Midwifery Test Questions

Midwifery Test Questions Related

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Mr. Costigan is a 50-year-old male patient who recently had a screening colonoscopy because it was recommended by his primary care provider as a screening measure. He received a report that noted inflammatory polyps. He is concerned because one of his friends had polyps that turned into cancer. While advising Mr. Costigan, the AGACNP tells him that

  • A. The polyps are considered precancerous, but if he has a colonoscopy every 3 to 5 years, any new polyps can be removed before they become malignant
  • B. The primary danger is when there is a family history of colon cancer; he should discuss with his mother and father the presence of any colon cancer in the family
  • C. There is no chance that these polyps could become cancerous, and their presence does not require any additional action or concern on his part
  • D. He would be best served at this point to discuss with an oncologist the risks and benefits of aggressive versus conservative treatment.
Correct Answer: A

Rationale: The correct answer is A because inflammatory polyps are indeed considered precancerous, meaning they have the potential to develop into cancer over time. By having regular colonoscopies every 3 to 5 years, any new polyps can be detected early and removed before they have a chance to become malignant. This approach helps in preventing the progression of polyps to cancerous lesions, thus reducing the risk of developing colon cancer.

Choice B is incorrect because while family history is a risk factor for colon cancer, the presence of inflammatory polyps in Mr. Costigan should not be overlooked or solely attributed to family history.

Choice C is incorrect because all polyps have the potential to become cancerous, including inflammatory polyps. Ignoring their presence can lead to missed opportunities for early intervention.

Choice D is incorrect because at this stage, the primary focus should be on surveillance and prevention through regular colonoscopies, rather than jumping into discussions about aggressive treatment options.

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A major predisposing factor to cardiac disease in pregnancy includes

  • A. Rheumatic heart disease
  • B. Notable peripheral oedema
  • C. Easy fatiguability
  • D. Basal crepitation
Correct Answer: A

Rationale: The correct answer is A: Rheumatic heart disease. This is because rheumatic heart disease is a known risk factor for cardiac complications during pregnancy due to the strain pregnancy places on the heart. Choice B, notable peripheral edema, is a symptom of heart failure but not a predisposing factor. Choice C, easy fatiguability, is a non-specific symptom and not a direct predisposing factor. Choice D, basal crepitation, is a sign of possible lung pathology and not directly related to cardiac disease in pregnancy. Therefore, the correct answer is A as it directly relates to an increased risk of cardiac issues during pregnancy.

A clinical feature that is indicative of transient tachypnea of the newborn is

  • A. Rapid respirations of up to 120/minute
  • B. There’s marked recession of the rib cage
  • C. Mostly common following a normal delivery
  • D. Diminished respirations of less than 40/minute
Correct Answer: A

Rationale: Step 1: Transient tachypnea of the newborn is characterized by rapid respirations due to delayed reabsorption of fetal lung fluid.
Step 2: Rapid respirations of up to 120/minute is a common clinical feature seen in newborns with transient tachypnea.
Step 3: This rapid breathing pattern distinguishes it from other conditions.
Step 4: Marked recession of the rib cage is more indicative of respiratory distress syndrome.
Step 5: Transient tachypnea can occur in both normal and cesarean deliveries, so choice C is incorrect.
Step 6: Diminished respirations of less than 40/minute would not be expected in transient tachypnea.
Summary: Choice A is correct because rapid respirations are a key clinical feature of transient tachypnea, while the other choices do not align with its characteristic presentation.

An indication for forceps delivery is

  • A. Inadequate size of the pelvis
  • B. Delay in second stage of labor
  • C. Unsuccessful vacuum extraction
  • D. Fetal distress in first stage of labor
Correct Answer: B

Rationale: The correct answer is B: Delay in second stage of labor. Forceps delivery is indicated when there is a delay in the second stage of labor to expedite delivery and prevent maternal and fetal complications. This could be due to factors such as maternal exhaustion, fetal distress, or ineffective pushing. Inadequate pelvis size (A) may necessitate a C-section, unsuccessful vacuum extraction (C) may require alternative interventions, and fetal distress in the first stage of labor (D) may not necessarily indicate the need for forceps delivery immediately.

Presence of a turtle’s sign is clearly indicative of

  • A. Prolonged labor
  • B. Occipito-posterior position
  • C. Shoulder dystocia
  • D. Shoulder presentation
Correct Answer: C

Rationale: The presence of a turtle sign during delivery is indicative of shoulder dystocia. This occurs when the baby's shoulders get stuck behind the mother's pelvic bones during delivery, leading to difficulty in delivering the baby's shoulders. The turtle sign refers to the retraction of the baby's head back into the birth canal after delivery of the head, resembling a turtle retracting into its shell. This sign is a clear indicator of shoulder dystocia. Choices A, B, and D are incorrect because prolonged labor, occipito-posterior position, and shoulder presentation do not specifically involve the retraction of the baby's head like in shoulder dystocia.

Which of the following is not a true statement with respect to decision making for a cognitively impaired patient?

  • A. Only a court can declare a patient incompetent
  • B. Impaired cognition does not make a person incompetent
  • C. Living wills typically are honored if a person is terminally ill
  • D. A patient can give informed consent if not declared incompetent
Correct Answer: C

Rationale: The correct answer is C because living wills typically are not always honored for cognitively impaired patients. Step-by-step rationale: A) Incorrect - A court can declare a patient incompetent if they are unable to make decisions. B) Incorrect - Impaired cognition can indeed make a person incompetent. D) Incorrect - A patient must have the capacity to understand information and make decisions to give informed consent.

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