Midwifery Practice Questions

Correct Answer: A

Rationale: The correct answer is A: Irritable bowel syndrome. Mrs. Maroldo's history of recurrent left lower quadrant pain that usually resolves with antibiotics suggests a chronic condition rather than an acute one like diverticulitis, appendicitis, or inflammatory bowel disease. Her lack of nausea, vomiting, and severe symptoms, along with the presence of diarrhea and no bowel movements, align more with irritable bowel syndrome. Additionally, her vital signs are not significantly elevated, ruling out acute conditions like appendicitis. Discomfort to deep palpation in the left lower quadrant is common in irritable bowel syndrome due to visceral hypersensitivity. Therefore, based on her chronic symptoms, lack of severe signs, and typical presentation, the most likely diagnosis is irritable bowel syndrome.

Correct Answer: B

Rationale: The correct answer is B: Escherichia coli. Puerperal sepsis is often caused by endogenous bacteria from the mother's own flora. E. coli is a common endogenous bacteria found in the gastrointestinal tract and can cause infection during childbirth. Chlamydia trachomatis is a sexually transmitted infection, not typically associated with puerperal sepsis. Clostridium tetani causes tetanus, not puerperal sepsis. Pseudomonas aeruginosa is an environmental pathogen, not typically an endogenous cause of puerperal sepsis.

Correct Answer: B

Rationale: The Kleihauer-Betke acid-elution test is recommended in the management of hemolytic jaundice prenatally because it helps determine the amount of fetal-maternal hemorrhage, which is crucial for assessing the need for Rh immune globulin administration to prevent Rh sensitization in Rh-negative mothers carrying Rh-positive fetuses. This test helps quantify the amount of fetal red blood cells in the maternal circulation, guiding appropriate management to prevent hemolytic disease of the newborn. The other choices (A, C, D) do not specifically require the Kleihauer-Betke test for management and are not directly related to fetal-maternal hemorrhage assessment.

Correct Answer: D

Rationale: The correct answer is D, as all three choices are key indicators for cesarean section during labor. Fetal distress indicates the baby is not tolerating labor well. Failure to progress may lead to complications for the mother or baby. Breech presentation increases the risk of complications during vaginal delivery. Therefore, all three indicators warrant consideration for a cesarean section to ensure the safety of both the mother and the baby.

Correct Answer: D

Rationale: The correct answer is D. A ruptured uterus can lead to fetal distress and necessitate a cesarean section. Failure of the cervix to dilate is indicative of a potential uterine rupture, as the uterus may not be able to contract effectively due to the rupture. Maternal dehydration (A), pyrexia (B), and oliguria (C) are not specific signs of a ruptured uterus and may be present in various other conditions. Therefore, failure of the cervix to dilate is the most relevant early sign in this scenario.