Midwifery Exam Practice Questions

Correct Answer: C

Rationale: The correct answer is C because establishing an intravenous line is essential for immediate access to administer fluids, medications, and blood products during the emergency cesarean section. This step ensures that the patient's vital signs can be supported, and any emergent interventions can be readily delivered. A: While informed consent is important, in an emergency situation, the priority is to ensure the patient's immediate medical needs are met. B: Inserting a Foley's catheter may be necessary during the procedure, but it is not the most critical assessment prior to the cesarean section. D: Shaving the perineal area is not a priority in an emergency situation and may be done during the preparation for surgery.

Correct Answer: A

Rationale: Rationale for choice A: Calcium channel antagonists are the treatment of choice for achalasia as they help relax the lower esophageal sphincter, improving swallowing. This is a non-invasive option that can provide symptom relief for many patients. Summary for other choices: B: Intrasphincter botulinum injection is a temporary solution and not considered the treatment of choice. C: Pneumatic dilation is another option for achalasia but is typically used if calcium channel antagonists are ineffective. D: Myotomy and partial fundoplication is a more invasive surgical option and usually considered if other treatments fail.

Correct Answer: C

Rationale: The correct answer is C. In Cushing's syndrome, there is excess cortisol production leading to sodium retention, potassium loss, and increased protein breakdown. Low sodium and potassium levels along with high BUN are commonly seen in patients with Cushing's syndrome. A: Low potassium and high glucose are possible findings, but high white blood cell count is not typically associated with Cushing's syndrome. B: High sodium and polycythemia are not typical findings in Cushing's syndrome, and low BUN is not consistent with the protein breakdown seen in this condition. D: High sodium and high chloride levels can be seen, but high RBCs are not typically associated with Cushing's syndrome.

Correct Answer: C

Rationale: The correct answer is C: Truncus arteriosus. In this congenital heart defect, a single large blood vessel arises from the heart instead of the normal two separate vessels (aorta and pulmonary artery). This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygen supply to the body. This condition is incompatible with life, causing immediate death after birth. A: Pulmonary stenosis and B: Aortic coarctation are also congenital heart defects but do not typically result in immediate death after birth. Pulmonary stenosis obstructs blood flow to the lungs, while aortic coarctation causes narrowing of the aorta. D: Ductus arteriosus is a normal fetal blood vessel that connects the pulmonary artery and the aorta but usually closes shortly after birth. Failure of closure can lead to health issues, but it is not typically a cause of immediate death after birth.

Correct Answer: D

Rationale: The correct answer is D, "All of the above." Fetal macrosomia, malpresentation, and pelvic abnormalities are all known causes of obstructed labor. Fetal macrosomia refers to a large baby, which can lead to difficulty in passing through the birth canal. Malpresentation occurs when the baby is not positioned optimally for delivery, such as breech or transverse positions. Pelvic abnormalities, such as a contracted pelvis, can impede the baby's passage during labor. Therefore, selecting option D is appropriate as it encompasses all the major causes of obstructed labor. Choices A, B, and C are not individually comprehensive enough to cover all potential causes of obstructed labor.