Midwifery Exam Questions

Correct Answer: C

Rationale: The correct answer is C: Baseline cardiac catheterization. Given the presence of a new onset grade IIVI crescendo-decrescendo cardiac murmur, a baseline cardiac catheterization is necessary to assess the severity and etiology of the murmur. This procedure will provide crucial information on the structure and function of the heart, helping to determine the appropriate management plan. A: Annual or biannual serial echocardiography is not necessary as the patient is currently asymptomatic and echocardiography has already revealed mild aortic calcification. B: Modification of activity level is not the immediate priority as the patient is very active physically and not reporting any limitations to daily activities. D: Statin therapy is not indicated based solely on the presence of a new murmur without further assessment of cardiac function through cardiac catheterization.

Correct Answer: D

Rationale: The correct answer is D because in deep transverse arrest, the sagittal suture of the fetal head is typically aligned with the oblique diameter of the pelvis, causing an obstruction in the descent of the baby. This alignment leads to a difficult labor scenario where the baby's head cannot pass through the pelvis due to the mismatch in diameters. Choices A, B, and C are incorrect because they do not accurately describe the specific anatomical alignment that characterizes deep transverse arrest. Choice A refers to occipito-frontal diameter, choice B refers to sub-occipito-bregmatic diameter, and choice C mentions a face to pubis delivery, which are not the defining features of deep transverse arrest.

Correct Answer: D

Rationale: Correct Answer: D Rationale: 1. Metformin should be held if the morning blood sugar is < 200 mg/dL to reduce the risk of lactic acidosis postoperatively. 2. Warfarin should be held 5 days before surgery to prevent excessive bleeding during the procedure. 3. Beta blocker (metoprolol) can be continued on the day of surgery to prevent rebound hypertension. 4. Vitamin E can be continued as it does not have significant interactions or adverse effects in this scenario. Summary: - Choice A is incorrect as it does not address the need to hold metformin and warfarin appropriately. - Choice B is incorrect as it discontinues medications too early and does not address metformin management. - Choice C is incorrect as it only addresses warfarin and does not consider metformin or other medications. - Choice D is the most appropriate approach as it addresses the specific considerations for each medication based on their effects and interactions.

Correct Answer: C

Rationale: The correct answer is C: Very low birth weight neonate. This designation is given to infants whose birth weight is less than 1500 grams. In this case, the neonate's weight of 1201 grams falls within the criteria for very low birth weight. Choice A is incorrect because being genetically small does not necessarily equate to low birth weight. Choice B is incorrect as low birth weight typically refers to infants weighing between 1500-2499 grams. Choice D is incorrect as extremely low birth weight pertains to infants weighing less than 1000 grams.

Correct Answer: C

Rationale: The correct answer is C: Gram negative infection. In sepsis, especially with a Gram negative infection, organ donation may pose a risk of transmitting the infection to the recipient. This can be life-threatening for the organ recipient. Renal failure (choice A), traumatic brain injury (choice B), and breast cancer (choice D) are not direct contraindications to organ donation. Renal failure may limit the suitability of certain organs, but it does not automatically disqualify a patient from donating other organs. Traumatic brain injury may impact brain donation but does not rule out other organ donation. Breast cancer may affect eligibility for certain organs but does not universally disqualify a patient from organ donation.