Midwifery Exam Questions and Answers PDF

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R. S. is a 66-year-old female with Cushings syndrome due to an ACTH-producing pituitary tumor. The tumor is readily isolated by imaging, and the patient had an uneventful surgery. When seeing her in follow-up, the AGACNP anticipates

  • A. Rapid reversal of symptoms, with good pituitary function
  • B. Transient rebound release of remaining pituitary hormones
  • C. Markedly improved dexamethasone suppression test
  • D. Hyponatremia and compensatory SIADH
Correct Answer: B

Rationale: The correct answer is B: Transient rebound release of remaining pituitary hormones. After surgical removal of the ACTH-producing pituitary tumor in Cushing's syndrome, there may be a transient rebound release of remaining pituitary hormones due to relief of negative feedback from the tumor. This can lead to a temporary increase in pituitary hormone levels before normalization.

Rationale:
1. Rapid reversal of symptoms with good pituitary function (Choice A) is less likely as it takes time for the pituitary gland to recover and resume normal hormone production post-surgery.
2. Markedly improved dexamethasone suppression test (Choice C) is not expected immediately after surgery as it may take time for the hypothalamic-pituitary-adrenal axis to normalize.
3. Hyponatremia and compensatory SIADH (Choice D) are unlikely post-operatively in Cushing's syndrome as removal of the ACTH-producing tumor should lead to normalization of

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The AGACNP is treating a patient with ascites. After a regimen of 200 mg of spironolactone daily, the patient demonstrates a weight loss of 0.75 kgday. The best approach to this patients management is to

  • A. Continue the current regimen
  • B. D/C the spironolactone and begin a loop diuretic
  • C. Add a loop diuretic to the spironolactone
  • D. Proceed to large-volume paracentesis
Correct Answer: A

Rationale: The correct answer is A: Continue the current regimen. Spironolactone is a potassium-sparing diuretic commonly used to treat ascites. The weight loss of 0.75 kg/day indicates that the current regimen is effective. Continuing the regimen is appropriate to avoid electrolyte imbalances. Discontinuing spironolactone (Choice B) can lead to rebound edema. Adding a loop diuretic (Choice C) may increase the risk of electrolyte disturbances. Large-volume paracentesis (Choice D) is reserved for cases of refractory ascites.

A non-pharmacological measure of pain relief in labour includes

  • A. Entonox
  • B. Cyclothane
  • C. Homeopathy
  • D. Diamorphine
Correct Answer: C

Rationale: The correct answer is C: Homeopathy. Homeopathy involves using highly diluted substances to stimulate the body's natural healing processes. In labor, homeopathy can help manage pain and support relaxation. Entonox (A) and Diamorphine (D) are pharmacological measures, while Cyclothane (B) is not a recognized pain relief option in labor. Homeopathy aligns with non-pharmacological approaches, making it the most suitable choice for pain relief in labor.

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

A correct statement about an acute small for gestational age neonate is

  • A. Entire body is proportionately reduced for gestational age
  • B. Head is disproportionately larger than the rest of the body
  • C. The body is disproportionately larger than the baby’s head
  • D. The neonate appears plumpy with a scaphoid shaped abdomen
Correct Answer: A

Rationale: The correct answer is A because an acute small for gestational age neonate will have all body parts proportionately reduced in size compared to a normal gestational age baby. This is due to intrauterine growth restriction. Choice B is incorrect because the head is not disproportionately larger. Choice C is incorrect as it states the body is larger than the head, which is not the case in SGA babies. Choice D is incorrect as SGA babies typically appear thin with a scaphoid abdomen, not plumpy.

The presenting diameter in brow presentation is

  • A. Mentovertical
  • B. Submentobregmatic
  • C. Suboccipitofrontal
  • D. Occipitalfrontal
Correct Answer: C

Rationale: The presenting diameter in brow presentation is the suboccipitofrontal diameter. This is because in brow presentation, the fetal head is in a deflexed position, with the largest diameter being from the subocciput (back of the head) to the frontal bone (forehead). This allows the head to enter the pelvis in the transverse diameter.

A: Mentovertical - This refers to the chin to the top of the head, not the correct diameter for brow presentation.
B: Submentobregmatic - This refers to the chin to the bregma, not the correct diameter for brow presentation.
D: Occipitalfrontal - This refers to the back of the head to the forehead, not the correct diameter for brow presentation.

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