Midwifery Exam Questions

Correct Answer: A

Rationale: In ventral displacement hypospadias, circumcision should be deferred to preserve prepuce for later surgical repair as the prepuce is needed for reconstruction. The prepuce can be used as a tissue graft to correct the hypospadias. In proximal displacement, the urethral opening is closer to the scrotum, making prepuce preservation less critical. Midscrotal hypospadias and meatus proximal to the corona do not typically involve prepuce preservation for surgical repair.

Correct Answer: A

Rationale: The correct answer is A because BCG vaccination is recommended for newborns regardless of maternal smear status to prevent tuberculosis. The neonate is at risk of TB exposure postnatally and needs protection. Maternal smear status does not affect the indication for BCG in the newborn. Choice B is incorrect because withholding BCG in this case would leave the neonate vulnerable to TB. Choices C and D are not applicable as they do not provide any information.

Correct Answer: B

Rationale: The correct answer is B: Acute pancreatitis. The clinical presentation of sudden, severe upper abdominal pain not related to food intake, along with the patient's position (lying on right side with hips and knees flexed), and presence of involuntary guarding suggest acute pancreatitis. The elevated white blood cell count indicates an inflammatory process. Dissecting aortic aneurysm (A) typically presents with abrupt, severe chest or back pain radiating to the abdomen, with signs of shock. Perforated peptic ulcer (C) presents with sudden, severe abdominal pain often related to food intake, with signs of peritonitis. Mallory-Weiss tear (D) presents with hematemesis after forceful or prolonged vomiting.

Correct Answer: C

Rationale: The correct answer is C: Autonomy and beneficence. Autonomy refers to the patient's right to make their own decisions regarding their healthcare. In this case, the patient is refusing reintubation, exercising his autonomy. However, beneficence, the duty to act in the patient's best interest, also comes into play as the patient's refusal could lead to respiratory failure and death. The conflict arises from balancing the patient's autonomy with the healthcare provider's duty to provide beneficial care. Choices A, B, and D are incorrect because they do not accurately capture the ethical conflict present in the scenario. Veracity (A) refers to truthfulness, which is not the primary issue here. Nonmalfeasance (B) is the duty to do no harm, which is not directly relevant to the conflict between the patient's autonomy and the need for beneficial care. Justice (D) relates to fairness in resource allocation and is not the primary issue in this case.

Correct Answer: B

Rationale: The correct answer is B: Hyperextension casting. The AGACNP knows that this treatment is appropriate for a condition that requires immobilization and support while allowing controlled movement. Hyperextension casting provides stability and support while promoting healing. Observation (A) would not provide adequate treatment for a condition requiring immobilization. Jewett brace (C) is typically used for spinal fractures, not for conditions that require hyperextension casting. Surgical intervention (D) would be considered if conservative measures like casting have failed.