Midwifery Exam Practice Questions

Correct Answer: C

Rationale: The correct answer is C. In myelodysplastic syndromes, splenectomy is indicated for sustained leukocyte elevation above 30,000 cells/�L to manage symptomatic splenomegaly and cytopenias. This is because an enlarged spleen can sequester and destroy blood cells, leading to low blood cell counts. Choices A, B, and D are incorrect as splenectomy is not typically indicated for major hemolysis unresponsive to medical management, severe symptoms of massive splenomegaly, or portal hypertension in the context of myelodysplastic syndromes.

Correct Answer: C

Rationale: The correct answer is C because living wills are typically not honored for terminally ill patients with impaired cognition. Firstly, living wills require the patient to be of sound mind to make decisions. Secondly, in the case of a cognitively impaired patient, their ability to express their wishes and understand the implications may be compromised. Therefore, healthcare providers may not be able to honor the living will accurately. Choices A, B, and D are incorrect because A) competency can be determined by healthcare professionals, B) impaired cognition can lead to incompetence, and D) informed consent requires the patient to understand the decision-making process.

Correct Answer: C

Rationale: The correct answer is C: Local anesthesia, cleansing, and suture repair. 1. Local anesthesia is needed to numb the area before suturing. 2. Cleansing is necessary to prevent infection and remove debris. 3. Suture repair is required for a jagged laceration to promote proper wound healing and minimize scarring. Other choices are incorrect: A: Antibiotic therapy is not indicated for clean, non-infected wounds like this laceration. B: Wound exploration for foreign bodies is not necessary in this case as the mechanism of injury is known and there is no indication of foreign bodies. D: Tetanus prophylaxis is important but not directly related to the immediate management of the laceration.

Correct Answer: C

Rationale: Rationale for Correct Answer (C): A trial of scar is indicated when a woman has had no more than two previous caesarean sections. This is because the risk of uterine rupture increases with each subsequent caesarean section due to scar tissue weakening. Limiting the number of previous scars reduces this risk. Therefore, option C is correct. Summary of Incorrect Choices: A: Estimated fetal weight is not a determining factor for a trial of scar. B: Availability of a level one hospital nearby is important for emergency situations but not a criteria for trial of scar. D: Adequate pelvis with true conjugate 10.5cm is important for vaginal delivery but not a specific requirement for a trial of scar.

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.