Midwifery Practice Questions

Midwifery Practice Questions Related

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Mr. Nelson is a 65-year-old male who has been advised that he is a candidate for coronary artery bypass grafting. He has been doing some internet research and is asking about whether or not he should have a beating heart bypass. Regarding off-pump coronary bypass grafting, the AGACNP advises Mr. Nelson that

  • A. There is a slightly higher risk of neurologic complications
  • B. Long-term results suggest that the grafts do not stay open as long as those in traditional bypass grafting
  • C. The incidence of off-pump bypass grafting has increased significantly in the last 10 years
  • D. The off-pump procedure is considerably more expensive but is correlated with better long-term outcomes
Correct Answer: A

Rationale: The correct answer is A: There is a slightly higher risk of neurologic complications.
Rationale:
1. Off-pump bypass grafting involves performing surgery on a beating heart without the use of a heart-lung machine.
2. The lack of cardiopulmonary bypass during off-pump surgery can lead to reduced blood flow to the brain, increasing the risk of neurologic complications.
3. This is why the AGACNP advises Mr. Nelson about the slightly higher risk of neurologic complications associated with off-pump bypass.
4. Choice B is incorrect as long-term results actually suggest similar or better patency rates for grafts in off-pump surgery.
5. Choice C is incorrect as the statement about the incidence increasing significantly in the last 10 years is not relevant to the risks of off-pump surgery.
6. Choice D is incorrect as off-pump surgery is not considerably more expensive and the correlation with better long-term outcomes is debatable.

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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?

  • A. Temperature > 102°F
  • B. White blood cell count > 14,000 cells/µL
  • C. Vomiting
  • D. Hematuria
Correct Answer: A

Rationale: The correct answer is A: Temperature > 102°F. A high fever in the context of right lower quadrant colicky pain raises concern for ureteral colic, which is often caused by kidney stones. Fever may indicate infection or obstruction, requiring urgent medical attention. Choices B, C, and D are incorrect because they are common findings in cases of ureteral colic but are not as specific to raise the index of suspicion. White blood cell count elevation and hematuria are common with kidney stones, while vomiting is a common symptom due to severe pain. However, fever is a more concerning sign that necessitates prompt evaluation.

Which one of the following is an obstetric emergency?

  • A. Aftercoming head in breech
  • B. Complete cephalic presentation
  • C. Complete breech presentation
  • D. Complete rupture of the uterus
Correct Answer: D

Rationale: The correct answer is D, complete rupture of the uterus. This is an obstetric emergency due to the risk of severe bleeding and potential harm to both the mother and the fetus. A ruptured uterus can lead to life-threatening complications such as hemorrhage and shock. In contrast, options A, B, and C are not considered obstetric emergencies. Aftercoming head in breech, complete cephalic presentation, and complete breech presentation are normal variations in labor that do not typically require immediate intervention like a ruptured uterus does.

The lie is defined as unstable when it keeps varying after

  • A. 36 weeks gestation
  • B. 42 weeks gestation
  • C. 38 weeks gestation
  • D. 40 weeks gestation
Correct Answer: A

Rationale: The correct answer is A (36 weeks gestation) because at this point in pregnancy, the fetus has reached a stable lie position. Before 36 weeks, fetal lie can vary due to the ample space in the uterus. After 36 weeks, the fetus tends to settle into a consistent head-down or breech position, making the lie stable. Choices B, C, and D are incorrect as they are past the point where the lie typically stabilizes, leading to less variability in fetal positioning.

Diamorphic anaemia results due to deficiency of

  • A. Iron and thiamine
  • B. Iron and folic acid
  • C. Folic acid and thiamine
  • D. Liver enzymes and iron
Correct Answer: B

Rationale: The correct answer is B: Iron and folic acid. Diamorphic anemia is characterized by the presence of both microcytic and macrocytic red blood cells, which can be caused by a deficiency in both iron and folic acid. Iron deficiency leads to microcytic anemia, while folic acid deficiency results in macrocytic anemia. Thiamine deficiency (Choice A) primarily affects the nervous system and does not directly cause diamorphic anemia. Liver enzymes deficiency (Choice D) does not directly lead to diamorphic anemia. Folic acid and thiamine deficiency (Choice C) can cause individual types of anemia but not diamorphic anemia.

The MOST common type of breech presentation is

  • A. Frank breech presentation
  • B. Complete breech presentation
  • C. Incomplete breech presentation
  • D. Footling breech presentation
Correct Answer: A

Rationale: The correct answer is A: Frank breech presentation. This is because the frank breech presentation is the most common type of breech presentation, accounting for about 50-70% of all breech births. In a frank breech presentation, the baby's buttocks are presenting first with the legs extended up towards the head. This position is considered the most favorable for a vaginal delivery compared to the other types of breech presentations.

Summary of incorrect choices:
B: Complete breech presentation - This type of breech presentation occurs when the baby's buttocks are presenting first with the knees bent and the feet near the buttocks. It is less common than the frank breech presentation.
C: Incomplete breech presentation - In this type, one or both of the baby's legs are presenting first instead of the buttocks. It is less common than the frank breech presentation.
D: Footling breech presentation - This type occurs when one or both of the baby's feet

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