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PRACTICE EXAM QUESTIONS &
ANSWERS(RATED A+)
Hyperemesis gravidarum, excessive nausea and vomiting, is influenced by all of the following except: A Increased hormones B Metabolic Disturbances C Psyche Disturbances D Excessive eating - ANSWERSD Excessive eating Hyperemesis gravidarum usually resolves spontaneously at: A 20 weeks B 14 weeks C 12 weeks D 24 weeks - ANSWERSB 14 weeks The cause of hyperemesis gravidarum is: A Failure of the placenta to implant effectively B Unknown C Low blood sugar levels D Polyhydramnios - ANSWERSB Unknown Antepartum haemorrhage is defined as bleeding from the genital tract occurring: A In late pregnancy B After the 20th week of gestation C Before the onset of labour D All of the above - ANSWERSD All of the above When assessing a woman who has had a severe APH the IMMEDIATE care will be: A To replace blood volume B To complete an ultrasound scan C To assess the foetal condition D To complete a vaginal speculum examination - ANSWERSA To replace blood volume In the event of an antepartum haemorrhage vaginal bleeding may be described as: A Revealed bleeding B Concealed bleeding
C Revealed and concealed (mixed) bleeding D All of the above - ANSWERSD All of the above Beverley Smith a primigravida at 29 weeks, presents at delivery suite with a history of one episode of painless vaginal bleeding. Ultrasound scanning reveals placenta previa with the placenta reaching the cervical os edge. Which type of placenta previa is Beverley presenting with? A Type I B Type II C Type III D Type IV - ANSWERSB Type II Vaginal bleeding due to placenta previa is initiated by: A Vaso constriction of vessels leading to the placenta B A sudden increase in maternal blood pressure C Blood seeping between foetal membranes and uterine wall D Tearing of anchoring villi as the lower segment forms - ANSWERSD Tearing of anchoring villi as the lower segment forms Suzie is diagnosed as having a multiple pregnancy. Ultrasound confirms twins. Multiple pregnancy may be suspected if: A Foetal limbs are felt on both sides of the abdominal midline B The uterus appears round, tense and tender C There is excessive foetal movement D The uterus appears too large for the estimated age of gestation - ANSWERSD The uterus appears too large for the estimated age of gestation Suzie asks about the likelihood of having dizygotic twins. The incidence: A Remains unchanged throughout the reproductive life B Increases with age C Decreased with age D Is not affected by age - ANSWERSB Increases with age Monozygotic twins: A Usually result from clomiphene treatment B Develop from one ovum and two spermatozoa C Share one placenta and one chorion D May be of different sexes - ANSWERSC Share one placenta and one chorion A monozygotic twin pregnancy is associated with: A Increased risk of foetal abnormalities B Increased maternal age C Family history of twins D Use of fertility drugs - ANSWERSA Increased risk of foetal abnormalities Following delivery of the twins Suzie is at increased risk of:
D All of the above - ANSWERSD All of the above A direct coombs investigation tests for: A Cystic fibrosis B Spina Bifida C Maternal antibodies D Kleihauer - ANSWERSC Maternal antibodies The process of forming antibodies is called iso-immunisation. Prevention of maternal iso-immunisation occurs by: A Avoiding Rh positive blood transfusion B Prevention of feto-maternal blood mixing C Administration of anti-D immunoglobulin D All of the above - ANSWERSD All of the above Should antibodies be formed, Janet's baby is at risk of developing which of the following? A Phenylkentonuria B Haemolytic disease of the newborn C Physiological jaundice D Hypoglycaemia - ANSWERSB Haemolytic disease of the newborn Cindy had an epidural during her labour. When giving an epidural the anaesthetist will inject the anaesthetic solution between: A The arachnoid mater and pia mater B The cauda equina and the cerebrospinal space C The duramater and the ligamentum flavum D The pudendal nerve and the uterine plexus - ANSWERSC The duramater and the ligamentum flavum Should Cindy suddenly become hypotensive following administration of an epidural anaesthetic which is the BEST course of action: A Turn the woman on her left side, give vasopressor, increase IV fluids B Increase IV fluids, give vasopressor, turn woman on her right side C Turn woman on her left side, increase IV fluids, administer O2 via a facemask D Give vasopressor, decrease IV fluids, turn woman on her left side - ANSWERSA Turn the woman on her left side, give vasopressor, increase IV fluids You are present when Mary, who is a severe diabetic, has a stillborn son. The FETAL DEATH rate is the number of infants born dead after 20 completed weeks of pregnancy and/or who weigh 400gms per: A 1000 total births B 1000 stillbirths C 100,000 total births D 100,000 stillbirths - ANSWERSA 1000 total births
The NEONATAL death rate per 1000 LIVE births is defined as: A Death occurring in the first 28 days of life B Death occurring in the first week of life C Death occurring in the first year of life D Death occurring in the first 24 hours of life - ANSWERSA Death occurring in the first 28 days of life Physiological jaundice in the newborn may be caused by ONE of the following: A Haemolytic disease of the newborn B Accumulation of bilirubin with breakdown of Hb C Sulphonamide drugs D Large doses (>5mgs) of Konakion IM - ANSWERSB Accumulation of bilirubin with breakdown of Hb Pathological Jaundice is a failure of bilirubin to be conjugated. WHICH of the following enzymes is necessary for conjugation of bilirubin: A Alpha amylase B Glucuronyl transferase C Tryspin D Protinase - ANSWERSB Glucuronyl transferase You notice Hilda's baby has nasal flaring and grunting respirations. Which condition is MOST likely to be developing? A Hypothermia B Respiratory distress syndrome C Dehydration D Respiratory infection - ANSWERSB Respiratory distress syndrome Tiny white spots across a newborns nose are called: A Mongolian spots B Haemangioma c Milia D Erythema toxicum - ANSWERSc Milia A neonate born to a drug dependent mother is MOST likely to exhibit which ONE of the following EARLY signs of drug effect: A Dry skin B Fever C High pitched cry D Restlessness - ANSWERSC High pitched cry Bettina, at term with ruptured membranes for 36 hours, is induced and delivers a healthy daughter. Within 24 hours of birth Bettina's baby manifests a temp of 38 degrees. Which of the following tests will take PRIORITY in the care of a newborn with a raised temp: A Blood glucose test
B The foetal position is in the transverse lie C The second stage of labour is prolonged D The anterior shoulder is 'caught' by the symphysis pubis - ANSWERSD The anterior shoulder is 'caught' by the symphysis pubis Hyperflexion of the mother's legs against her abdomen is one non-invasive means of expediting delivery of the baby in shoulder dystocia. This manoeuvre is known as: A Gonik manoeuvre B Rubin technique C McRobert's manœuvre D Loveset manœuvre - ANSWERSC McRobert's manœuvre Following delivery Anna has a primary post partum haemorrhage. This is bleeding: A After the delivery of the baby until six weeks post partum B Intra and post partum and up to six hours post partum C During the third stage of labour and within the following 24 hours D From the second stage of labour until 48 hours post partum - ANSWERSC During the third stage of labour and within the following 24 hours Which of the following amounts constitutes a post partum haemorrhage? A 300mls B 500mls C 1000mls D 1500mls - ANSWERSB 500mls Which of the following factors may increase the risk of post partum haemorrhage: A Maternal anaemia B Placenta praevia C Placenta Accreta D All of the above - ANSWERSD All of the above Anna is diagnosed with placenta accreta, a condition BEST described as: A Morbid adherence of the placenta to the uterine wall B Intra-uterine fibroids C A placenta with sccenturiate lobe D None of the above - ANSWERSA Morbid adherence of the placenta to the uterine wall Elizabeth is experiencing a prolonged labour after two previous precipitate labours. Her prolonged labour is most likely due to: A Transverse lie B Cephalo-pelvic disproportion C Occiput posterior position D Breech presentation - ANSWERSC Occiput posterior position
You visit Joan at home in the post partum period. She complains to you that she finds it difficult to walk due to pain in her left leg. On examination you find that her calf is very swollen tender and hot. You measure both calves and find that the left calf is 3cms larger than the right. What diagnosis would you suspect? A Pulmonary embolus B Deep vein thrombosis C Superficial thrombosis D Infection - ANSWERSB Deep vein thrombosis The physician confirms your diagnosis and Joan is commenced on what specific group of drug therapy: A Antibiotics B Antipyretics C Analgesics D Anticoagulants - ANSWERSD Anticoagulants Kate is G1 P0, 38/40 gestation. You visit her at home and she states that she feels fine. You observe that she has oedema of the hands and feet. On assessment her BP is 170/110 and the urinalysis shows +++protein. As the LMC what condition would you suspect? A Gestational hypertension B Eclampsia C Pyelonephritis D Pre-Eclampsia - ANSWERSD Pre-Eclampsia You explain to Kate that she needs to be admitted to hospital for further tests and delivery of her baby. A blood screen indicates a raised uric acid and a scan shows reduced liquor volume. The obstetrician has recommended an induction of labour. Contra indications for induction of labour include all of the following EXCEPT: A Cephalopelvic disproportion B Malpresentation C Fetal distress D Prematurity - ANSWERSD Prematurity In an attempt to reduce cerebral irritability one of the following drugs may be given to Kate via IV infusion: A Labetalol hydrochloride B Magnesium sulphate C Frusemide D Oxytocin - ANSWERSB Magnesium sulphate Kate and her partner are informed of the necessity of an induction of labour. On vaginal examination her Bishops score was said to be favourable. What does a bishop's score assess? A Consistency of the cervix and station B Effacement and dilation
D Involuntary movements, impaired memory and impaired judgement - ANSWERSB The production of thick mucous, destruction of structure and function of organs The two arteries of the umbilical cord carry: A Deoxygenated blood to the placenta B Oxygenated blood to the foetus C Oxygenated blood to the intervillous spaces D Deoxygenated blood to the decidua basalis - ANSWERSA Deoxygenated blood to the placenta Physiological anaemia of pregnancy is explained as: A Hypovolaemia, a fall in haemoglobin, and fibrinolysis B Red cell reduction, fibrinolysis and hypervolaemia C Hypervolaemia, red cell reduction and haemodilution DHypervolaemia, white cell reduction and haemodilution - ANSWERSC Hypervolaemia, red cell reduction and haemodilution Compression of the inferior vena cava by the pregnant uterus can result in: A A stress response B Peripheral vasodilation C Supine hypotension D Varicose veins - ANSWERSC Supine hypotension Tracey a G1 P0 is 18 weeks pregnant. Her last menstrual period began on 10 October, her expected delivery date would be: A 17 June B 17 July C 27 July D 2 August - ANSWERSB 17 July Complementary therapies are being used more frequently in midwifery care. The NZCOM consensus statement on this indicates that: A The midwife can use these therapies if she is comfortable doing so B The midwife must have completed a recognised course before using complementary therapies C Complementary therapies are not to be used at any time by the midwife D The midwife can use any complementary therapies provided the woman gives her informed consent - ANSWERSB The midwife must have completed a recognised course before using complementary therapies Tracey asks you as her midwife about the use of homeopathy during pregnancy, you do not use homeopathy in your practice. You: A Advise Tracey to go to the library to find some information on the subject B Get some reading material for Tracey and advise her on the use of homeopathics C You refer her to a homeopath who can provide her with the information
D You tell her you do not use homeopathics and so cannot help her - ANSWERSC You refer her to a homeopath who can provide her with the information Tracey is having problems with constipation and asks you for advice. You: A Advise that she can take a laxative each morning to help avoid constipation B Advise she go to her GP for help and advice C Tell her constipation is aggravated by taking iron supplements so they are best avoided D Advise she increase the fibre and fluid intake in her diet - ANSWERSD Advise she increase the fibre and fluid intake in her diet Tracey asks you advice about her nutritional requirements during pregnancy. You advise that: A Insufficient dietary calcium may interfere with normal fetal bone growth B She should take vitamin and mineral supplements during her pregnancy C In order to meet her increased energy demands she should be eating for two D Tea and coffee help with the absorption of iron - ANSWERSA Insufficient dietary calcium may interfere with normal fetal bone growth Anaemia during pregnancy may place a woman at risk for: A Uterine atony and postpartum haemorrhage B Prolonged pregnancy C An increase in ferritin and haematocrit D Jaundice - ANSWERSA Uterine atony and postpartum haemorrhage What does your initial labour assessment include? A Maternal temperature, vaginal examination and fetal heart rate B Maternal vital signs, assessment of contractions, abdominal palpation and fetal heart sounds C Maternal urine test, temperature, pulse, resps, rectal examination DFetal heart sounds, maternal pulse and urine test - ANSWERSB Maternal vital signs, assessment of contractions, abdominal palpation and fetal heart sounds
