NARM Flashcards
“Midwives believe that every woman has a right to a safe, satisfying birth in the setting of her own choice, with respect for human dignity, cultural sensitivity, and informed choice.” The quote is an example of a:
1) Code of Ethics
2) Definition of Midwifery Practice
3) Policy and Protocol for the Practice of Midwifery
4) Philosophy of Care
4) Philosophy of Care
In which portion of the fallopian tubes does fertilization normally occur?
1) the ampulla
2) the interstitial segment
3) the infundibulum
4) the isthmus
1) the ampulla
A prenatal factor that may cause a hemorrhage is:
1) mismanagement of third stage
2) grand multipara
3) uterine atony
4) baby not able to nurse right away
2) grand multipara
During an abdominal examination of a woman at term, the midwife feels the cephalic prominence on the same side as the fetal parts. This is indicative of which of the following?
1) face presentation
2) vertex (occipital) presentation
3) transverse lie
4) ROA position
2) vertex (occipital) presentation
The increased activity of the endometrial glands during the luteal phase of the female reproductive cycle is stimulated by:
1) progesterone
2) estrogen
3) oxytocin
4) prolactin
1) progesterone
Shelley is a 25 year old gravida 3 para 2 who has missed two menstrual periods and is making her initial visit to the midwife. The midwife gave her a pregnancy test and it was positive. Shelley reports nausea and occasional vomiting in the mornings. Which physiologic change of pregnancy is probably causing Shelley’s nausea and vomiting?
1) altered stomach position
2) increased gastric motility
3) reflux of acidic secretions in to the lower esophagus
4) high levels of human chorionic gonadotropin
4) high levels of human chorionic gonadotropin
Janine had a baby 10 days ago and during a routine check up, she mentions to her midwife that the baby is requiring more frequent breast feeding. This change is probably associated with:
1) a diminished milk supply
2) the neonate’s first growth spurt
3) the need for supplemental feedings, such as cereal
4) early stages of mastitis
2) the neonate’s first growth spurt
Fetal heart rate variability is not affected by:
1) maternal sleep
2) the second stage of labor
3) fetal sleep
4) maternal drug use
1) maternal sleep
A woman is laboring at a birth center, and is acting irritable and cranky with her husband and mother-in-law, who have been with her almost constantly all night. She also has two sisters and a female cousin present, and a doula. The most appropriate action for the midwife to take would be to:
1) tell everyone to clear the room and stay out until she is pushing, because they are in the way
2) take her on a long walk outside with only her husband and the midwife
3) ask for some time alone with her and inquire whether the crowd is bothering her
4) tell her she must choose only two companions to stay in the room with her, the doula and one other person
3) ask for some time alone with her and inquire whether the crowd is bothering her
Which neonatal assessment finding should the midwife report to a physician if she finds this while conducting a newborn exam at one hour after birth?
1) a positive blink reflex
2) a positive Ortolani’s sign
3) a respiratory rate of 70 breaths per minute
4) a pulse of 170 beats per minute
2) a positive Ortolani’s sign
Which of the following is the largest diameter of the fetal head?
1) biparietal
2) occipitofrontal
3) suboccipitobregmatic
4) occipitomental
4) occipitomental
During the first 10-12 weeks of pregnancy, the corpus luteum:
1) gradually progresses and becomes obliterated
2) secretes estrogen to maintain the pregnancy
3) secretes hCG to maintain the pregnancy
4) secretes progesterone to maintain the pregnancy
4) secretes progesterone to maintain the pregnancy
Constipation during pregnancy is usually the result of:
1) prolonged stomach emptying time and decreased intestinal motility
2) increased peristalsis and flatulence
3) increased cardiac workload, resulting in delayed peristalsis
4) reflux of acidic gastric contents
1) prolonged stomach emptying time and decreased intestinal motility
Which of the following is a positive sign of pregnancy:
1) positive pregnancy test
2) enlargement of the abdomen and fetal movement
3) amenorrhea
4) ultrasound
4) ultrasound
A child born to a woman over the age of 35 has an increased risk of:
1) Trisomy 21
2) cleft palate
3) cystic fibrosis
4) meningomyelocele
1) Trisomy 21
Which of the following is the best recommendation for a woman with morning sickness?
1) nothing will really alleviate it; counsel her to just accept it
2) eat a dry carbohydrate, such as crackers, before getting out of bed
3) drink large quantities of fluids with meals, especially water
4) eat three meals a day and avoid eating between meals
2) eat a dry carbohydrate, such as crackers, before getting out of bed
The definition of pica is:
1) the craving for non-food, non-nutritive substances such as ice, clay, dirt, starch or plaster
2) the vitamin deficiency that leads to excessive itching
3) a cultural definition of suppressed appetite caused by pregnancy nausea
4) the body’s reaction to vitamin C deficiency that causes sores all over the body
1) the craving for non-food, non-nutritive substances such as ice, clay, dirt, starch or plaster
Which of the common discomforts of pregnancy generally have their initial onset during the first trimester of pregnancy?
1) backache
2) dyspnea
3) fatigue
4) varicose veins
3) fatigue
A woman reports she is having some slight vaginal bleeding and occasional mild cramps at 10 weeks from LMP. She is best characterized as having:
1) a threatened abortion
2) a missed abortion
3) an imminent abortion
4) an incomplete abortion
1) a threatened abortion
Which of the following dangerous complications of pregnancy would be characterized by shoulder pain?
1) gallbladder infection
2) peptic ulcer
3) ruptured tubal pregnancy
4) cancer of the cervix
3) ruptured tubal pregnancy
Women with a diagnosis of severe preeclampsia have an increased risk of:
1) complete abortion
2) placenta previa
3) abruptio placenta
4) retained placenta
3) abruptio placenta
Thrush in the newborn is directly related to contact in the birth canal with which of the following organisms?
1) candida albicans
2) neisseria gonorrhoea
3) treponema pallidum
4) staphylococcus aureus
1) candida albicans
To protect her unborn child from toxoplasmosis, a pregnant woman should:
1) avoid people known to have German Measles
2) avoid eating inadequately cooked meat
3) avoid sexual relations with known carriers
4) be vaccinated against it early in her pregnancy
2) avoid eating inadequately cooked meat
An example of a sex chromosome abnormality is:
1) Down’s Syndrome
2) Tay-Sach’s disease
3) Trisomy 13
4) Turner Syndrome
4) Turner Syndrome
A typical gynecoid pelvis has which of the following characteristics?
1) rounded inlet, nonprominenant ischial spines and wide, round pubic arch
2) heart shaped inlet, prominent ischial spines and a narrow, deep pubic arch
3) oval outlet, prominent or nonprominent ischial spines, and normal pubic arch
4) flattened at the inlet, prominent ischial spines and sacrum, and a wide pubic arch
1) rounded inlet, nonprominenant ischial spines and wide, round pubic arch
A cephalic presentation includes all of the following, except:
1) brow
2) face
3) shoulder
4) vertex
3) shoulder
The midwife has been helping answer the questions of a woman who has just given birth for the first time. Which behavior shows that the new mother understands correct teaching on breastfeeding?
1) breastfeeding every 4 hours
2) allowing the baby to breastfeed for only 3-5 minutes from each breast
3) breastfeeding every 2-3 hours or on demand, whichever comes first
4) supplementing her breastfeeding with glucose water in the first three days
3) breastfeeding every 2-3 hours or on demand, whichever comes first
In counseling a woman interested in natural family planning, the midwife would inform her that the most effective method is:
1) the calendar/rhythm method
2) the basal body temperature method
3) diaphragm/withdrawal method
4) the sympto-thermal method
4) the sympto-thermal method
The midwife is performing Leopold’s maneuvers and determines that the fetus is ROA. Which of the following did she find?
1) round, firm object low in the pelvis, small parts on the mother’s right side, and a soft rounded shape in the fundus
2) round, firm object low in the pelvis, small parts on the mother’s left side, and a soft rounded shape in the fundus
3) soft rounded shape on the mother’s right side, firm rounded shape on the mother’s left side, and small parts at the level of the umbilicus
4) soft rounded shape in the lower pelvis, small parts on the mother’s right side, and a firm, round object in the fundus
2) round, firm object low in the pelvis, small parts on the mother’s left side, and a soft rounded shape in the fundus
Which of the following describes contractions with a frequency of 3 minutes?
1) a contraction that lasts for 3 minutes, followed by a period of relaxation
2) contractions that last for 60 seconds with a 1 minutes rest in between
3) contractions that last for 30 seconds with a 2 1/2 minute rest in between
4) contractions that last for 45 seconds, with a 3 minute rest in between
3) contractions that last for 30 seconds with a 2 1/2 minute rest in between
The midwife takes fetal heart tones and finds they are 158 bpm. Which of the following actions is appropriate?
1) inform the mother that the rate is normal
2) reassess the FHT in 5 minutes because it is too high
3) change the mother’s position because the FHT are too high
4) tell the mother she is having a girl because the heart rate is fast
1) inform the mother that the rate is normal
While performing a vaginal exam, the midwife determines that the fetus is in a cephalic presentation and that the occiput has reached the level of the ischial spines. The station is:
1) -2 (minus two station)
2) -1 (minus one station)
3) 0 (zero station)
4) +1 (plus one station)
3) 0 (zero station)
A laboring woman’s membranes rupture at the end of a contraction. The midwife’s first action would be to:
1) assess FHT
2) change the bed so she will be comfortable
3) instruct the woman to push
4) perform a vaginal exam
1) assess FHT
Which is most descriptive of a cephalohematoma:
1) a subcutaneous collection of edematous fluid on the infant’s head
2) blood vessels between the cranial bone and the periosteal layer rupture, leading to bleeding in the subperiosteal space
3) it typically disappears within 24 hours of birth
4) traction and rupture of paravaginal veins by the oncoming presenting part
2) blood vessels between the cranial bone and the periosteal layer rupture, leading to bleeding in the subperiosteal space
Signs and symptoms of a patient with precipitous labor may include all the following, except:
1) contraction every 2 minutes, lasting 90 seconds
2) rapid progressive cervical dilation
3) prolonged transition stage
4) discomfort that seems out of proportion to the dilation
3) prolonged transition stage
During pelvimetry, a primigravida is found to have a diagonal conjugate of 10 cm. Based on this information, the midwife would expect her labor to be:
1) within normal length of time for a primigravida
2) prolonged, with slow fetal descent after +2 (plus two) station
3) prolonged, with failure of the head to engage
4) normal in first stage, with prolonged pushing in second stage
3) prolonged, with failure of the head to engage
A woman with a partial placenta previa delivers following a three hour labor. The complication she is most likely to develop in the early postpartal period is:
1) hemorrhage
2) infection
3) hypofibrinogenemia
4) prolapsed uterus
1) hemorrhage
The midwife notes a cord protruding from a laboring woman’s vagina. The first action would be to:
1) call an ambulance and then call the physician
2) start administering oxygen by mask and assess the mother’s vital signs
3) place a clean towel on the cord and wet it with sterile saline solution
4) apply manual pressure to the presenting part and have the mother assume a knee-chest position
4) apply manual pressure to the presenting part and have the mother assume a knee-chest position
The normal breathing pattern for a full-term baby is predominately:
1) chest breathing with nasal flaring
2) abdominal with synchronous chest movements
3) diaphragmatic with chest lag
4) shallow and irregular respirations
2) abdominal with synchronous chest movements
The average heart beat range for a full-term, quiet and awake newborn is
1) 80-100 beats per minute
2) 100-120 beats per minute
3) 120-140 beats per minute
4) 150-180 beats per minute
3) 120-140 beats per minute