Midwifery Exam Questions and Answers PDF

Correct Answer: A

Rationale: The correct answer is A: Acute mitral valve regurgitation. The presence of a grade VVI systolic murmur that radiates to the midaxillary line suggests mitral valve involvement. Mitral regurgitation leads to acute onset of symptoms such as dyspnea and pulmonary congestion, indicated by coarse rales on auscultation. The murmur is loudest at the point of maximal impulse due to eccentric regurgitation jet. Acute aortic valve regurgitation (B) typically presents with a diastolic murmur. Acute cardiac tamponade (C) would present with Beck's triad and pulsus paradoxus. Acute pulmonary embolus (D) would present with sudden onset dyspnea and pleuritic chest pain.

Correct Answer: A

Rationale: The correct answer is A: Six hours postnatally. Cephalohematoma is a collection of blood between a baby's skull and the periosteum. It typically appears several hours after birth due to trauma during delivery, causing bleeding under the periosteum. This allows time for the blood to accumulate and form a distinct swelling, making the onset around six hours postnatally. Choices B, C, and D are incorrect as they do not align with the typical timeline for the development of cephalohematoma.

Correct Answer: D

Rationale: The correct answer is D: Check the neonate�s vital signs every 2-4 hourly. This is the priority action because neonates undergoing phototherapy are at risk for dehydration and temperature instability. Monitoring vital signs regularly helps to detect any signs of dehydration, such as decreased urine output or increased heart rate, and ensures timely intervention. Explanation for other choices: A: Turning the neonate every six hours routinely is important for preventing pressure ulcers but is not the priority when compared to monitoring vital signs for potential complications. B: Encouraging the mother to discontinue breastfeeding is incorrect as breastmilk provides essential nutrients and hydration, which are important for neonates, even during phototherapy. C: Notifying the physician if the skin turns bronze-colored is important to address a potential adverse reaction to phototherapy but does not take precedence over monitoring vital signs for immediate concerns.

Correct Answer: C

Rationale: Correct Answer: C - Fine needle aspiration does not allow grading of tumors. Rationale: 1. Fine needle aspiration (FNA) collects cells for cytology evaluation, not tissue for grading. 2. Grading requires evaluation of tissue architecture, which is not possible with FNA. 3. FNA is useful for diagnosis but not for determining tumor grade. Summary: A: Incorrect - Excisional biopsy is preferred over incisional biopsy to obtain the entire tumor for diagnosis and grading. B: Incorrect - Core needle biopsy has a lower false positive rate compared to fine needle aspiration. D: Incorrect - Core needle and incisional biopsies differ in the amount of tissue sampled and potential for false results.

Correct Answer: C

Rationale: The correct answer is C: His blood pressure is likely a physiologic response to traumatic head injury. Rationale: 1. Physiologic response: Traumatic head injury can lead to autonomic dysregulation, causing increased sympathetic activity and elevated blood pressure to maintain cerebral perfusion. 2. Compensation mechanism: The body may increase blood pressure in response to hypotension to ensure vital organs receive adequate blood flow. 3. Treatment consideration: Understanding that elevated blood pressure can be a compensatory mechanism helps guide appropriate management strategies for traumatic head injury patients. Summary: A: Vasopressors can be used in traumatic head injury depending on the specific situation, and they are not always contraindicated. B: While hypotension can worsen outcomes in traumatic head injury, this choice overstates the risk without providing context. D: Identifying the cause of hypotension is crucial in managing traumatic head injury patients and should not be disregarded in favor of stabilizing the head injury.