Midwifery Exam Practice Questions

Correct Answer: B

Rationale: The correct answer is B: Rotational injury. Flexion-distraction injuries of the thoracolumbar spine are often caused by rotational forces that occur during accidents such as motor vehicle collisions or falls. These forces lead to the spine being twisted, causing separation of the vertebrae. Blunt trauma (A) can cause various spinal injuries but is not specific to flexion-distraction injuries. Seat belts (C) are designed to prevent spinal injuries by restraining the body during a collision. Gunshot wounds (D) can cause spinal cord injuries but are not commonly associated with flexion-distraction injuries of the thoracolumbar spine.

Correct Answer: A

Rationale: The correct answer is A because the Brain Trauma Foundation recommends intracranial pressure monitoring for patients with traumatic brain injury and a GCS of 3 to 8, regardless of the head CT findings. Intracranial pressure monitoring helps in the management of elevated intracranial pressure, which can be life-threatening. Abnormal head CT findings may indicate the need for immediate intervention, but intracranial pressure monitoring is still recommended for all patients in this GCS range to guide treatment decisions. Choices B, C, and D are incorrect because hypotension, age > 40 years old, and bradycardia are not factors that would exclude a patient from needing intracranial pressure monitoring in the presence of a GCS of 3 to 8.

Correct Answer: D

Rationale: The correct answer is D because deep transverse arrest occurs when the level of the occiput and the sinciput is the same, leading to a failure of descent of the fetal head through the pelvis. This alignment issue hinders the progress of labor despite adequate contractions. A: Incorrect. Flexion being well maintained is not a defining characteristic of deep transverse arrest. B: Incorrect. While strong uterine contractions can contribute to labor challenges, deep transverse arrest is specifically related to the alignment of the fetal head. C: Incorrect. The curvature of the sacrum is not directly related to deep transverse arrest.

Correct Answer: A

Rationale: In face presentation, the face is an ill-fitting presenting part, leading to obstructed labor. The face has larger diameters, making it difficult to pass through the birth canal. This differs from vertex delivery where the head can mold to fit. Caput succedaneum is swelling of the soft tissues on the baby's head and does not directly cause obstructed labor.

Correct Answer: B

Rationale: The correct answer is B: By altering immune development. The maternal microbiome plays a crucial role in shaping the fetal immune system during pregnancy. Microbes in the mother's body can influence the development of the fetus's immune system through various mechanisms, such as immune cells crossing the placenta. This interaction helps the fetus develop tolerance to maternal antigens. Choice A (By increasing fetal weight) is incorrect because the maternal microbiome's influence is not primarily related to weight gain. Choice C (By reducing placental oxygen levels) is incorrect as it does not directly relate to the immune system development. Choice D (By enhancing amniotic fluid) is incorrect as the main influence is on the immune system rather than amniotic fluid enhancement.