Midwifery Exam Questions and Answers PDF

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Mr. Novello is an 81-year old male patient who presents with crampy abdominal pain in the hypogastrum and a vague history as to his last normal bowel movement. Physical examination reveals distention and high-pitched bowel sounds. The patient says he has never has this kind of problem before and denies any history of abdominal surgery. Abdominal radiographs reveal a frame pattern of colonic distention. The AGACNP considers

  • A. A stimulant laxative to relieve bowel contents
  • B. Carcinoma of the bowel as a leading diagnosis
  • C. Decompression of the colon with rectal tube
  • D. Angiography to rule out mesenteric ischemia
Correct Answer: C

Rationale: The correct answer is C: Decompression of the colon with rectal tube. This is the most appropriate intervention for a patient with acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome. In this condition, there is colonic distention without an actual mechanical obstruction, leading to symptoms like abdominal pain, distention, and high-pitched bowel sounds. Decompression with a rectal tube can help relieve the distention and prevent complications like perforation.

Choice A (stimulant laxative) is incorrect because ACPO is not due to simple constipation, so laxatives would not be effective. Choice B (carcinoma of the bowel) is unlikely given the acute onset and lack of risk factors. Choice D (angiography for mesenteric ischemia) is not indicated in this case as there are no signs of acute ischemia.

In summary, the correct choice is C because it directly addresses the underlying issue of colonic distention in

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T. G. is a 48-year-old female who presents with biliary colic. She has had previous episodes but has resisted operation because she is afraid of anesthesia. Today her physical exam reveals a clearly distressed middle-aged female with right upper quadrant pain, nausea, and vomiting. Which of the following findings suggests a complication that requires a surgical evaluation?

  • A. A temperature of 101.5°F
  • B. A leukocyte count of 18,000/µL
  • C. A palpable gallbladder
  • D. A positive Murphy’s sign
Correct Answer: A

Rationale: The correct answer is A: A temperature of 101.5°F. A fever indicates an inflammatory response, which could be due to a complication like cholecystitis or cholangitis. Elevated leukocyte count (choice B) supports infection but is not as specific as a fever. Palpable gallbladder (choice C) may suggest inflammation but not necessarily a complication. A positive Murphy's sign (choice D) is indicative of gallbladder inflammation but does not directly indicate a complication requiring surgical evaluation.

The presenting diameters in face presentation are

  • A. Submentovertival, bitemporal
  • B. Submentobregmatic, bitemporal
  • C. Submentobregmatic, biparietal
  • D. Mentovertical, bitemporal
Correct Answer: A

Rationale: The correct answer is A: Submentovertival, bitemporal. In a face presentation, the presenting diameters are submentovertival (chin to vertex) and bitemporal (temple to temple). This is because the fetus is in a face-first position with the chin presenting first. Option B is incorrect because submentobregmatic is not a recognized presenting diameter in face presentation. Option C is incorrect as biparietal refers to the widest transverse diameter of the fetal head, not relevant in face presentation. Option D is incorrect as mentovertical is not a valid presenting diameter in face presentation.

Wernicke’s encephalopathy and Mallory-Weiss syndrome are among the complications of

  • A. Placenta praevia
  • B. Hypertensive disorders
  • C. Vitamin B deficiency
  • D. Hyperemesis gravidarum
Correct Answer: D

Rationale: Step-by-step rationale for why D is correct:
1. Hyperemesis gravidarum is severe nausea and vomiting during pregnancy.
2. Prolonged vomiting can lead to electrolyte imbalances and nutritional deficiencies.
3. Vitamin B deficiency, specifically thiamine, can result in Wernicke’s encephalopathy.
4. Mallory-Weiss syndrome can occur due to repeated retching and vomiting.
5. Therefore, hyperemesis gravidarum can lead to both Wernicke’s encephalopathy and Mallory-Weiss syndrome.
Summary:
A: Placenta praevia is related to abnormal placental placement, not vomiting.
B: Hypertensive disorders are associated with high blood pressure, not vomiting-related complications.
C: Vitamin B deficiency can lead to Wernicke’s encephalopathy but is not directly caused by hyperemesis gravidarum.

Which of the following is highly associated with preterm babies?

  • A. Social habits
  • B. Genetic factors
  • C. Multiple gestation
  • D. Chronic conditions
Correct Answer: C

Rationale: The correct answer is C: Multiple gestation. Preterm birth is more common in multiple gestation pregnancies due to the increased strain on the mother's uterus and cervix. This can lead to early labor and delivery. Social habits (choice A) and genetic factors (choice B) may play a role in preterm birth but are not highly associated. Chronic conditions (choice D) can also contribute to preterm birth, but multiple gestation is a stronger predictor.

Specific management of moderate pre-eclampsia involves

  • A. Admission at first contact
  • B. Managing as an outpatient case
  • C. Admission in the intensive care unit
  • D. Encouraging plenty of oral fluids
Correct Answer: B

Rationale: Correct Answer: B (Managing as an outpatient case)

Rationale:
1. Moderate pre-eclampsia indicates stable condition.
2. Outpatient management allows close monitoring without hospitalization.
3. Early intervention can prevent progression to severe pre-eclampsia.
4. Hospital admission is reserved for severe cases or complications (not moderate).
5. Encouraging fluids is important, but not the specific management for pre-eclampsia.

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