Midwifery Exam Questions and Answers PDF

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Lester R. is a 58-year-old male who is being evaluated for nocturia. He reports that he has to get up 2 to 3 times nightly to void. Additional assessment reveals urinary urgency and appreciable post-void dribbling. A digital rectal examination reveals a normal-sized prostate with no appreciable hypertrophy. The best approach to this patient includes

  • A. Administration of the American Urological Association (AUA) Symptom Scale
  • B. Laboratory assessment to include a PSA
  • C. Ordering a prostate ultrasound
  • D. Assessment of nonprostate causes of nocturia
Correct Answer: D

Rationale: The correct answer is D: Assessment of nonprostate causes of nocturia. In this case, the patient's symptoms of nocturia, urinary urgency, and post-void dribbling are not indicative of prostate enlargement. Given that the digital rectal examination revealed a normal-sized prostate with no hypertrophy, it is essential to explore other potential causes of nocturia in this patient. By assessing non-prostate causes of nocturia, such as diabetes, urinary tract infection, medication side effects, or sleep disorders, a more accurate diagnosis and appropriate treatment plan can be developed. This approach will lead to better patient outcomes compared to focusing solely on prostate-related evaluations.

Option A: Administration of the AUA Symptom Scale is not the best approach in this case because the patient's symptoms are not primarily related to prostate enlargement.

Option B: Laboratory assessment to include a PSA is not necessary since the digital rectal examination already indicated a normal-sized prostate with no appreciable hypertrophy.

Option C: Ordering a

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A specific clinical feature of respiratory distress syndrome includes

  • A. Grunting on inspiration
  • B. Grunting on expiration
  • C. Flaring of the nostrils
  • D. Neonatal tachycardia
Correct Answer: B

Rationale: The correct answer is B: Grunting on expiration. In respiratory distress syndrome, the infant may exhibit grunting on expiration due to the difficulty in maintaining lung inflation during exhalation. This is a compensatory mechanism to increase functional residual capacity. Grunting on inspiration (choice A) may be seen in other respiratory conditions. Flaring of the nostrils (choice C) is a sign of increased work of breathing but is not specific to respiratory distress syndrome. Neonatal tachycardia (choice D) can be a nonspecific sign of distress and is not a specific feature of respiratory distress syndrome.

Psychosocial adversities are among the predisposing factors of puerperal psychosis.

  • A. TRUE
  • B. FALSE
  • C. -
  • D. -
Correct Answer: T

Rationale: Step-by-step rationale:
1. Puerperal psychosis is a severe mental health condition occurring postpartum.
2. Psychosocial adversities, such as stress or lack of social support, can trigger or exacerbate mental health issues.
3. Therefore, psychosocial adversities can be predisposing factors for puerperal psychosis.
4. Option A (TRUE) is correct as it aligns with the established relationship between psychosocial factors and mental health.
Summary: Option A is correct because psychosocial adversities can indeed contribute to the development of puerperal psychosis, making it a relevant predisposing factor. Options B, C, and D are incorrect as they do not provide any rationale or evidence to support their validity.

In True cephalopelvic disproportion

  • A. Half of the patients will need an operative delivery
  • B. The problem may be overcome during labor
  • C. Operative delivery is unnecessary
  • D. Operative delivery will be needed
Correct Answer: D

Rationale: In True cephalopelvic disproportion, the baby's head is too large to pass through the mother's pelvis. This condition often requires operative delivery (C-section) as a vaginal birth is not possible. Choice D is correct because operative delivery is indeed needed to safely deliver the baby. Choice A is incorrect as not all patients with cephalopelvic disproportion will necessarily require operative delivery. Choice B is also incorrect as the issue cannot generally be overcome during labor due to physical constraints. Choice C is incorrect as operative delivery is usually necessary in cases of true cephalopelvic disproportion to prevent complications.

A patient presents with a 2-day history of abdominal pain, fever, vomiting, and diarrhea. A surgical abdomen is ruled out, and radiography demonstrates inflammation of the small bowel and colon. Microscopy supports a diagnosis of Campylobacter jejuni, and the patient is prepared for discharge from the emergency room. Important patient education includes advising her that

  • A. The bacteria may be spread for as long as she has diarrhea
  • B. The disorder should resolve on its own; recurrence is rare but represents a much more serious condition
  • C. She will need to take a 10-day course of antibiotics
  • D. There is no readily identified food source of this bacteria
Correct Answer: D

Rationale: Step 1: Campylobacter jejuni is a bacteria commonly associated with foodborne illness, often found in undercooked poultry and unpasteurized milk.
Step 2: The patient's symptoms and microbiological findings are consistent with Campylobacter infection.
Step 3: Advising the patient that there is no readily identified food source of this bacteria is important for preventing future exposure and potential reinfection.
Step 4: Choices A, B, and C are incorrect as they do not address the specific educational need related to food safety and prevention of Campylobacter infection.

When counseling a patient about his surgical options for an ulcer that has been refractory to medical therapy, the AGACNP advises the patient that he will need

  • A. Lifelong vitamin D replacement
  • B. Excision of the ulcer, which produces an 80% cure rate
  • C. To eat much smaller, more frequent meals
  • D. Some form of vagotomy
Correct Answer: D

Rationale: Correct Answer: D. Some form of vagotomy

Rationale:
1. Vagotomy is a surgical procedure that involves cutting the vagus nerve to reduce acid production in the stomach, which can help in treating ulcers.
2. Vagotomy is often recommended when ulcers are refractory to medical therapy, making it an appropriate surgical option.
3. Lifelong vitamin D replacement (A) is not typically necessary for ulcer treatment. Excision of the ulcer (B) is not a common treatment and does not address the underlying cause. Eating smaller meals (C) may help manage symptoms but is not a surgical option for refractory ulcers.

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