Midwifery Test Questions

Correct Answer: C

Rationale: The correct answer is C: Seat belts. Flexion-distraction injuries of the thoracolumbar spine are commonly caused by seat belts due to the mechanism of injury during a motor vehicle accident. When a sudden deceleration occurs, the body is restrained by the seat belt while the spine continues to move forward, leading to hyperflexion of the spine. This results in distraction forces at the thoracolumbar junction, causing injury. Blunt trauma (choice A) can cause various types of spinal injuries but is not specifically associated with flexion-distraction injuries. Rotational injury (choice B) typically leads to injuries such as fractures or dislocations, not flexion-distraction injuries. Gunshot wounds (choice D) can cause direct spinal damage, but they do not typically result in flexion-distraction injuries.

Correct Answer: C

Rationale: The correct answer is C: Truncus arteriosus. In this condition, there is a single large vessel arising from the heart that gives rise to the systemic, pulmonary, and coronary arteries. This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygenation of the body, causing immediate death after birth. A: Pulmonary stenosis and B: Aortic coarctation typically do not cause immediate death after birth. D: Ductus arteriosus is a normal fetal structure that closes shortly after birth and its presence would not directly cause immediate death.

Correct Answer: A

Rationale: The correct answer is A because immediate cesarean is crucial to prevent further complications and ensure the safety of the mother and baby. Monitoring for signs of shock is essential to detect any deterioration in the mother's condition. Fluid resuscitation helps stabilize the mother's hemodynamic status. Option B is incorrect as observation alone may delay necessary interventions. Option C is partially correct as immediate cesarean is necessary but does not address monitoring for shock and fluid resuscitation. Option D is incorrect as continuous monitoring alone is insufficient to manage incomplete uterine rupture.

Correct Answer: C

Rationale: The correct answer is C: Magnesium sulphate. In eclampsia, magnesium sulphate is the drug of choice because it helps prevent seizures by reducing neuromuscular irritability and blocking peripheral neuromuscular transmission. It also has vasodilatory effects, improving uteroplacental blood flow. Phenobarbitone (A) is not recommended due to its sedative effects. Calcium gluconate (B) is used to treat hyperkalemia, not eclampsia. Sodium bicarbonate (D) is used for metabolic acidosis, not eclampsia. In summary, magnesium sulphate is preferred for its efficacy in preventing and managing seizures in eclampsia.

Correct Answer: D

Rationale: Step-by-step rationale for why D is correct: 1. Arteriolar dilators such as sodium nitroprusside are used to manage hypertensive crisis by rapidly reducing blood pressure. 2. Pheochromocytoma surgery can result in catecholamine release, causing severe hypertension. 3. Arteriolar dilators act directly on blood vessels to lower blood pressure quickly. 4. Alpha-adrenergic antagonists (A) can worsen hypotension, beta-adrenergic antagonists (B) can lead to unopposed alpha-adrenergic effects, and intravenous vasodilators (C) may not act rapidly enough.