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178 Cards in this Set
- Front
- Back
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Which of the following is the largest diameter of the fetal head? 1) biparietal 2) occipitofrontal 3) suboccipitobregmatic 4) occipitomental |
4) occipitomental |
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During pelvimetry, a primigravida is found to have a diagonal conjugate of 10 cm. Based on this information, the midwife would expect her labor to be: 1) within normal length of time for a primigravida 2) prolonged, with slow fetal descent after +2 (plus two) station 3) prolonged, with failure of the head to engage 4) normal in first stage, with prolonged pushing in second stage |
3) Prolonged, with failure of the head to engage *Diagonal conjugate should be at least 11.5 cm |
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The average heart beat range for a full-term, quiet and awake newborn is |
120 - 140 BPM |
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Difficulty in voiding after childbirth may be due to all the following factors, except: 1) decreased sensitivity of the bladder 2) lack of fluid intake during labor 3) relaxation of the abdominal wall 4) compression of the urethra |
4) compression of the urethra |
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The clinical manifestations of mastitis include: 1) hard, warm nodular areas in the outer quadrant of the breast 2) cessation or diminishing of milk production 3) marked engorgement and pain 4) soft, pliable breasts with a bluish tinged line running up the breast |
1) hard, warm nodular areas in the outer quadrant of the breast |
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All of the following birth defects could be detected by genetic screening, except: 1) autosomal abnormalities 2) neural tube defects 3) thalassemia 4) alpha fetoprotein |
4) alpha fetoprotein |
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The difference between a disinfectant and an antiseptic is that: 1) a disinfectant is used on lifeless objects only, while an antiseptic is used on the skin's surface 2) a disinfectant kills bacterial spores, while an antiseptic does not 3) a disinfectant does not achieve sterilization and an antiseptic does 4) disinfectants are chemical substances, while antiseptics are not |
1) a disinfectant is used on lifeless objects only, while an antiseptic is used on the skin's surface |
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Immediately following fertilization, the fertilized egg is called a: 1) morula 2) zygote 3) embryo 4) blastocyst |
2) zygote |
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A typical human gestation from conception is: 1) 280 days 2) 365 days 3) 266 days 4) 300 days |
266 days |
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All of the following are contraindications to labor induction, except: 1) invasive cervical carcinoma 2) unexplained vaginal bleeding 3) low-lying placenta 4) active genital herpes infection |
3) low-lying placenta |
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Contractions that are a sign of active labor will: 1) mainly be felt in the front 2) decrease when walking 3) increase when walking 4) be irregular |
3) increase when walking |
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The following are true about the fetal skull except: 1) the anterior fontanel is triangular and bounded by the frontal bones and the parietal bones 2) the sagittal suture is the antero-posterior division between the parietal bones 3) the biparietal diameter is the largest transverse diameter of the head 4) the bitemporal is the greatest distance between the two temporal structures |
1) the anterior fontanel is triangular and bounded by the frontal bones and the parietal bones |
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Which of the following is associated with the android pelvis? 1) oval shaped inlet 2) narrow pubic arch 3) excellent labor patterns 4) a well curved sacrum |
2) narrow pubic arch |
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The relation of the fetal head to its trunk is: 1) flexion 2) attitude 3) presentation 4) posture |
2) attitude |
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In this type of breech, the bottom comes first, with the legs flexed at the hip and extended at the knees (with feet near the ears): 1) complete 2) frank 3) footling 4) kneeling |
2) frank |
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Which one of the following is a sign of placental separation? 1) contractions every 2 minutes 2) cord is still pulsing 3) cord does not retract when pressing above the pubic bone 4) cord retracts when pressing above the pubic bone |
3) cord does not retract when pressing above the pubic bone |
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When performing an emergency episiotomy, the midwife must cut: 1) only after administering a local anesthetic 2) slowly, with several small snips 3) between contractions, as head descends 4) during a contraction as head crowns |
4) during a contraction as head crowns |
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Shock patients will often complain of: 1) headaches 2) thirst 3) feeling hot 4) itchiness |
2) thirst |
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Women in shock after blood loss following childbirth will often: 1) want to sit up and eat 2) feel hot and feverish 3) feel a surge of energy right before passing out 4) feel cool and clammy |
4) feel cool and clammy |
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Which of the following is a probable sign of pregnancy: 1) Goodell's sign 2) FHT with doppler 3) amenorrhea 4) mother reporting fetal kicks at 16 weeks |
1) Goodell's sign |
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The chorion layer of the amniotic sac: 1) directly encircles the fetus 2) directly encircles the amniotic fluid 3) directly encircles the amnion layer of the amniotic sac 4) directly encircles the uterus |
3) directly encircles the amnion layer of the amniotic sac |
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Profuse bleeding from the uterus, especially between periods, is called: 1) metrorrhagia 2) amenorrhea 3) dysmenorrhea 4) toxic shock syndrome |
1) metrorrhagia |
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What is the normal range for respirations in an adult? 1) 10-15 2) 12-20 3) 60-80 4) 80-90 |
2) 12-20 |
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Which of the following is NOT an effect of cold stress on the newborn? 1) metabolic acidosis 2) pulmonary vasoconstriction 3) hypoglycemia 4) respiratory alkalosis |
4) respiratory alkalosis (Increased respiration elevates the blood pH beyond the normal range. Can be caused by hyperthermia) |
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What is the most frequent reason for seizures in the neonatal period? 1) side effects of maternal medication/drug use 2) hypoglycemia 3) hyperkalemia 4) hypoxic-ischemic encephalopathy |
4) hypoxic-ischemic encephalopathy Brain injury caused by oxygen deprivation to the brain, also commonly known as intrapartum asphyxia. |
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Using the 5 digit Para system, what does 2 2 0 3 1 signify? 1) 2 term, 2 abortions, 0 preterm, 3 living children, 1 miscarriage 2) 2 term, 2 preterm, 0 abortions, 3 living children, 1 multiple birth 3) 2 term, 2 preterm, 0 abortions, 3 living children, 1 miscarriage 4) 2 preterm, 2 abortions, 0 term, 3 living children, 1 multiple birth |
2) 2 term, 2 preterm, 0 abortions, 3 living children, 1 multiple birth
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The basic shape of the anthropoid pelvis is: 1) round 2) transverse oval 3) anterior/posterior oval 4) heart |
3) anterior/posterior oval |
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The basic shape of the android pelvis is: 1) round 2) transverse oval 3) anterior/posterior oval 4) heart |
4) heart |
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The pubic arch of the platypelloid pelvis is: 1) >90 degrees 2) <90 degrees 3) = 90 degrees 4) a narrow arch |
1) >90 degrees |
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The heart begins beating in the embryo during which week (from conception)? 1) 2 weeks 2) 6 weeks 3) 1 week 4) 4 weeks |
4) 4 weeks |
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Normal adult blood pressure for a pregnant woman is: 1) 90/60 - 130/70 2) 90/50 - 140/90 3) 70/40 - 160/75 4) 50/90 - 120/80 |
2) 90/50 - 140/90 |
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A woman suffering from eclampsia may experience: 1) diuresis 2) oliguria 3) hypotension 4) diabetes |
2) oliguria |
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If discovered during a prenatal exam, all of the following would necessitate a physician consult, except: 1) infection 2) lack of FHT 3) severe anemia 4) dyspareunia |
4) dyspareunia (Painful sex) |
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A rubella titer of <1:10 indicates: 1) immunity 2) non-immunity 3) need for an immunization 4) infection |
2) non-immunity |
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Risk of Respiratory Distress Syndrome (RDS) is slight whenever the concentration of lecithin in amniotic fluid is at least how many times greater than sphingomyelin? 1) three times 2) four times 3) two times 4) ten times |
3) two times |
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In clinical pelvimetry, if the pelvis is adequate, the angle of the pubic arch should be at least: 1) 90 degrees 2) 70 degrees 3) 1 finger breadth 4) 5 finger breadths |
1) 90 degrees |
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During an abdominal examination of a woman at term, the midwife feels the cephalic prominence on the same side as the fetal parts. This is indicative of which of the following? 1) face presentation 2) vertex (occipital) presentation 3) transverse lie 4) ROA position |
2) vertex (occipital) presentation |
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The increased activity of the endometrial glands during the luteal phase of the female reproductive cycle is stimulated by: 1) progesterone 2) estrogen 3) oxytocin 4) prolactin |
1) progesterone
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Which neonatal assessment finding should the midwife report to a physician if she finds this while conducting a newborn exam at one hour after birth? 1) a positive blink reflex 2) a positive Ortolani's sign 3) a respiratory rate of 70 breaths per minute 4) a pulse of 170 beats per minute |
2) a positive Ortolani's sign (hip click) |
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In which portion of the fallopian tubes does fertilization normally occur? 1) the ampulla 2) the interstitial segment 3) the infundibulum 4) the isthmus |
1) the ampulla (the longest and widest portion of the fallopian (uterine) tube between the infundibulum and the isthmus of the tube) |
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Difficulty in voiding after childbirth may be due to all the following factors, except: 1) decreased sensitivity of the bladder 2) lack of fluid intake during labor 3) relaxation of the abdominal wall 4) compression of the urethra |
4) compression of the urethra |
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The clinical manifestations of mastitis include: 1) hard, warm nodular areas in the outer quadrant of the breast 2) cessation or diminishing of milk production 3) marked engorgement and pain 4) soft, pliable breasts with a bluish tinged line running up the breast |
1) hard, warm nodular areas in the outer quadrant of the breast |
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A woman reports she is having some slight vaginal bleeding and occasional mild cramps at 10 weeks from LMP. She is best characterized as having: 1) a threatened abortion 2) a missed abortion 3) an imminent abortion 4) an incomplete abortion |
1) a threatened abortion |
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Which is most descriptive of a cephalohematoma: 1) a subcutaneous collection of edematous fluid on the infant's head 2) blood vessels between the cranial bone and the periosteal layer rupture, leading to bleeding in the subperiosteal space 3) it typically disappears within 24 hours of birth 4) traction and rupture of paravaginal veins by the oncoming presenting part |
2) blood vessels between the cranial bone and the periosteal layer rupture, leading to bleeding in the subperiosteal space |
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Congenital syphilis may be contracted by the baby: 1) at birth 2) during the fifth month of pregnancy 3) during the first month of pregnancy 4) during breastfeeding |
2) during the fifth month of pregnancy |
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A positive direct Coombs test done on the cord blood indicates the presence of: 1) antibodies coating the baby's red blood cells 2) antigens coating the mother's red blood cells 3) fetal red blood cells in the maternal serum 4) maternal red blood cells in the fetal circulation |
1) antibodies coating the baby's red blood cells |
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On the first day postpartum, the fundus should be: 1) at the level of the symphysis pubis 2) at the level of the umbilicus 3) midway between the umbilicus and the symphysis pubis 4) 2 finger breadths below the umbilicus |
2) at the level of the umbilicus |
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Uterine involution occurs as a result of: 1) a decrease in the number of myometrial cells 2) necrosis of the hypertrophic myometrial cells 3) autolysis of protein material within the uterine wall 4) necrotic degeneration of the placental site |
3) autolysis of protein material within the uterine wall |
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A postpartum patient reports she feels very uncomfortable sitting and has a "full feeling down there". The midwife would suspect: 1) cystitis 2) a suture may have come undone 3) postpartum infection 4) vulvarhematoma |
4) vulvarhematoma |
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Station refers to what, in relation to the ischial spines? 1) the degree of descent of the presenting part 2) the degree of crowning of the head 3) the degree of engagement of the head 4) the degree of palpation of the presenting part |
1) the degree of descent of the presenting part |
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If a baby is delivering in face presentation, he must rotate to: 1) transverse position 2) oblique position 3) mentum posterior position 4) mentum anterior position |
4) mentum anterior position |
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Chadwick's sign is: 1) softening of the cervix 2) blue or purple coloration of the cervix and vulva 3) soft spot in the middle of the uterus 4) enlargement of the uterus |
2) blue or purple coloration of the cervix and vulva |
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A typical human gestation (from LMP) is how many days? 1) 280 2) 365 3) 266 4) 245 |
1) 280 |
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A rubella titer of >1:64 indicates: 1) infection 2) non-immunity 3) need for RhoGam 4) need for immunization |
1) infection |
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The ischial spines of the android pelvis are: 1) wider apart than any pelvic type 2) prominent 3) blunt 4) not easily felt |
2) prominent |
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Which of the following terms is used to describe an increase in the size of existing cells? 1) hypertrophy 2) hyperplasia 3) hypermeiosis 4) hypermetosis |
1) hypertrophy |
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During first stage of labor, a clinical sign of maternal distress is: 1) hypotension 2) tachycardia 3) bradycardia 4) respirations of 16 per minute |
2) tachycardia |
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All of the following are diseases commonly screened for in the newborn during metabolic screening, except: 1) homocystinuria 2) maple sugar urine 3) galactosemia 4) kernicterus |
4) kernicterus |
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If there is arterial bleeding, the blood will: 1) spurt in an arch 2) gush then stop right away 3) trickle bleed and be watery 4) be thick and deep red |
1) spurt in an arch |
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As blood pressure falls during clinical shock, the perfusion of vital organs falls with it; the best indication of whether the brain is being adequately perfused is the: 1) blood pressure 2) pulse 3) level of consciousness 4) respirations |
3) level of consciousness |
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In shock, a person's respirations: 1) rise 2) fall 3) stay the same 4) become strong and fast |
1) rise |
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How long after birth does complete regeneration of the endometrium at the placental site take? 1) 1 week 2) 2 weeks 3) 4 weeks 4) 6 weeks |
4) 6 weeks |
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The Curve of Carus is: 1) the curve formed by the sacrum, coccyx, and pubic bones 2) the curve of the fetal neck when the occiput is fully flexed 3) the curve formed by the sacrum and the ischial spines 4) the curve formed by the pubic arch |
1) the curve formed by the sacrum, coccyx, and pubic bones |
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One placenta divided into three parts, either completely separated or joined in part, but held together by one set of membranes is called a: 1) succenturiate 2) vasa previa 3) triplex 4) duplex |
3) triplex |
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The sagittal suture of the fetal head is felt midway between the symphysis pubis and the sacral promontory. This would indicate: 1) synclitism 2) asynclitism 3) deep transverse arrest 4) engagement |
1) synclitism |
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The posterior transverse suture is called the: 1) sagittal suture 2) lambdoidal suture 3) coronal 4) frontal |
2) lambdoidal suture |
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Failure of tissue perfusion caused by changes in the circulation that occur as a result of severe infection is called: 1) metabolic shock 2) septic shock 3) neurogenic shock 4) anaphylactic shock |
2) septic shock |
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If a baby has suffered from uteroplacental insufficiency, the midwife can expect to see a baby who is/has: 1) FAS 2) SGA 3) CNS damage 4) LGA |
2) SGA |
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A condition in the newborn that is commonly associated with polyhydramnios is: 1) LGA 2) RDS 3) urinary problems 4) FAS |
3) urinary problems |
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A newborn exhibits the following at 5 minutes: Heart rate of 110 bpmSlow, irregular breathing with grunting and retractionsSome flexion of the extremitiesA grimace in response to stimulusSome cyanosis of the oral area, trunk, and extremities What is the 5 minute Apgar score for this infant? |
6 |
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In shock, a person's blood pressure typically: 1) rises for a short time then falls 2) falls but then rises again 3) stays the same 4) rises to 140/90 and stays there |
1) rises for a short time then falls |
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In shock, a person's pulse: 1) rises 2) falls 3) stays the same 4) falls to 50 and stays there |
1) rises |
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Betty is having her 6th baby at home. She has a history of fast labors. The midwife has just checked her and she is 10 cm. With the next contraction the waters break with great force and the cord falls down. She immediately tells the midwife that she has to push. What does the midwife do first? 1) give her shepherds purse to maximize oxygenation 2) encourage her to push hard and get the baby out fast 3) put her in knee and chest position 4) slow the birth down by pressing on her perineum so that she does not tear |
2) encourage her to push hard and get the baby out fast |
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Which of the following women is most likely to suffer from mastitis? 1) a breastfeeding woman in the first 7 days postpartum 2) a breastfeeding woman more than a week postpartum 3) a non-breastfeeding woman in the first 7 days postpartum 4) a non-breastfeeding woman more than a week postpartum |
2) a breastfeeding woman more than a week postpartum |
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The risks to a fetus of a woman who is not immune to rubella include: 1) gastrointestinal malformations 2) reproductive abnormalities, hypoglycemia, and learning disabilities 3) deafness, heart defects, cataracts, and cognitive disabilities 4) lung tissue immaturity, limb malformation, failure to thrive |
3) deafness, heart defects, cataracts, and cognitive disabilities |
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Testing an Rh-negative mother for antibodies determines: 1) the presence of immunoglobins in the blood of the mother who is Rh-negativeSubmitted answer 2) sensitization of the Rh-negative mother with Rh+positive antibodies, indicating the potential for increased risk to the fetus 3) the ability of the fetus to withstand the increased stress of maternal antibodies in an immunocompromised state 4) the presence of Rh-negative antibodies in an Rh-negative fetus |
2) sensitization of the Rh-negative mother with Rh+positive antibodies, indicating the potential for increased risk to the fetus |
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Which of the following is a late sign of severe pre-eclampsia? 1) ankle edema 2) headaches and visual disturbances 3) skin that bruises easily 4) blood pressure of 140/90 |
2) headaches and visual disturbances |
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Sexually transmitted diseases are: 1) always treatable with antibiotics 2) more easily diagnosed and treated in men than women 3) more easily diagnosed and treated in women than men 4) easily caught from public restroom surfaces like toilet seats |
2) more easily diagnosed and treated in men than women |
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The virus involved in genital warts is: 1) genital herpes 2) herpangina 3) human papilloma 4) human immunodeficiency |
3) human papilloma |
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Meisha, a G1P0, has been in hard labor for 24 hours and has reached 7 cm. The midwife notices a horizontal indented line beginning to appear across her abdomen. This is likely: 1) Bandl's ring 2) a full bladder 3) indication that the baby is posterior 4) this is a normal occurrence at 7 cm |
1) Bandl's ring |
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In newborns, an early sign of sepsis is: 1) hypothermia 2) hyperglycemia 3) jitteriness 4) crying |
1) hypothermia |
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Which hormone controls the proliferative phase of the menstrual cycle? 1) progesterone 2) lutinizing hormone 3) estrogen 4) hCG |
3) estrogen |
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Which of the following essential oils has been identified as helping to reduce blood pressure in pregnancy at term? 1) ylang ylang 2) peppermint 3) rosemary 4) thyme |
1) ylang ylang |
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Which pelvic diameter is considered normal? 1) a bituberous diameter approximately 5 cm 2) an obstetric conjugate approximately 9 cm 3) interspinous diameter approximately 8 cm 4) diagonal conjugate approximately 11.5 cm |
4) diagonal conjugate approximately 11.5 cm |
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The cervical cap: 1) adheres to the cervix by suction 2) stays on only when spermacide is applied 3) should be inserted 6 hours before intercourse4) rests in the posterior fornix and against the back of the symphysis pubis |
1) adheres to the cervix by suction |
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Placenta percreta occurs when: 1) chorionic villi invade through the entire uterine wall to the serosa layer 2) chorionic villi extend further than the myometrium and penetrate the uterine wall 3) the placenta covers the entire uterus 4) the placenta delivers with both the fetal side and the maternal side presenting at once |
1) chorionic villi invade through the entire uterine wall to the serosa layer |
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Which of the following is false? 1) lochia rubra is bright red and lasts 2-3 days 2) lochia serosa is pink and lasts 2-3 weeks 3) lochia alba is white and begins approximately 10 days after birth 4) lochia that lasts past 4 weeks may mean the mother is overdoing activity |
2) lochia serosa is pink and lasts 2-3 weeks |
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How often do miscarriages occur after pregnancy has been clinically diagnosed? 1) 1 in 2 2) 1 in 10 3) 1 in 50 4) 1 in 100 |
2) 1 in 10 |
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In the female reproductive system, which of the following secretes progesterone? 1) the pituitary gland 2) the corpus luteum 3) the graafian follicles 4) the fallopian tubes |
2) the corpus luteum |
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Which is more common in women of child-bearing age? 1) urethral diverticula 2) periurethral cysts 3) testicular epidermoid cyst 4) ovarian cyst |
4) ovarian cyst |
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Which of the following is not usually felt while doing pelvimetry, and if it is felt, it could indicate a too narrow inlet: 1) diagonal conjugate 2) ischial spines 3) coccyx 4) sacral curve |
1) diagonal conjugate |
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Developmental milestones the newborn should reach in the first six weeks include all of the following, except: 1) attentiveness to a face 2) lifting the head higher than 45 degrees 3) spontaneous and responsive smiling 4) spontaneous vocalizations |
2) lifting the head higher than 45 degrees |
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The chorion is: 1) a thick membrane that develops from the trophoblast 2) a thin protective membrane containing amniotic fluid 3) the endometrium after implantation 4) the second cavity of the blastocyst |
1) a thick membrane that develops from the trophoblast |
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The sexual differentiation process does not occur in the fetus until the: 1) 1st lunar month 2) 2nd lunar month 3) 3rd lunar month 4) 4th lunar month |
2) 2nd lunar month |
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A fetus weighing about 300 grams and measuring 18 cm in length that can actively suck and swallow amniotic fluid is approximately how many weeks gestation? 1) 14 weeks 2) 16 weeks 3) 20 weeks 4) 28 weeks |
3) 20 weeks |
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At one minute after birth, baby Jane is floppy, her extremities are blue, she is breathing shallowly, and her heart rate is 110. Response to stimulus is minimal. Her one minute APGAR would be: 1) 3 2) 4 3) 5 4) 6 |
3) 5 |
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The following is true about postpartum complications leading to death: 1) puerperal morbidity refers to postpartum complications leading to death 2) a nosocomial infection is caused by the birth environment or the care provider 3) endometritis is caused by uterine lining outside of the uterus 4) maternal mortality rate refers to deaths attributed to complications of pregnancy per 1,000 women |
2) a nosocomial infection is caused by the birth environment or the care provider |
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A woman is 6 months postpartum and complains of incontinence. All of the following should be ruled out, except: 1) stress incontinence 2) urge incontinence 3) rectocele, urethrocele, cystocele, etc 4) vaginal prolapse |
4) vaginal prolapse |
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Square window, popliteal angle, and scarf sign are all tests that refer to: 1) physical maturity 2) the newborn exam 3) neurological maturity 4) psychological maturity |
3) neurological maturity |
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Which of the following placental anomalies would the midwife most expect to find in the placenta of a woman with severe chronic hypertension? 1) placental tissue that is pale and yellowish-gray 2) edema of the placenta 3) placental cysts 4) extensive infarction of entire cotyledons |
4) extensive infarction of entire cotyledons |
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Developing follicles and the graafian follicle are found in the: 1) medulla of the ovaries 2) cortex of the ovaries 3) infundibulum 4) mesovarium ligament |
2) cortex of the ovaries |
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Which principle factors cause the vaginal pH to be acidic? 1) cervical mucus changes 2) secretions from the Skene's gland 3) action of Doderlein's bacillus 4) secretions from Bartholin's gland |
3) action of Doderlein's bacillus |
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The fetus receives oxygenated blood through the: 1) ductus arteriosus 2) foramen ovale 3) mother's arteries 4) umbilical vein |
4) umbilical vein |
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Ovulation occurs: 1) at the time of menstruation 2) approximately 14 days after the onset of menstruation 3) approximately 14 days before the onset of menstruation 4) somewhere around 28 days after the last menstruation |
3) approximately 14 days before the onset of menstruation |
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The most diagnostic feature of eclampsia is: 1) hypertension 2) edema 3) visual disturbances 4) convulsions |
4) convulsions |
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How many chromosomes are there in the human cell? 1) 4 2) 12 3) 23 4) 46 |
4) 46 |
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Megaloblastic anemia is primarily due to which of the following: 1) a lack of vitamin C and D in the diet 2) blood loss or fluid loss from the cells 3) deficiency in folic acid or vitamin B12 malabsorption 4) metabolic changes of pregnancy |
3) deficiency in folic acid or vitamin B12 malabsorption |
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What is the ultimate aim of prenatal counseling? 1) to help direct the mother in the most responsible choice 2) to elicit cooperation 3) to engage midwife and client trust 4) to be open and share beliefs and ideas about birth and mothering |
1) to help direct the mother in the most responsible choice |
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Which term refers to the thick folds of membranous stratified epithelium on the internal vaginal wall, capable of stretching during the birth process to accommodate delivery of the baby? 1) external os 2) fornices 3) dartos muliebris 4) rugae |
4) rugae |
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Which portion of the fallopian tube is the site of sterilization? 1) the infundibulum 2) the ampulla 3) the interstitial segment 4) the isthmus |
4) the isthmus |
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Case Study: Beth, a 33 year old G4P3 at 26 weeks gestational age, was in a car accident in which she sustained significant blood loss. She is in stable condition now. Her laboratory results reveal the following: Hemoglobin 9 ml/dl; elevated reticulocyte count; and a mean corpuscular volume of 86. These results suggest which of the following: 1) macrocytic anemia 2) microcytic anemia 3) normocytic anemia 4) hemolytic anemia |
3) normocytic anemia |
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Repeating a client's words when the midwife is gathering information for her health history is known as: 1) feedback 2) empathetic response 3) confrontation 4) reflection |
4) reflection |
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If a pregnant woman has been diagnosed with gestational diabetes but is within the normal BMI (her weight is within the ideal range for her height), what are the percentage odds of her developing diabetes mellitus sometime in the future? 1) 0% 2) 5% 3) 25% 4) 60% |
3) 25% |
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The physiologic effects of estrogen do not include: 1) development of secondary sex characteristics2) prevention of uterine motility during pregnancy 3) myometrial thickening 4) maturation of ovarian follicles |
2) prevention of uterine motility during pregnancy |
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Which hormone is responsible for the production of the clear, elastic cervical mucus associated with spinnbarkeit and ferning? 1) progesterone 2) prostaglandin 3) estrogen 4) FSH |
3) estrogen |
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Which procedure allows for examination of the amniotic fluid through the intact membranes? 1) amniocentesis 2) amnioscopy 3) amniotomy 4) fetoscopy |
2) amnioscopy |
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Which fetal blood vessel carries blood with the highest oxygen content in utero? 1) umbilical vein 2) umbilical artery 3) fetal capillaries 4) pulmonary artery |
1) umbilical vein |
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Case Study: Kim, Hispanic, age 25, comes for an initial visit. She has missed two menstrual periods; her last period was October 30th. Her obstetric history reveals one elective abortion and the birth of a son 4 years ago at 39 weeks gestation. Her present pregnancy has been confirmed. Her husband accompanies her. Based on the above history, the midwife should classify Kim as: 1) gravida 2 para 1101 2) gravida 2 para 1011 3) gravida 3 para 0111 4) gravida 3 para 1011 |
4) gravida 3 para 1011 |
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Continuation of Case Study: Kim, Hispanic, age 25, comes for an initial visit. She has missed two menstrual periods; her last period was October 30th. Her obstetric history reveals one elective abortion and the birth of a son 4 years ago at 39 weeks gestation. Her present pregnancy has been confirmed. Her husband accompanies her. Which assessment finding noted during the exam would best support the diagnosis of pregnancy? 1) ballottement of the uterus 2) abdominal enlargement 3) bluish discoloration of the vaginal discharge 4) softening of the lower uterine segment |
4) softening of the lower uterine segment |
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A pregnant woman drinks 1 quart of milk daily, which supplies her with large amounts of: 1) vitamin B12 and niacin 2) folic acid and thiamine 3) riboflavin and vitamin A 4) vitamin C and complete protein |
3) riboflavin and vitamin A |
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A client tells the midwife that she experiences intermittent nosebleeds. Which normal physiologic change of pregnancy is probably responsible? 1) elevated hCG level 2) hyperemia of the nasal mucous membranes 3) vascular congestion of nasal turbinates from tissue edema 4) elevated blood pressure |
2) hyperemia of the nasal mucous membranes |
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The midwife diagnoses slight megaloblastic anemia from folic acid deficiency during a routine prenatal checkup at 25 weeks gestation. The midwife would recommend that the woman eat more: 1) fish, cheese, and eggs 2) green, leafy vegetables 3) milk and milk products 4) citrus fruits |
2) green, leafy vegetables |
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Case Study: Abby, a 26 year old mother of 5 year old twin sons, is making her initial visit to the prenatal clinic. Her obstetric history reveals the birth of a stillborn infant in the 38th week of gestation and the birth of her twins in the 35th week of gestation. She is currently 16 weeks gestation. Based on Abby's obstetric history, the midwife should classify her as: 1) gravida 2 para 1102 2) gravida 3 para 1201 3) gravida 3 para 1102 4) gravida 4 para 1202 |
3) gravida 3 para 1102 |
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The midwife is caring for a pregnant woman whose blood is Rh-negative. The midwife would discuss administration of RhoGAM at the 28th week of gestation if the woman had a: 1) negative direct Coombs test result 2) negative indirect Coombs test result 3) positive direct Coombs test result 4) positive indirect Coombs test result |
2) negative indirect Coombs test result |
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While listening to fetal heart tones, the midwife counts 130 and detects a synchronous whistling sound. These findings indicate: 1) uterine soufflé 2) funic soufflé 3) fetal bradycardia 4) fetal tachycardia |
2) funic soufflé |
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Magnesium sulfate is administered primarily to: 1) increase the central nervous system's response to stimuli 2) decrease neuromuscular irritability 3) increase calcium reabsorption by the muscles4) reduce peripheral vascular resistance and lower the blood pressure |
2) decrease neuromuscular irritability |
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The midwife should be aware of clinical manifestations of magnesium sulfate toxicity, which include: 1) headache, blurred vision, and 3+ proteinuria 2) respiratory depression and loss of deep tendon reflexes 3) flushing and sweating 4) ringing in the ears and a metallic taste in the mouth |
2) respiratory depression and loss of deep tendon reflexes |
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Disseminated intravascular coagulation (DIC) is a possible complication of abruptio placenta. Which assessment finding would indicate that a woman is developing DIC? 1) bleeding of the nose and gums 2) rapid clotting at the site of the IV stick 3) joint pain 4) increased pain and anxiety |
1) bleeding of the nose and gums |
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Darla comes to the midwife complaining of painful and "itchy" bumps on her vagina. Upon examination the midwife notes a half dozen vesicles on her labia minora and majora. Darla states that she has had a fever and general malaise for about 5 days. She has some inguinal lymphadenopathy. Which of the following is the most likely cause of these findings? 1) secondary syphilis 2) herpes simplex virus 3) human papillomavirus 4) bartholin's cysts |
2) herpes simplex virus |
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Which of the following changes in cervical mucus signals the "peak day" in the menstrual cycle during which ovulation is most likely to occur? 1) the first day during which the cm is thick, sticky, and tacky 2) the first day in which the cm is clear, slippery, and stretchy 3) the last day during which the cm is thick, sticky, and tacky 4) the last day during which the cm is clear, slippery, and stretchy |
4) the last day during which the cervical mucus is clear, slippery, and stretchy |
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If a fetus suffers from malnutrition in the womb during the time of development when cells are increasing in number, then the damage suffered by the fetus is best characterized as which of the following? 1) irreversible 2) reversible 3) asymmetric 4) catabolic |
1) irreversible |
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Which of the following increases absorption of nonheme iron? 1) milk 2) tea 3) meat 4) egg whites |
3) meat |
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The baseline FHT for a fetus which is developing normally usually is:
1) 100 to 120 beats/minute and irregular 2) 120 to 160 beats/minute and irregular 3) 120 to 160 beats/minute and regular 4) 140 to 180 beats/minute and regular |
2) 120 to 160 beats/minute and irregular |
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Robin is a G1P0 who has been in labor for 20 hours. Her water broke 5 hours ago. She suddenly complains of chest pain and has pink, frothy sputum and diaphoresis. These may be early signs of: 1) HELLP syndrome 2) amniotic fluid embolism 3) disseminated intravascular coagulation (DIC) 4) pneumonia |
2) amniotic fluid embolism |
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As the midwife examines a woman's vagina and perineum during the fourth stage of labor, she notices that the woman has a laceration that involves the vaginal mucosa, posterior fourchette, perineal skin, perineal muscles, and the external anal sphincter. This laceration is classified as which of the following: 1) a first degree laceration 2) a second degree laceration 3) a third degree laceration 4) a fourth degree laceration |
3) a third degree laceration |
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When is the mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) most likely to occur? 1) in the first 20 weeks of pregnancy 2) in the third trimester 3) during labor and delivery 4) during breastfeeding |
3) during labor and delivery |
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Theresa, a gravida 1, is admitted to the birth center in labor. She complains of abdominal pain that seems to "come and go" and states that her water may have broken on the way to the birth center. Which procedure would best determine if Theresa has SROM? 1) a CBC 2) a fern test 3) urinalysis 4) a vaginal examination |
2) a fern test |
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Which of the following best describes the cervix of the average multigravida on the verge of true labor? 1) 50% to 100% effaced with a fingertip to 1 centimeter dilation 2) 50% to 100% effaced with 2 to 3 centimeters dilation 3) little or no effacement with a fingertip to 1 centimeter dilation 4) little or no effacement with 1 to 2 centimeter or more dilation |
4) little or no effacement with 1 to 2 centimeter or more dilation |
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June calls the midwife to her home in the late morning after laboring alone all night. The midwife determines that June's amniotic membranes ruptured several hours ago. Which action would be the midwife's priority in caring for June? 1) increasing her fluid intake 2) monitoring her fluid intake and output 3) cleaning her perineal area often during labor 4) monitoring her temperature every 2 hours |
4) monitoring her temperature every 2 hours |
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Listening through a contraction with the doppler, the midwife notes that a FHT deceleration occurs during the increment of the contraction, reaches its lowest point at the acme of the contraction, and returns to baseline during decrement of the contraction. This type of deceleration indicates: 1) fetal distress 2) uteroplacental insufficiency 3) fetal vagal nerve stimulation 4) umbilical cord compression |
3) fetal vagal nerve stimulation |
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Cecille is panting with contractions and complains of tingling and numbness in her hands and feet. Which action would best alleviate Cecille's complaints? 1) administering 4 liters oxygen by face mask 2) telling her to breath deeply from her stomach 3) telling her to exhale into her cupped hands and then re-inhale 4) having her exhale into a paper bag then breath in room air |
3) telling her to exhale into her cupped hands and then re-inhale |
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Which breathing pattern should the midwife suggest for use during early second stage? 1) slow panting 2) fast panting 3) breath holding for no more than 5 seconds while pushing with open glottis 4) breath held pushes while a coach counts to 10, pushing with closed glottis |
3) breath holding for no more than 5 seconds while pushing with open glottis |
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Pregnant women often experience muscle cramps in one or both legs. These cramps may be the result of: 1) physiological hemodilution 2) pressure on the lumbosacral nerve plexus 3) pressure on the pudendal nerve 4) calcium-potassium imbalance |
2) pressure on the lumbosacral nerve plexus |
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Frieda is a gravida 1 para 0 who has been in labor for 4 hours without any progress. Initial assessment reveals dilation of 2 cm, 100% effacement, -1 station, contractions intensely painful occurring every 2-3 minutes lasting 70 seconds, membranes intact, and FHT of 166. Maternal vital signs include blood pressure of 120/60, temperature 98.6, pulse rate of 94, and respiratory rate of 24. Which contraction pattern is indicated by the above assessment findings? 1) normal 2) hypotonic 3) hypertonic 4) tetanic |
3) hypertonic |
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Frieda is a gravida 1 para 0 who has been in labor for 4 hours without any progress. Initial assessment reveals dilation of 2 cm, 100% effacement, -1 station, contractions intensely painful occurring every 2-3 minutes lasting 70 seconds, membranes intact, and FHT of 166. Maternal vital signs include blood pressure of 120/60, temperature 98.6, pulse rate of 94, and respiratory rate of 24. Frieda states she feels constipated and bloated; which action would be appropriate? 1) administer 2 fleet enemas with her lying on her side2 2) offer her a full soapy enema with a bag and tubing 3) offer her fruit juices to drink along with a high fiber snack 4) give her nothing-by-mouth because she is high risk to have a cesarean |
3) offer her fruit juices to drink along with a high fiber snack |
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The first step in preventing preterm labor is: 1) remembering the causative factors 2) risk assessment and patient teaching 3) early management with tocolytic agents 4) cervical cerclage at 28 weeks gestation |
2) risk assessment and patient teaching |
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Breastmilk is produced in the: 1) alveoli 2) fatty tissue 3) lymphatic system 4) areola |
1) alveoli |
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Which hormone stimulates the let down reflex during breastfeeding? 1) prolactin 2) estrogen 3) progesterone 4) oxytocin |
4) oxytocin |
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Compared with mature breastmilk, colostrum contains: 1) less fat and carbohydrates 2) less protein and minerals 3) less immunoglobins 4) the same amount of nutrients |
1) less fat and carbohydrates |
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What is the most common cause of uterine rupture? 1) separation of a previous cesarean section scar 2) congenital anomalies of the uterus 3) labor stimulation/augmentation with oxytocin or prostaglandins 4) external cephalic version |
1) separation of a previous cesarean section scar |
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Which of the following findings would be considered abnormal in a newborn at approximately 1 1/2 hours following birth? 1) a state of deep sleep 2) a light murmur audible on auscultation 3) absence of bowel sounds 4) a heart rate of 108 BPM |
3) absence of bowel sounds |
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On a vaginal exam of a breech presentation, the midwife feels the sacrum in the left, transverse portion of the maternal pelvis. Which of the following is used to describe this fetus' variety and position? 1) LOT 2) LST 3) frank LOT 4) frank LST |
2) LST |
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Which of the following best describes the trigger that causes milk ejection from the breast? 1) fall in progesterone and estrogen levels 2) increase in human placental lactogen (HPL) 3) suppression of oxytocin release 4) sucking by the newborn |
4) sucking by the newborn |
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A newborn with gastroschisis is most at risk for which of the following complications? 1) hyperthermia 2) seizures 3) hyperglycemia 4) dehydration |
4) dehydration |
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Which assessment finding is most indicative of postpartum infection? 1) elevated body temperature 2) increased pulse rate 3) a white blood cell count of 25,000 4) foul smelling lochia |
4) foul smelling lochia |
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At the one week checkup, Kendra tells the midwife she cannot breastfeed because she is returning to work. She asks when her periods will return. The midwife states correctly that the non-breastfeeding woman typically resumes menstruating in about: 1) 4-6 weeks 2) 8-12 weeks 3) 3-6 months 4) 4-8 months |
2) 8-12 weeks |
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Breastmilk, while feeding a term infant who is two weeks old, typically looks: 1) yellow and thick 2) bluish white and thin 3) pinkish white and thick 4) yellow and thin |
2) bluish white and thin |
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In which days surrounding childbirth is it most likely that maternal varicella infection will be passed to the newborn? 1) day 10 before birth to day 5 following birth 2) day 2 before birth to day 6 following birth 3) day 6 before birth to day 2 following birth 4) day 5 before birth to day 10 following birth |
3) day 6 before birth to day 2 following birth |
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Gabriela is a 22 year old gravida 1 para 1001 who complains of frequent, urgent and painful urination two days after delivery. Her temperature is 101.4 F, she has suprapubic tenderness and moderate lochia rubra. Lab results reveal a urinary tract infection. The midwife knows the Gabriela may be predisposed to such infections because of: 1) her gravity 2) trauma to the trigone of the bladder 3) her parity 4) weakness of the urethral sphincter |
2) trauma to the trigone of the bladder |
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Case Study: Karen is a 35 year old, gravida 5, para 4010 who complains of severe pain and edema of her right leg and thigh on the second day after delivery. A physician consult confirms the diagnosis of femoral thrombophlebitis and the doctor admits Karen to the hospital and orders 5,000 units of heparin every 12 hours. The physician has prescribed heparin for Karen to: 1) increase the amount of active plasmin in the blood 2) cause the total lysis of the clot 3) prevent additional thrombus formation 4) decrease the risk of developing DIC |
3) prevent additional thrombus formation |
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Karen is a 35 year old, gravida 5, para 4010, who complains of severe pain and edema of her right leg and thigh on the second day after delivery. Additional therapy for Karen, which the midwife can help with, should include: 1) encouraging walking and exercise of the affected leg 2) maintaining Karen on strict bed rest, monitoring pedal pulses and applying moist heat to the affected area 3) massaging the affected area frequently and applying moist heat 4) maintaining Karen on strict bedrest and applying ice packs to the affected area |
2) maintaining Karen on strict bed rest, monitoring pedal pulses and applying moist heat to the affected area |
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Which of the following is the most reliable way to detect abnormal or periodic fetal heart rate changes or patterns when using a fetoscope or doppler? 1) counting the fetal heart rate over the course of 1 minute through a contraction 2) counting the fetal heart rate for 15 seconds and multiplying by 4 3) counting the fetal heart rate twice for 30 seconds, once during a contraction and once between a contraction 4) counting the fetal heart rate in 5-second increments allowing a 5-second break between the period of counting during a contraction |
4) counting the fetal heart rate in 5-second increments allowing a 5-second break between the period of counting during a contraction
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June is a 20 year old gravida 1, para 0101 who came late for prenatal care. On the day she delivers in the birth center, the midwife gets her lab work back and it shows she is HIV positive. June sees a doctor and begins to receive an antiretroviral. Which effect is not associated with this therapy? 1) prevention of viral replication 2) delayed development of acquired immune deficiency syndrome 3) stimulation of bone marrow activity 4) production of increased numbers of CD4 T cells |
3) stimulation of bone marrow activity
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June is a 20 year old gravida 1, para 0101 who came late for prenatal care. On the day she delivers in the birth center, the midwife gets her lab work back and it shows she is HIV positive. June initially bottle feeds, but at 3 days she says her milk has come in and she wants to breastfeed. The midwife should inform her that: 1) she can breastfeed because HIV is not transmitted in breastmilk 2) she must first give the baby an antibody titer to determine if she can breastfeed 3) HIV is more readily transmitted to the newborn when breastmilk and formula are mixed fed 4) new mothers are always encouraged to breastfeed their babies, and she can start now |
3) HIV is more readily transmitted to the newborn when breastmilk and formula are mixed fed
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Which organism is the most common cause of mastitis? Submitted answer 1) Staphylococcus aureus 2) Escherichia coli 3) Beta-hemolytic streptococcus 4) Methicillin-resistant staphylococcus aureas |
1) Staphylococcus aureus
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Absence of the moro reflex in a newborn could mean any of these things, except: 1) damage to the central nervous system 2) damage to the brachial plexus 3) a fractured pelvis 4) Potter's Syndrome |
4) Potter's Syndrome
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A neonate with respiratory distress syndrome typically shows definitive signs and symptoms within how many hours after delivery? Submitted answer 1) 4 hours 2) 8 hours 3) 12 hours 4) 24 hours |
1) 4 hours
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Unequal bilateral femoral pulses in a neonate typically indicates: 1) congenital hip dislocation 2) ventricular septal defect 3) patent ductus arteriosus 4) coarctation of the aorta |
4) coarctation of the aorta
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Which is the most reliable early indicator of neonatal infection? 1) an elevated temperature 2) a change in feeding pattern 3) a palpable liver 4) excessive mucus |
2) a change in feeding pattern
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In a neonate with erythroblastosis fetalis, the disease is known to result from: 1) maternal drug use 2) prematurity 3) destruction of red blood cells 4) gestational diabetes |
3) destruction of red blood cells
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The midwife watches a newborn breastfeeding 3 hours after the delivery. Which reaction would indicate possible esophageal atresia? 1) projectile vomiting 2) choking 3) substernal retractions 4) nasal flaring |
2) choking
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During a newborn exam on the third day, the midwife notices that the baby feels cold. Her initial action should be to: 1) assess his temperature 2) assess his respiratory status 3) dress him in a warm sleeper 4) undress him to look at his overall color |
1) assess his temperature
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Case Study: Dana had a home birth three days ago. During a routine home visit, the midwife notices that baby Patrick appears moderately jaundiced. She runs lab work and gets results that indicate that he has a serum bilirubin level of 12 mg/dl. She advises he get sunlight phototherapy at home. Considering Dana has type B positive blood, Patrick's condition is probably the result of: 1) Rh incompatibility 2) ABO incompatibility 3) impaired bilirubin conjugation 4) excessive fetal hemoglobin |
3) impaired bilirubin conjugation
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Lynn has been laboring at home for 16 hours and is beginning to seem anxious and restless. She complains of dry lips and looks pale. Her pulse is 100 and her temperature is slightly elevated. What should the midwife do first? 1) treat for signs of shock 2) check for ketones in the urine and treat for ketoacidosis 3) call 911 as these are all signs of uterine rupture 4) tell Lynn to lie down and rest between contractions |
2) check for ketones in the urine and treat for ketoacidosis
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A shrill, high pitched cry in the newborn most likely means: 1) colic 2) increased intracranial pressure 3) prematurity 4) it is normal when babies are upset |
2) increased intracranial pressure
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Which of the following is most directly responsible for closure of the ductus arteriosus? 1) decrease in blood pH 2) increase in lymph circulation 3) increased pressure in the left atrium 4) increase in oxygen levels in the blood |
4) increase in oxygen levels in the blood
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Which instruction about proper diaphragm use and care would be incorrect? 1) use a water soluble jelly 2) store the diaphragm in a cool place 3) check the diaphragm for tears or holes after each use 4) be refitted for a new one after a weight gain or loss of 15 pounds |
3) check the diaphragm for tears or holes after each use
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Which factor in the health history would contraindicate the use of a diaphragm? 1) frequent urinary tract infections 2) pelvic inflammatory disease (PID) 3) hypertension 4) smoking one pack of cigarettes daily |
1) frequent urinary tract infections
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