Midwifery Exam Practice Questions

Correct Answer: A

Rationale: The correct answer is A because the Brain Trauma Foundation recommends intracranial pressure monitoring for patients with traumatic brain injury and a GCS of 3 to 8, regardless of the head CT findings. Intracranial pressure monitoring helps in the management of elevated intracranial pressure, which can be life-threatening. Abnormal head CT findings may indicate the need for immediate intervention, but intracranial pressure monitoring is still recommended for all patients in this GCS range to guide treatment decisions. Choices B, C, and D are incorrect because hypotension, age > 40 years old, and bradycardia are not factors that would exclude a patient from needing intracranial pressure monitoring in the presence of a GCS of 3 to 8.

Correct Answer: B

Rationale: The correct answer is B: Magnesium sulphate. It is the drug of choice for managing eclampsia due to its ability to prevent and control seizures. Magnesium sulfate acts as a central nervous system depressant and smooth muscle relaxant, helping to prevent further seizures. Phenobarbitone (A) is not the first-line treatment for eclampsia. Calcium gluconate (C) is used to counteract calcium channel blocker toxicity, not for eclampsia. Sodium bicarbonate (D) is used to treat metabolic acidosis, not eclampsia.

Correct Answer: B

Rationale: The correct answer is B: By altering immune development. The maternal microbiome plays a crucial role in shaping the fetal immune system during pregnancy. Microbes in the mother's body can influence the development of the fetus's immune system through various mechanisms, such as immune cells crossing the placenta. This interaction helps the fetus develop tolerance to maternal antigens. Choice A (By increasing fetal weight) is incorrect because the maternal microbiome's influence is not primarily related to weight gain. Choice C (By reducing placental oxygen levels) is incorrect as it does not directly relate to the immune system development. Choice D (By enhancing amniotic fluid) is incorrect as the main influence is on the immune system rather than amniotic fluid enhancement.

Correct Answer: B

Rationale: The correct answer is B: Klumpke's palsy. Neonatal injury to nerve roots C8 & T1 leads to Klumpke's palsy, characterized by paralysis of the lower arm and hand muscles. This occurs due to damage to the lower trunk of the brachial plexus. Erb's palsy (choice A) involves C5 & C6 nerve roots, causing weakness in the shoulder and upper arm. Phrenic injury (choice C) affects the diaphragm, leading to breathing difficulties. Radial palsy (choice D) results from damage to the radial nerve, causing wrist drop and weakness in forearm muscles. Klumpke's palsy specifically matches the description of injury to nerve roots C8 & T1.

Correct Answer: C

Rationale: Step-by-step rationale for choice C: 1. Progressive cervical dilatation indicates effective labor progress. 2. Stopping the syntocinon drops prematurely allows natural labor progression. 3. Prematurely stopping drops before reaching full dilation may hinder labor. 4. Achieving cervical dilatation is a crucial indicator for successful labor. Summary: A: Contractions should be strong, not just moderate. B: Maternal observations alone do not determine labor progress. D: Fetal-related observations are important but not the primary indicator for stopping drops.