral colic?
Correct Answer: A
Rationale: Hematuria (blood in the urine) is a common associated finding in ureteral colic. The presence of blood in the urine suggests that there may be damage or irritation to the urinary tract, typically caused by the passage of a kidney stone through the ureter. Along with the sharp, colicky pain in the right lower quadrant, the presence of hematuria significantly raises the suspicion for ureteral colic.
Question 4 of 5
The AGACNP knows that when evaluating a patient with suspected acute pyelonephritis, which of the following is not a common feature?
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.
Question 5 of 5
On postoperative day 7 following hepatic transplant, the patient evidences signs and symptoms of acute rejection, confirmed by histologic examination. The AGACNP knows that first-line treatment of acute rejection consists of
Correct Answer: D
Rationale: The first-line treatment for acute rejection following hepatic transplant is high-dose corticosteroids, such as methylprednisolone. This is because corticosteroids have potent anti-inflammatory and immunosuppressive effects that can help suppress the immune response causing rejection. Cyclosporine, azathioprine, and sirolimus are also commonly used immunosuppressive medications in transplant patients, but in this case of acute rejection, the immediate treatment of choice is methylprednisolone.