Band 7 Midwifery Interview Questions and Answers

Band 7 Midwifery Interview Questions and Answers Related

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Mrs. Coates is a 65-year-old female who is on postoperative day 1 following a duodenal resection for a bleeding ulcer. She had an uneventful immediate postoperative course, but throughout the course of day 1 she has complained of a mild abdominal discomfort that has progressed throughout the day. This evening the AGACNP is called to the bedside to evaluate the patient for persistent and progressive discomfort. Likely causes of her symptoms include all of the following except

  • A. Colic due to return of peristalsis
  • B. Leakage from the duodenal stump
  • C. Gastric retention
  • D. Hemorrhage
Correct Answer: C

Rationale: The correct answer is C: Gastric retention. Mrs. Coates' symptoms of persistent and progressive discomfort are not likely due to gastric retention because she underwent a duodenal resection for a bleeding ulcer, which would bypass the stomach. Therefore, gastric retention is not a possible cause.

A: Colic due to return of peristalsis is a possible cause as peristalsis returning after surgery can cause discomfort.
B: Leakage from the duodenal stump is a possible cause as it can lead to abdominal discomfort postoperatively.
D: Hemorrhage is a possible cause given her history of bleeding ulcer and surgery.

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S. R. is a 51-year-old male patient who is being evaluated for fatigue. Over the last few months he has noticed a marked decrease in activity tolerance. Physical examination reveals a variety of ecchymoses of unknown origin. The CBC is significant for a Hgb of 10.1 gdL, an MCV of 72 fL and a platelet count of 65,000L the remainder of the CBC is normal. Coagulation studies are normal, but bleeding time is prolonged. The AGACNP recognizes that initial management of this patient will include

  • A. Avoidance of elective surgery and nonessential medications
  • B. Prednisone 60 mg daily until platelets normal
  • C. Monoclonal antibody therapy such as rituximab
  • D. Splenectomy
Correct Answer: D

Rationale: The correct answer is D: Splenectomy. In this case, the patient presents with signs of immune thrombocytopenic purpura (ITP) with low platelet count and bleeding time prolongation. Splenectomy is the definitive treatment for ITP as the spleen is the site of platelet destruction. Avoiding elective surgery and medications (choice A) may be necessary to prevent bleeding complications but do not address the underlying issue. Prednisone (choice B) is used for acute treatment but not for long-term management. Monoclonal antibody therapy (choice C) is an option for refractory cases but not first-line therapy.

Which one of the following signs is indicative of possible shoulder dystocia during delivery?

  • A. Failure of internal rotation of the head
  • B. Fetal head retracts against the perineum
  • C. Gentle traction aids in effecting the delivery
  • D. The occiput slowly restitutes towards the left side
Correct Answer: B

Rationale: The correct answer is B: Fetal head retracts against the perineum. This sign indicates possible shoulder dystocia as it suggests the baby's shoulders are impacted and unable to pass through the birth canal. The retraction of the fetal head against the perineum is a classic sign of shoulder dystocia, which requires specific maneuvers to dislodge the shoulders and facilitate delivery.

A: Failure of internal rotation of the head is not specific to shoulder dystocia.
C: Gentle traction should not be applied in cases of shoulder dystocia as it can worsen the situation.
D: The occiput restituting towards the left side is not a sign of shoulder dystocia, as it refers to the rotation of the fetal head during delivery.

Hepatic encephalopathy is a clinical syndrome seen in patients with chronic liver disease its presentation may range from mild personality changes, to psychosis, to coma. The primary chemical mediators of hepatic encephalopathy include all of the following except

  • A. Gamma-aminobutyric acid (GABA)
  • B. Ammonia
  • C. False neurotransmitters
  • D. Serotonin
Correct Answer: B

Rationale: The correct answer is B: Ammonia. Ammonia is a primary chemical mediator of hepatic encephalopathy. In patients with chronic liver disease, the liver's ability to detoxify ammonia is compromised, leading to its accumulation in the bloodstream and subsequent neurotoxic effects causing encephalopathy. Gamma-aminobutyric acid (GABA), false neurotransmitters, and serotonin are all implicated in the pathophysiology of hepatic encephalopathy. GABA is involved in neurotransmission, false neurotransmitters are substances that disrupt normal neurotransmission, and serotonin levels are altered in hepatic encephalopathy.

Convulsions in amniotic fluid embolism are confused for:

  • A. Antepartum eclampsia
  • B. Presence of stroke
  • C. Pre-existing epilepsy
  • D. Postpartum eclampsia
Correct Answer: D

Rationale: The correct answer is D: Postpartum eclampsia. In amniotic fluid embolism, convulsions can mimic postpartum eclampsia due to similarities in symptoms such as seizures and hypertension. However, the key differentiator is the timing of onset - postpartum eclampsia occurs after delivery, while amniotic fluid embolism typically occurs during labor or immediately postpartum. Choices A, B, and C are incorrect as they do not align with the timing and clinical presentation of amniotic fluid embolism. Antepartum eclampsia occurs before delivery, stroke presents with neurological deficits, and pre-existing epilepsy is a chronic condition unrelated to the immediate postpartum period.

Causes of Down syndrome are

  • A. Trisomy, deletion and non-disjunction
  • B. Mosaicism, duplication and translocation
  • C. Translocation, mosaicism and deletion
  • D. Mosaicism, trisomy and translocation
Correct Answer: D

Rationale: The correct answer is D because Down syndrome is primarily caused by trisomy of chromosome 21. This means there is an extra copy of chromosome 21, leading to the characteristic features of the syndrome. Mosaicism and translocation of chromosome 21 can also result in Down syndrome, albeit less frequently. Option A includes deletion, which is not a common cause of Down syndrome. Option B lists duplication, which is not a typical mechanism for Down syndrome. Option C includes deletion and mosaicism, but trisomy is the main cause of Down syndrome, making option D the most accurate choice.

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