Midwifery Exam Practice Questions

Correct Answer: B

Rationale: Step 1: Family history of colon cancer is a significant risk factor for developing colon cancer. Step 2: By discussing with his parents, Mr. Costigan can determine if there is a family history of colon cancer. Step 3: Knowing this information can help assess his own risk and guide appropriate screening and preventive measures. Step 4: The primary danger for Mr. Costigan lies in potential genetic predisposition rather than the presence of inflammatory polyps. Step 5: Therefore, discussing with family members about any history of colon cancer is crucial for his overall risk assessment and management. Summary: - Choice A is incorrect as the frequency of colonoscopy should be individualized based on the patient's risk factors. - Choice C is incorrect as all polyps have the potential to become cancerous, especially inflammatory polyps. - Choice D is incorrect as consulting an oncologist at this stage is premature without first assessing family history.

Correct Answer: C

Rationale: Rationale for Correct Answer (C): 1. The patient's symptoms of decreased capacity for intake and nausea after eating suggest gastroparesis, a common complication post-ulcer surgery. 2. Given the history of complicated peptic ulcer disease and prior surgery, medication may be ineffective, necessitating potential reoperation. 3. The AGACNP advises that another surgery may be needed, indicating that medication alone may not suffice to address the issue. Summary of Incorrect Choices: A: Endoscopy is not necessary at this point as the symptoms are likely indicative of a functional issue rather than a structural problem. B: While gastroparesis can occur post-ulcer surgery, the patient's symptoms are more suggestive of gastroparesis rather than chronic gastroparesis as a known complication. D: The frequency of occurrence of symptoms after ulcer surgery is not relevant to the current management of the patient's symptoms.

Correct Answer: C

Rationale: The correct answer is C: Fever. The first clinical manifestation of physiologic stress ulcer is often a fever due to the body's response to stress. This is because stress can trigger an inflammatory response, leading to an increase in body temperature. Epigastric pain (choice A) is more commonly associated with peptic ulcers. Change in mental status (choice B) is not a typical early symptom of physiologic stress ulcer. Hemorrhage (choice D) is a severe complication that can occur later in the course of the disease, but it is not typically the first clinical manifestation.

Correct Answer: C

Rationale: Step 1: In normal labor, the cervix undergoes effacement and dilation. Step 2: A short and thin cervical canal indicates progression towards labor. Step 3: Long and thick cervical canal suggests a delay in labor progress. Step 4: Choice C, short and thin cervical canal, is indicative of abnormal labor. Summary: A, B, and D do not reflect changes in the cervix seen in labor, making them incorrect choices.

Correct Answer: A

Rationale: The correct answer is A: Hypogastrinemia and acid hyposecretion. Gastrinoma is a tumor that secretes excessive gastrin, leading to hypergastrinemia and increased acid secretion. However, due to a negative feedback mechanism, chronic exposure to high gastrin levels can cause downregulation of gastrin receptors on parietal cells, leading to decreased acid secretion. Therefore, in gastrinoma, despite high gastrin levels, acid secretion may be reduced due to this negative feedback loop. Choices B, C, and D are incorrect because they do not align with the expected relationship between gastrin levels and acid secretion in gastrinoma.