Midwifery Exam Questions

Correct Answer: C

Rationale: The correct answer is C, Couvelaire uterus. This condition is characterized by a bruised and edematous appearance of the uterus due to severe placental abruption. The rationale is that a Couvelaire uterus specifically refers to this presentation, while the other choices do not. A: Wernicke's encephalopathy is a neurological disorder caused by thiamine deficiency. B: Uterine prolapse is the descent or herniation of the uterus into or beyond the vagina. D: Asherman's syndrome involves intrauterine adhesions leading to menstrual irregularities.

Correct Answer: C

Rationale: The correct answer is C: Protein intake of 50 g daily. In hepatic encephalopathy, reducing protein intake helps decrease ammonia production. Excessive ammonia leads to neurological symptoms. Lactulose (choice A) is correct for hepatic encephalopathy as it helps eliminate ammonia through the gut. Spironolactone (choice B) is a diuretic and not indicated for hepatic encephalopathy. Zolpidem (choice D) is a sleep aid and not relevant to managing ammonia accumulation. In summary, choice C is correct because it directly targets the underlying issue of ammonia accumulation in hepatic encephalopathy, while the other choices do not address this specific concern.

Correct Answer: D

Rationale: Correct Answer: D Rationale: 1. Metformin should be held if the morning blood sugar is < 200 mg/dL to reduce the risk of lactic acidosis postoperatively. 2. Warfarin should be held 5 days before surgery to prevent excessive bleeding during the procedure. 3. Beta blocker (metoprolol) can be continued on the day of surgery to prevent rebound hypertension. 4. Vitamin E can be continued as it does not have significant interactions or adverse effects in this scenario. Summary: - Choice A is incorrect as it does not address the need to hold metformin and warfarin appropriately. - Choice B is incorrect as it discontinues medications too early and does not address metformin management. - Choice C is incorrect as it only addresses warfarin and does not consider metformin or other medications. - Choice D is the most appropriate approach as it addresses the specific considerations for each medication based on their effects and interactions.

Correct Answer: D

Rationale: The correct answer is D: Serotonin. Serotonin is not a primary chemical mediator of hepatic encephalopathy. The main chemical mediators involved in hepatic encephalopathy are A: Gamma-aminobutyric acid (GABA), B: Ammonia, and C: False neurotransmitters. GABA plays a role in inhibiting neurotransmission, ammonia is a key factor in the pathogenesis of hepatic encephalopathy, and false neurotransmitters are produced due to altered amino acid metabolism in the liver. Serotonin is not a key player in the development of hepatic encephalopathy, hence it is the correct answer.

Correct Answer: D

Rationale: The correct answer is D because in deep transverse arrest, the sagittal suture of the fetal head is typically aligned with the oblique diameter of the pelvis, causing an obstruction in the descent of the baby. This alignment leads to a difficult labor scenario where the baby's head cannot pass through the pelvis due to the mismatch in diameters. Choices A, B, and C are incorrect because they do not accurately describe the specific anatomical alignment that characterizes deep transverse arrest. Choice A refers to occipito-frontal diameter, choice B refers to sub-occipito-bregmatic diameter, and choice C mentions a face to pubis delivery, which are not the defining features of deep transverse arrest.