NARM Flashcards by Gabriella Price

“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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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Which of the following is the largest diameter of the fetal head?

1) biparietal
2) occipitofrontal
3) suboccipitobregmatic
4) occipitomental

4) occipitomental

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

Vitamin K is administered in the immediate neonate period because: 1) a newborn's liver is incapable of producing sufficient vitamin K to deal with transient neonatal coagulation problems 2) hemolysis of the fetal red blood cells increase coagulation problems 3) newborns are susceptible to changes in temperature, which increase jaundice 4) newborns lack the intestinal bacteria with which to synthesize vitamin K

4) newborns lack the intestinal bacteria with which to synthesize vitamin K

The midwife sees a two hour old newborn gagging and turning blue. The first thing the midwife should do is: 1) try to get him breastfeeding 2) aspirate the oral and nasal pharynx with a bulb syringe 3) give oxygen by positive pressure ventilation 4) raise the infant's head and stimulate crying by slapping the soles of the feet

2) aspirate the oral and nasal pharynx with a bulb syringe

The blue coloration of a newborn's hands and feet is called: 1) vernix caseosa 2) acrocyanosis 3) harlequin color 4) erythema neonatorum

2) acrocyanosis

Infants of diabetic mothers are at risk for which of the following problems? 1) erythroblastosis fetalis 2) hypercalcemia 3) respiratory distress syndrome 4) hypothyroidism

3) respiratory distress syndrome

Congenital syphilis may be contracted by the baby: 1) at birth 2) during the fifth month of pregnancy 3) during the first month of pregnancy 4) during breastfeeding

2) during the fifth month of pregnancy

Which of the following signs indicate hypoglycemia in the newborn? 1) blotchy skin 2) hypertonia 3) jitteriness 4) soft, weak cry

3) jitteriness

Hemolytic disease of the neonate may be produced by the union of: 1) Rh- mother with Rh- father 2) Rh- mother with a Rh+ father 3) Rh+ mother with Rh-father 4) type B mother with type O father

2) Rh- mother with a Rh+ father

A positive direct Coombs test done on the cord blood indicates the presence of: 1) antibodies coating the baby's red blood cells 2) antigens coating the mother's red blood cells 3) fetal red blood cells in the maternal serum 4) maternal red blood cells in the fetal circulation

1) antibodies coating the baby's red blood cells

On the first day postpartum, the fundus should be: 1) at the level of the symphysis pubis 2) at the level of the umbilicus 3) midway between the umbilicus and the symphysis pubis 4) 2 finger breadths below the umbilicus

2) at the level of the umbilicus

Uterine involution occurs as a result of: 1) a decrease in the number of myometrial cells 2) necrosis of the hypertrophic myometrial cells 3) autolysis of protein material within the uterine wall 4) necrotic degeneration of the placental site

3) autolysis of protein material within the uterine wall

Twelve hours postpartum, the midwife checks the mother's fundus and finds it enlarged and boggy. What would the midwife do first? 1) take her vital signs to rule out hypertension so she can give methergine 2) check the consistency of the fundus at 15 minute intervals and chart this information 3) administer an oxytocic drug 4) massage the uterus firmly with one hand while supporting it with other hand

4) massage the uterus firmly with one hand while supporting it with other hand

Which of the following instructions should be given to a postpartal mother about perineal care? 1) cleansing the area should be a sterile procedure 2) the area should be cleansed from front to back 3) stitches should be soaked twice a day in a warm sitz bath for 10 minutes 4) an antiseptic should be used to cleanse the perineum to prevent infection

2) the area should be cleansed from front to back

Difficulty in voiding after childbirth may be due to all the following factors, except: 1) decreased sensitivity of the bladder 2) lack of fluid intake during labor 3) relaxation of the abdominal wall 4) compression of the urethra

4) compression of the urethra

A postpartum patient reports she feels very uncomfortable sitting and has a "full feeling down there". The midwife would suspect: 1) cystitis 2) a suture may have come undone 3) postpartum infection 4) vulvarhematoma

4) vulvarhematoma

The clinical manifestations of mastitis include: 1) hard, warm nodular areas in the outer quadrant of the breast 2) cessation or diminishing of milk production 3) marked engorgement and pain 4) soft, pliable breasts with a bluish tinged line running up the breast

1) hard, warm nodular areas in the outer quadrant of the breast

A woman who has given birth to three children is a: 1) primipara 2) segunda 3) multipara 4) puerperal

3) multipara

The first indication of puerperal infection is usually: 1) excessive bleeding 2) chills with an elevated temperature 3) vomiting and nausea 4) severe abdominal pain

2) chills with an elevated temperature

The types of pelvis may be classified into any of the following, except: 1) gynecoid 2) ovoid 3) android 4) anthropoid

2) ovoid

The laceration which includes the anal sphincter but does not completely split the sphincter is called a: 1) 1st degree 2) 2nd degree 3) 3rd degree 4) anal rupture

3) 3rd degree

A male child is the result of the union of: 1) an x-chromosome from both the sperm and the ovum 2) an x-chromosome from the sperm and a y-chromosome from the ovum 3) a y-chromosome from the sperm and an x-chromosome from the ovum 4) a y-chromosome from both the sperm and ovum

3) a y-chromosome from the sperm and an x-chromosome from the ovum

When is the first time fetal heart tones are heard by the doppler? 1) 7-10 weeks 2) 12-14 weeks 3) 10-12 weeks 4) 16-18 weeks

3) 10-12 weeks

If a pregnant woman has cats or eats undercooked meat, she could be at risk for: 1) Hepatitis A 2) Toxoplasmosis 3) Cirrhosis of the liver 4) Pre-eclampsia

2) Toxoplasmosi

Leukorrhea is defined as: 1) the absence of menstruation 2) a profuse, thin or thick vaginal secretion that begins in the first trimester 3) spotting during the pregnancy with or without pain 4) the presence of leukocytes in the urine

2) a profuse, thin or thick vaginal secretion that begins in the first trimester

A mother confides in her midwife that she is nervous about her partner's ability to support her in labor. Which of the following would be an appropriate response from the midwife? 1) recommend she ask her partner not to attend the birth 2) tell her to hire a doula for additional support 3) invite her to talk in further detail about these concerns 4) assure her that no mother plans to rely on her partner for knowledgeable support, that is why she hired a midwife

3) invite her to talk in further detail about these concerns

The lactation amenorrhea method of birth control is typically reliable as long as: 1) the baby is under 6 months old 2) the woman is breastfeeding twice a day 3) the woman has her periods 4) the woman has other children

1) the baby is under 6 months old

Molly is newly pregnant. She has two children living at home. A third child died of birth defects at 4 days of age. She has never had an abortion or miscarriage. Which of the following accurately describes her now? 1) Gravida 3 para 2 AB 0 2) Gravida 3 para 3 AB 0 3) Gravida 4 para 2 AB 0 4) Gravida 4 para 3 AB 0

4) Gravida 4 para 3 AB 0

Each uterine contraction consists of three phases. The contraction is the strongest during which phase? 1) increment 2) acme 3) climax 4) decrement

2) acme

Which of the following is considered a positive sign of pregnancy? 1) movement 2) auscultation of fetal parts 3) fetal heart tones heard with a doppler 4) increase in maternal weight gain

3) fetal heart tones heard with a doppler

Excessive use of antibiotics may result in a vaginal infection with: 1) Candida albicans 2) Human immunodeficiency virus 3) Bacterial vaginosis 4) Genital herpes virus

1) Candida albicans

Which of the following correctly divides pregnancy into three trimesters by weeks, according to LMP? 1) 1st - 1 to 12 weeks, 2nd - 13 to 24 weeks, 3rd - 25 to 40 weeks 2) 1st - 1 to 13 weeks, 2nd - 14 to 27 weeks, 3rd - 27 to 40 weeks 3) 1st - 1 to 12 weeks, 2nd - 13 to 27 weeks, 3rd - 28 to 40 weeks 4) 1st - 1 to 20 weeks, 2nd - 21 to 30 weeks, 3rd - 31 to 40 weeks

3) 1st - 1 to 12 weeks, 2nd - 13 to 27 weeks, 3rd - 28 to 40 weeks

Which of the following is a presumptive sign of pregnancy? 1) Goodell's sign 2) FHT with doppler 3) nausea 4) Hegar's sign

3) nausea

Using Naegel's rule, the EDD for a woman who reports her LMP as April 13 would be: 1) December 20 2) January 20 3) January 2 4) February 1

2) January 20

The purpose of Leopold's maneuvers is to: 1) feel the mother's stomach tone 2) check her for linea negra 3) estimate fetal weight 4) determine fetal lie and presentation

4) determine fetal lie and presentation

All of the following birth defects could be detected by genetic screening, except: 1) autosomal abnormalities 2) neural tube defects 3) thalassemia 4) alpha fetoprotein

4) alpha fetoprotein

Chronic hypertension refers to: 1) a pre-existing condition of high blood pressure 2) high blood pressure brought on by pregnancy 3) a psychological condition occurring in the postpartum stage 4) high blood pressure brought on by the medical examiner

1) a pre-existing condition of high blood pressure

For purposes of microbial control, the term sterilization implies: 1) the removal of pathogenic forms of microorganisms 2) the lowering of microbial count 3) the destruction of all forms of microbial life 4) the destruction of microorganisms only on the body surface

3) the destruction of all forms of microbial life

The difference between a disinfectant and an antiseptic is that: 1) a disinfectant is used on lifeless objects only, while an antiseptic is used on the skin's surface 2) a disinfectant kills bacterial spores, while an antiseptic does not 3) a disinfectant does not achieve sterilization and an antiseptic does 4) disinfectants are chemical substances, while antiseptics are not

1) a disinfectant is used on lifeless objects only, while an antiseptic is used on the skin's surface

Anatomy is defined as: 1) a group of organs that cooperate to accomplish a common purpose 2) the study of the structure and shape of the body and the body parts, and their relationship to one another 3) groups of similar cells that have a common function 4) the study of how the body and its parts work or function

2) the study of the structure and shape of the body and the body parts, and their relationship to one another

Physiology is defined as: 1) the study of how the body and its parts work or function 2) a structure composed of two or more tissue types that performs a specific function 3) the study of the structure and shape of the body and body parts, and their relationship to one another 4) the smallest of all living units

1) the study of how the body and its parts work or function

An ultrasound at 12 weeks gestation could establish all the following except: 1) a viable, intrauterine pregnancy 2) multiple pregnancy 3) presence of fetal abnormalities such as anecephaly 4) confirmation of Down's Syndrome

4) confirmation of Down's Syndrome

Two hormones the placenta produces are: 1) oxytocin and estrogen 2) progesterone and oxytocin 3) estrogen and progesterone 4) prolactin and estrogen

3) estrogen and progesterone

The essential male hormone responsible for reproduction is: 1) testosterone 2) estrogen 3) progesterone 4) prostaglandins

1) testosterone

In a normal monthly cycle, ovulation occurs around day: 1) 7 2) 21 3) 14 4) 2

3) 14

If conception fails to occur, menstruation takes place as a result of: 1) increased progesterone 2) stimulation of the graafian follicle 3) Gn-RH secretion 4) degeneration of the corpus luteum

4) degeneration of the corpus luteum

Which term refers to the externally visible structures of the female reproductive system, which are formed by two folds of fatty tissue covered with skin, extending from the mons pubis anteriorly to merge with the muscles of the perineum, and protect the inner genitalia? 1) mons pubis 2) vestibule 3) outer cervical os 4) labia majora

4) labia majora

Which hormone stimulates and maintains milk production after childbirth? 1) estrogen 2) progesterone 3) calcitonin 4) prolactin

4) prolactin

Where does fertilization usually occur? 1) the fallopian tubes 2) the ovaries 3) the uterus 4) the peritoneal cavity

1) the fallopian tubes

The primary function of human chorionic gonadotropin (hCG) is to: 1) confirm the diagnosis of pregnancy 2) maintain the corpus luteum during the first trimester 3) nourish the fetus 4) stabilize the uterus during pregnancy

2) maintain the corpus luteum during the first trimester

Carmen is an Rh negative woman in the first stage of labor who has started showing signs of a sinusoidal fetal heart tone pattern. What should the midwife do? 1) change maternal position and continue monitoring FHT 2) give an herbal tincture of Black and Blue Cohosh 3) transport to a hospital for delivery 4) give oxygen to the mother by nasal cannula

3) transport to a hospital for delivery

Childbirth is also called: 1) maturation 2) parturition 3) gestation 4) matriarchism

2) parturition

"Menarche" is defined as: 1) the first menstrual period 2) the last menstrual period 3) the moment fertilization occurs 4) the cessation of pregnancy

1) the first menstrual period

Immediately following fertilization, the fertilized egg is called a: 1) morula 2) zygote 3) embryo 4) blastocyst

2) zygote

The embryonic stage is defined as: 1) 3-21 weeks 2) 16-20 weeks 3) 1-4 weeks 4) 2-8 weeks

4) 2-8 weeks

The function of the placenta is to: 1) prevent infection 2) mix the fetal and maternal blood 3) provide nutrients 4) allow for fetal movement

3) provide nutrients

Amniotic fluid does all of the following except: 1) absorbs shock 2) permits fetal movement 3) maintains fetal temperature 4) provides oxygen to the fetus

4) provides oxygen to the fetus

During what period of pregnancy is the baby most susceptible to teratogens (from conception)? 1) 1-4 weeks 2) 16-20 weeks 3) 2-12 weeks 4) 36-40 weeks

3) 2-12 weeks

At what week, from conception, does the embryonic period begin? 1) 2 weeks 2) 5 weeks 3) 8 weeks 4) 3 weeks

1) 2 weeks

The fetal stage of development starts at what week of gestation (from conception)? 1) 6 weeks 2) 9 weeks 3) 16 weeks 4) 20 weeks

2) 9 weeks

The fetal heartbeat can first be heard with a fetoscope between (from LMP): 1) 2-5 weeks 2) 6-8 weeks 3) 10-14 weeks 4) 18-20 weeks

4) 18-20 weeks

Despite the midwife's best efforts to give care to a mother who is a survivor of sexual abuse, she has continued to have severe emotional problems. The midwife questions the wisdom of a home birth for her. Before jumping to conclusions, the midwife would: 1) talk to her about her issues and tell her that she has been a bit much to handle and may need to consider a hospital birth 2) discuss her concerns with the mother's backup physician as to how to best proceed 3) tell the mother that she will overlook these issues and proceed with the plans for a home birth if the woman pays on time 4) tell her most women with previous sexual abuse have these emotional problems and should consider a cesarean

2) discuss her concerns with the mother's backup physician as to how to best proceed