Midwifery Practice Questions

Correct Answer: C

Rationale: The correct answer is C because in obstructive shock due to a large pulmonary embolus, there is increased resistance to blood flow out of the right ventricle, leading to elevated right ventricular pressure. This causes a backup of blood into the pulmonary circulation, increasing left ventricular pressure. The increased left ventricular pressure results in decreased cardiac output as the left ventricle struggles to pump against the increased resistance. A: Elevated atrial and decreased ventricular pressures - This is incorrect as obstructive shock typically results in elevated ventricular pressures due to increased resistance. B: Elevated right-sided and decreased left-sided pressures - This is partially true, but C is a more complete answer that explains the consequences of these pressures on cardiac output. D: Elevated left ventricular pressure and decreased systemic vascular resistance - This is incorrect as obstructive shock leads to increased, not decreased, systemic vascular resistance due to the embolus obstructing blood flow.

Correct Answer: A

Rationale: The correct answer is A: Type A aortic aneurysm. Type A involves the ascending aorta, which is more critical due to proximity to the heart. Immediate surgical intervention is necessary to prevent catastrophic complications like aortic dissection or rupture. Choice B, Type B, usually involves the descending aorta and can often be managed through medical therapy initially. Choice C, Descending aneurysm, may not require immediate surgery unless symptomatic or rapidly expanding. Choice D, Symptomatic aneurysm, could refer to any type and would need further evaluation to determine the urgency of surgical intervention.

Correct Answer: A

Rationale: Placenta praevia is more common in women with a history of multiple pregnancies (Grandmultiparity), as repeated stretching of the uterine wall can lead to abnormal placental implantation. Preeclampsia is a separate condition associated with hypertension in pregnancy. Placenta fenestrate and placenta increta are specific placental abnormalities but do not directly cause placenta praevia.

Correct Answer: D

Rationale: The correct answer is D: All neonates need vitamin K for activation of thrombokinase. Vitamin K is essential for the synthesis of clotting factors in the liver, including thrombokinase, which plays a crucial role in blood clotting. In neonates, there is a deficiency of vitamin K due to limited transfer across the placenta and low levels in breast milk. Administering vitamin K at birth helps prevent hemorrhagic disease of the newborn. Choices A, B, and C are incorrect because vitamin K does not directly impact immunity, prevent jaundice, or promote normal gut bacteria growth in neonates.

Correct Answer: B

Rationale: The correct answer is B: Captopril. Captopril is an angiotensin-converting enzyme (ACE) inhibitor that can lead to oligohydramnios in pregnant women due to its effect on reducing fetal renal function. This can result in decreased amniotic fluid levels. Diazepam (A) is a benzodiazepine used for anxiety and is not associated with oligohydramnios. Ampicillin (C) is an antibiotic commonly used during pregnancy and does not cause oligohydramnios. Pethidine (D) is an opioid analgesic with no known association with oligohydramnios in pregnancy.