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MIDWIFERY EXAM PRACTICE STUDY GUIDE
Hypothyroidism - Answers - A condition of a deficient thyroid Lymphoma - Answers - lymphatic tumor Bradycardia - Answers - slow heart Primigravida - Answers - a women who is pregnant for the first time Appendectomy - Answers - surgical removal of the appendix Hysterectomy - Answers - surgical removal of the uterus Anesthesia - Answers - without feeling Tachypnea - Answers - Fast breathing Apnea - Answers - not breathing Antepartum - Answers - before birth Postpartum - Answers - after birth Intrapartum - Answers - between birth Dystocia - Answers - Condition of a difficult/abnormal childbirth Multipara - Answers - a woman that has had more than one offspring Hypothermia - Answers - low temperature Perianal - Answers - around the rectum Sublingual - Answers - pertaining to under the tongue Dysuria - Answers - condition of painful urination Suprapubic - Answers - above the pubis Pelvimetry - Answers - measurement of the pelvis A fast heart rate - Answers - tachycardia A condition of decreased urine - Answers - cystitis
Bladder inflammation - Answers - Uritis An inflamed vein caused by a clot - Answers - thrombophlebitis condition of having high blood sugar - Answers - hyperglycemia Destruction of blood - Answers - hemolysis An abnormal condition of appearing blue - Answers - cyanosis excessive vomiting - Answers - peremesis Disease of the nerves - Answers - neuropathy Difficulty breathing - Answers - dyspnea A woman who has never given birth - Answers - nulliparous A woman who has given birth once - Answers - primiparous white blood cells - Answers - leukocytes A condition of having a lack of clotting cells (platelets) - Answers - thrombopenia Having too much water from the amnion - Answers - polyhydramnios You have been having chronic pains in your upper abdomen and your physician refers you to a specialist in diseases of the digestive tract called a - Answers - Gastroenterologist Your mother is having her uterus surgically removed along with her ovaries. Removal of ovaries is called - Answers - hysterectomy A woman has become sterile due to chronic inflammation of her uterine tubes from frequent infection with sexually transmitted diseases. This tubal inflammation is called - Answers - salpingitis A female patient has a special X-ray procedure of the breasts performed the X-ray image is called a - Answers - mammogram Inflammation of the veins is termed - Answers - phlebitis The medical technician who draws blood from a vein for laboratory tests is called a - Answers - phlebotomist
English midwives of the seventeenth century were licensed by - Answers - The Church of England What were some factors in the decline of midwifery between the 16th and 20th centuries - Answers - 1. Religious attitudes that viewed midwives as a threat and/or as being witches 2. Midwives lack of access to education 3. Campaign by physicians to discredit midwives 4. Midwives' lack of organization 5. The general low status of women in society 6. Replacement of midwives with physicians Delivering babies was historically viewed as "women's work". What factors led men to become interested in attending women in birth? - Answers - Medicine became more competitive, and birth was viewed as a lucrative business and attending a woman during birth ensured an ongoing patient population consisting of the whole family What was on way that pregnant women contributed to the decline of midwifery in the 18th and 19th centuries? - Answers - By following the fashionable trend to have male midwives attend them What factor could have sustained the practice of midwifery? - Answers - Allowing women access to medical education Tactics used to discredit midwives in the early 20th century included which of the following? Select all that apply. A. Characterizing midwives as slovenly and unclean B. Promoting legislation to standardize and broaden midwifery practice C. Blaming the high infant and maternal mortality rates on midwives D. portraying midwives as "loose" women, promiscuous and immoral E. Claims that trying to improve the practices of midwives was impossible - Answers - A, C, D, E What was the goal of the "midwife problem" campaign? Select all that apply. A. To prevent midwives from practicing B. To prevent midwives from overcharging C. To determine and set fair fees for midwifery services D. To improve obstetric care practices E. To raise the status of physicians - Answers - A The first nurse-midwifery service in the US (Select all that apply) A. was staffed by British trained midwives brought to the US by Mary Breckinridge B. provided care to families in remote, mostly primitive areas of the Kentucky mountains C. had, over the first 25 years of service, a maternal mortality rate of 12 per 10,000, compared to the national rate of 34 per 10,000 for the same period D. established the first school for midwives in the US - Answers - A, B, C Which of the following statements are true about midwifery and childbirth, up until the mid-1900s (select all that apply)
A. "traditional" midwives continued to pass on their knowledge via apprenticeship B. birth moved from taking place primarily in the home to primarily in the hospital C. some health departments provided training of midwives by public health nurses D. Fewer physicians and the higher birth rate (1950s "baby boom") led to acceptance of midwives and hospital privileges for CNMs. - Answers - B, C The Midwives Alliance of North America (MANA) was established (select all that apply) A. in 1982 B. as an organization supporting all midwives C. as a school for direct-entry (non-nurse) midwives D. and identified core competencies and standards for midwives E. and began certifying direct-entry midwives - Answers - A, B, C, D, E MANA helped from which organization? - Answers - NARM What organizations offer certification for non-nurse midwives? - Answers - ACNM and MEAC National accreditation of midwifery education programs leading to the Certified Professional Midwife credential is through the? - Answers - Midwifery Education and Accreditation Council True or False? Direct-entry midwifery is illegal in some states - Answers - True Lay midwifery was first legalized in Texas in: - Answers - Midwifery has always been legal in Texas What was the name of the book published in 1975 that had a major impact on both natural childbirth and midwives/midwifery? - Answers - Spiritual Midwifery Who authored the book "Spiritual Midwifery"? - Answers - Ina May Gaskin Define "Core Competencies" - Answers - delineate the fundamental knowledge, skills and behaviors expected of members of the profession What are the following are the four broad principles that define the ethics of working with or caring for human beings? - Answers - Autonomy, Beneficence, Justice and Nonmaleficence Credit for the perseverance of midwifery as a profession in the US should be given to - Answers - Women's insistence on midwifery care Competency-based certification by the North American Registry of Midwives includes all of the following except: A. Verification of character B. Verification of minimum clinical requirements
Your gravida 2, para 1 client calls you at 26 weeks to report light bleeding. The first thing you should do is: - Answers - Order an ultrasound immediately True diabetes is related to all of the following complications except A. Postpartum hemorrhage B. Neonatal respiratory distress C. Pre-eclampsia D. Oligohydramnios E. Neonatal hypoglycemia - Answers - A Your Gravida 3, Para 1 client at 16 weeks gestation complains of occasional nausea, fatigue, mild "crampy" feelings. She denies any bleeding or other vaginal discharge and has no other complaints. Vitals signs are all normal, she has gained 2 lbs since her last visit, and her fundus is approximately midway between the pubic bone and her umbilicus. Her urine check shows the following: Protein= trace, Glucose=negative, Blood = negative, Nitrates= positive, Ketones= trace, Leukocytes= trace, You suspect: - Answers - Morning sickness with poor appetite Carol, your Gravida 1, Para 0 client is in early labor. She should be encouraged to - Answers - rest and conserve her energy A Gravida 2, Para 0 client is at 41 4/7 weeks gestation. She calls to report that she hasn't felt the baby move for several hours. You see her and find the FHT consistently 140, even with vigorous palpation. Fundal height measures 37 cm, a drop of 1cm from her exam 5 days ago. - Answers - The birth is imminent. Advise rest The midwife visits a postpartum multipara client on day 3. She complains of abdominal pain when nursing. All of the following are appropriate remedies except: A. Frequent urination B. Motrin C. Cramp bark tincture D. Aspirin - Answers - D The two essentials in stabilization of the newborn in the first few minutes after birth are:
- Answers - Ensure a clear airway and warmth Barrier precautions should be used in all of the following situations except: A. Examining a mother's teeth and mouth B. Cleaning up blood from a bathroom floor C. Performing a breast exam on a lactating mother D. Palpating a mother's abdomen who's skin is extremely sweaty E. Handling the newborn following birth - Answers - D
You are assisting a client in labor. Her membranes rupture suddenly and splash your face and eyes. You should - Answers - Flush your eyes with water and wash your face as soon as possible Which of the following statements concerning cleanliness and universal precautions is not correct? A. You should always wash your hands prior to handling the newborn at a postpartum visit B. When washing hands you should remove any rings or jewelry with rough edges and clean beneath your nails C. Always wear clean clothes to a birth D. Gloves should be worn when drawing blood and collecting vaginal cultures E. Wearing gloves is an acceptable alternative to hand washing - Answers - E Assessments made during labor should be charted - Answers - As soon as they are completed All of the following are true about medical charts except: A They are legal documents B. Skip one line before the beginning of each new entry C. All entries should be dated, timed and initialed D. Draw one straight line through any mistake made and write "error" above it - Answers
- B Which of the following should not be included in your client's chart? A. A complete record of all her prenatal exams, including refusal or agreement to recommended procedures B. Notes concerning any consultation with another healthcare provider C. The date, time and notes from any phone conversations between you and your client D. Any email correspondence between you and your client E. None of the above is a correct answer - Answers - E Your 17 year old client's mother drops by your office. She wants to know if her daughter's lab test results are back so she will know if she is anemic. You should: A. Explain you can only give the results to her daughter B. Give the results to your client's mother since your client is a minor C. Give your client's lab results to her mother since it is in the best interests of your client D. Leave your client's chart lying open so her mother can read it - Answers - A Are visual disturbances subjective or objective? - Answers - Subjective Are headaches subjective or objective? - Answers - Subjective Is protein in the urine subjective or objective? - Answers - objective
A normal range for an adult oral temperature is: - Answers - 96.4-100. True or False: A normal axillary temperature is approximately .5-1 degree F lower than an oral temperature. - Answers - True All of the following are a normal axillary temperature in a newborn except: A. 98. B. 97. C. 98. D. 97.0 - Answers - A What is a normal range for a tympanic membrane temperature? - Answers - 98.2 F - 100F A normal range for a temporal temperature reading is: - Answers - 98.7 F - 100.5 F True or False: A temporal artery temperature is normally about a degree higher than an oral temperature. - Answers - True What are six factors that cause hypothermia or fever. - Answers - hypothyroidism, dehydration, hyperthyroidism, infection, starvation and hard exercise Which of the following is NOT a cause of hypothermia? A. Hypothyroidism B. Hypoglycemia C. Starvation D. Stress - Answers - D What affect does pregnancy have on body temperature? - Answers - increase by .5 C What are two risks or contraindication to taking a rectal temperature? - Answers - Low white cell count and Constipation In which of the following situations would a temperature measurement using a thermometer inserted into the sublingual pocket be inappropriate A. A newborn baby being held by his mother B. A woman you are examining at her initial prenatal exam C. A coherent woman in labor who has not eaten or drank anything within the past 30 minutes - Answers - A Which of the following is not a contraindication for obtaining an oral temperature? A. A person who just smoked a cigarette B. A person experiencing nausea or vomiting C. A person who is asleep D. A person who is a nose breather - Answers - D
What location for temperature measurement would be most likely to result in the transmission of pathogens? - Answers - Mouth Which of the following are necessary factors in obtaining an accurate axillary temperature? Select all that apply: A. No mouth breathing during measurement B. Maintaining good skin contact C. Must be left in place an adequate amount of time D. Wait at least 30 minutes following bathing - Answers - C True or False: The presence of amniotic fluid and vernix in a newly born infant rules out the use of the tympanic membrane location for temperature measurement - Answers - True Which of the following can cause an inaccurate reading when using a temporal thermometer? Select all that apply A. Moving the thermometer too quickly B. Breaking contact with the skin C. Presence of sweat D. Wearing a hat or wig - Answers - C and D True or False: One of the main advantages of using a temporal artery thermometer is the many reliable studies demonstrating the accuracy of this method. - Answers - False Define Pulse - Answers - Contraction of the heart causes blood flow forward, which creates a pressure known as a pulse What is a normal, average pulse rate in a healthy non-pregnant adult woman? - Answers - 65 - 85 beats What is a normal pulse range in a healthy non-pregnant adult woman? - Answers - 60 - 100 bpm What is the normal pulse range for a newborn? - Answers - between 110 and 160 bpm What is the normal average pulse rate for a newborn? - Answers - approximately 130 bpm You are counting the pulse of your new client who is at 12 weeks gestation. You note each pulse occurs with a varies interval between beats. You describe the rhythm of her pulse as: - Answers - Irregular While listening to Carla's apical pulse you note that her heart rate varies with respiration, speeding up during inhalation and slowing during expiration. This is called - Answers - Sinus arrhythmia
Explain why accurate measurements of blood pressure are particularly important during pregnancy - Answers - Changes in blood pressure can have serious consequences for both the woman and baby Define blood pressure - Answers - Blood pressure is the force exerted by the blood on the blood vessel walls Compare systolic and diastolic pressure - Answers - Systolic pressure is when the arteries contain the maximal amount of blood pressure while diastolic pressure is when the lease amount of blood pressure is in the artery What is an adults average blood pressure - Answers - 120/ The World Health Organization and Institute for Health and Clinical Excellence define hyptertension as: - Answers - over or equal to 140/ What is an abnormal variation in blood pressure from one arm to the other arm? - Answers - 20 mmHg systolic pressure difference and 10 mmHg diastolic pressure difference. Hypotension and Hypertension What 5 factors contribute to the blood pressure? - Answers - Cardiac output, peripheral vascular resistance, circulating blood volume, viscosity, and elasticity of vessel walls Discuss the normal changes in blood pressure during pregnancy as outlined in Skills for Midwifery Practice - Answers - There will be a slight decrease during the first semester. Blood pressure continues to rise returning to prepregnancy levels by term How is pulse pressure measured? - Answers - You measure the pulse pressure by getting the difference between the systolic blood pressure and diastolic blood pressure. According to Skills for Midwifery, what is considered to be a normal pulse pressure? - Answers - 20 mmHg According to Nursing Health Assessment, what is considered to be a normal pulse pressure? - Answers - 40 mmHg What are Korotcuff sounds? - Answers - The Korotcuff sounds are the blood-pressure phases. Define and describe the auscultatory gap. - Answers - The auscultatory gap comes in 5% of hypertensive patients during Phase II. It is a short period of silence during this phase At about what rate should the cuff be deflated? - Answers - 2 - 3 mmHg per secon
Average energy intake recommended for energy balance and weight maintenance in adults - Answers - EER Average intake level that meets the need of half of all healthy individuals - Answers - EAR Recommended range of caloric intakes for the energy-yielding nutrients - Answers - AMDR An updated set of nutritional reference values that apply to healthy people - Answers - DRI When an RDA has yet to be established, this value serves as the recommended adequate intake level - Answers - AI Highest intake level of a nutrient thought to be safe - Answers - UL Average intake level that meets or exceeds the needs of 97-98% of healthy individuals - Answers - RDA Which dietary tool requires both training of the client as well as explicit take-home instructions to the client? - Answers - Diet records Dr. Sullivan is conducting a clinical trial to determine if vitamin Z can improve test performance of students in an introductory college nutrition course. Dr. Sullivan puts all the students' names in a hat and draws names to determine if they will be placed in the control or the experimental group. The experimental group receives a capsule of vitamin Z and the control group a "Sugar pill" that tastes and looks identical to the vitamin Z capsule. Neither Dr. Sullivan nor the participants know who is receiving which treatment. This experiment is best described as: - Answers - Double-blind, random selection, placebo controlled Assuming each has the same number of calories, which has the greatest nutrient density? A. 1 medium fresh orange B. 3/4 cup orange juice C. 2 whole wheat crackers D. 1 slice of white enriched bread - Answers - A Describe how the FDA determines a serving size. - Answers - The FDA based its calculations on a 2000-calorie diet Which of the following is required on a food label? A. Potassium (mg/serving) B. Calcium (mg/serving) C. Magnesium (mg/serving)
Why is it NOT necessary to eat all essential amino acids at one meal? - Answers - By taking all of the essential amino acids at one meal you make the different transporting sites get on ekind of amino acid and not the other. Also, it can be toxic to the body to take a lot of amino acids at once. A deficiency of protein can lead to a condition called _____ in which fluid accumulates in the body's tissue spaces. - Answers - Edema Which of the following supplements would you recommend a vegan add to his/her diet - Answers - protein Vegetarian diets are associated with increased consumption of - Answers - vitamins B12 and D The two primary co-enzymes in oxidative metabolism are derived from: - Answers - Antioxidants Which food should be avoided in galactosemia? - Answers - non-fat milk IN general, which are the two most toxic fat soluble vitamins? - Answers - Vitamin A and D are the most toxic Which of the following is true about iron? - Answers - heme iron is more easily absorbed Which of the following decreases the absorption of zinc and iron - Answers - oxalic acid What minerals are correctly linked with the associated disease risk? - Answers - Chromium and type 2 diabetes Which of the following is the BEST source of thiamin? - Answers - Whole grains Important as part of the TPP compound involved in energy metabolism - Answers - Thiamin Trace mineral involved in protein, fat, and carbohydrate metabolism - Answers - Manganese Needed by the liver to detoxify alcohol - Answers - Sulfur Component of the coenzyme FAD - Answers - Riboflavin Critical in the synthesis of thyroid hormones - Answers - Iodine MAde from the amino acid tryptophan - Answers - Niacin
Supplement used to treat premenstrual syndrome - Answers - B Approximately 1/3 of riboflavin is supplied int he American diet by - Answers - Milk Jackie eats a banana, tuna fish sandwich, dry granola, and a slice of cheese. Which of these foods has the highest amount of available niacin - Answers - tuna fish What is the primary symptom of niacin toxicity? - Answers - Flushing Chromium assists in _____ uptake - Answers - glucose _____ is a type of mental retardation caused by insufficient iodine during fetal development. - Answers - Cretinism Identify the 4 major mineral salts known as electrolytes. - Answers - Sodium, potassium, chloride and phosphorous True or False: When blood volume decreases, blood pressure increases - Answers - False True or False: a diet rich in potassium has been shown to help maintain a healthy blood pressure - Answers - True Phosphorus absorption is enhanced by - Answers - Vitamin D One cup of water is equal to - Answers - 240 ml What water-soluble vitamin can regenerate vitamin E after it has been oxidized? - Answers - Vitamin C What is a function of vitamin E? - Answers - protecting PUFA in cell membranes from oxidation Taking vitamin E supplements along with _____ can cause uncontrollable bleeding. - Answers - anticoagulants What is rich in sources of vitamin C? - Answers - Green and red peppers What is a symptom associated with consuming a megadose of vitamin C? - Answers - nausea and diarrhea Which three minerals are cofactors of the superoxide dismutase enzyme complex? - Answers - copper, zinc and maganese Selenium is part of the ________ antioxidant enzyme system - Answers - Peroxidase
Antioxidant; protects cell membranes of phagocytes and prevents damage to normal tissue during immune response - Answers - Vitamin C Necessary for gene expression and enzyme activation for B and T cell proliferation - Answers - Zinc Necessary for adequate growth factor which allows immune cells to multiply - Answers - Protein/energy Proper function neutrophils, of T cells, and B cells - Answers - Iron T and B cell proliferation; coenzyme for glutathione peroxidase - Answers - Selenium Four characteristics of a healthful weight - Answers - 1. A weight that is appropriate for your age and physical development
- A weight that you can achieve and sustain without severely curtailing your food intake or constantly dieting
- A weight based on your genetic background and family history of body shape and weight
- A weight that is compatible with normal blood pressure, lipid levels, and glucose tolerance. Impulsive, low self-esteem, seeks attention, extroverted, and erratic describe personality traits of - Answers - bulimia nervosa True or False: For physical activity to improve general health and fitness each session should be at least 10 minutes without interuption - Answers - False Each day Nina power-walks for 45 minutes. What fuel sources provide energy during this activity - Answers - fatty acids and glucose IN what event would carbohydrate loading be the most beneficial - Answers - Weight lifting The food-borne illness caused by Campylobacter jejuni is associated with consuming: - Answers - Water that has been contaminated with fecal material Tapeworms, fluked, and roundworms are examples of - Answers - helminthes Solanine is a toxin found in: - Answers - green potatoes True or False: The safety of raw seafood cannot be guaranteed, it must be cooked - Answers - True
Foods most commonly associated with Salmonella intoxication are? - Answers - eggs and chicken Genetic modification - Answers - Changing an organism's natural traits by altering the DNA material Pasteurization - Answers - Sterilization process that applies high temperatures for a short period of time Nitrates - Answers - Antibacterial and color enhancer used in meats Freeze drying - Answers - Preservation technique that rapidly evaporates water at low temperatures Pesticides - Answers - A family of chemicals used to destroy agents that harm plants Irradiation - Answers - Sterilization process in which radiation energy is applied to foods Aseptic Packaging - Answers - Packaging process that does not require refrigeration or preservatives A food product containing 95% organically produced ingredients would be labeled - Answers - Organic True or False: Organic farmers cannot use pesticides - Answers - False
