Midwifery Exam Practice Questions

Correct Answer: D

Rationale: The correct diagnostic test for the patient is a barium enema. This test is commonly used to evaluate the colon and rectum for conditions such as colonic obstruction, inflammatory bowel disease, or colorectal cancer. In this case, the patient's presentation of left lower quadrant pain with a history of constipation and variable bowel habits suggests a possible colonic obstruction, which can be visualized through a barium enema. A CT scan with contrast may be helpful in some cases but may not provide as clear a view of the colon as a barium enema. CBC with WBC differential is a general blood test and would not directly aid in diagnosing colonic issues. Colonoscopy, while a valuable tool for evaluating the colon, may not be suitable for this patient initially due to the acute nature of the presentation and the need to first rule out a potential obstruction.

Correct Answer: A

Rationale: The correct answer is A: Keep client well hydrated. Encouraging plenty of fluids helps prevent dehydration, maintain adequate urine output, and promote flushing of the urinary tract to prevent infections, all crucial for postnatal clients with urinary tract trauma. Proper hydration also supports overall health and aids in the healing process. B: Maintain proper fluid balance - While important, the main aim is to keep the client well hydrated to support healing. C: Facilitate proper healing - Proper hydration does facilitate healing, but the primary aim is to keep the client well hydrated. D: Control growth of organisms - While hydration can help in preventing infections, the main aim is to keep the client well hydrated.

Correct Answer: A

Rationale: In face presentation, the face is an ill-fitting presenting part, leading to obstructed labor. The face has larger diameters, making it difficult to pass through the birth canal. This differs from vertex delivery where the head can mold to fit. Caput succedaneum is swelling of the soft tissues on the baby's head and does not directly cause obstructed labor.

Correct Answer: C

Rationale: The correct answer is C. In myelodysplastic syndromes, splenectomy is indicated for sustained leukocyte elevation above 30,000 cells/�L to manage symptomatic splenomegaly and cytopenias. This is because an enlarged spleen can sequester and destroy blood cells, leading to low blood cell counts. Choices A, B, and D are incorrect as splenectomy is not typically indicated for major hemolysis unresponsive to medical management, severe symptoms of massive splenomegaly, or portal hypertension in the context of myelodysplastic syndromes.

Correct Answer: B

Rationale: The correct answer is B: Rotational injury. Flexion-distraction injuries of the thoracolumbar spine are often caused by rotational forces that occur during accidents such as motor vehicle collisions or falls. These forces lead to the spine being twisted, causing separation of the vertebrae. Blunt trauma (A) can cause various spinal injuries but is not specific to flexion-distraction injuries. Seat belts (C) are designed to prevent spinal injuries by restraining the body during a collision. Gunshot wounds (D) can cause spinal cord injuries but are not commonly associated with flexion-distraction injuries of the thoracolumbar spine.