Q:1-A client at 11 weeks’ gestation complains of severe and extreme nausea and vomiting.
During history taking, the midwife learns that the client vomits at least three times a day. An
ultrasound is performed and reveals that the client is negative for hydatidiform mole and
multiple pregnancy. The midwife suspects a case of hyperemesis gravidarum. The client is
admitted for monitoring. Which of the following interventions is the least appropriate for the
client?
a. Increase oral intake of fluids.
b. Administer 3,000 mL of Ringer’s lactate.
c. Administer metoclopramide.
d. Monitor fluid intake and urinary output.
Q:2-A midwife tells a client who is trying to get pregnant to eat fresh fruits and green and
leafy vegetables before conceiving. The midwife also recommends 400 mcg of folic acid a
day. Once she gets pregnant, the midwife may recommend that the client increase her folic
acid intake to 600 mcg per day during the first trimester. Which of the following is not a
benefit of folic acid supplementation before and during pregnancy?
Mark one answer:
It prevents the formation of large but ineffective red blood cells.
It prevents neural tube defects.
It decreases the baby’s risk for cleft lip or palate.
It ensures proper functioning of the thyroid gland.
Q:3-A client is in her 18th week of pregnancy. Which of the following psychosocial changes
is expected at this time?
Mark one answer:
The client is ambivalent about being pregnant.
The client begins to imagine how she will feel during the delivery.
The client is excited to attend childbirth educational classes.
The client engages in nest-building activities.
Q:4-The midwife is creating a teaching plan for a program that encourages women to have
their regular Pap smear. Which of the following groups of women is the midwife’s priority?
Mark one answer:
Women infected with Treponema pallidum.
Women with a history of genitalia herpes.
Women who are on oral contraceptives.
Women who have plans of conceiving within the next year.
Q:5-A pregnant client asks the midwife about nonpharmacologic methods for managing labor
pains. The midwife informs her about a method that is based on the idea that childbirth is a
natural and joyful process. This method also stresses the importance of having the
husband’s support during the pregnancy, labor and early postpartum period. It also
encourages walking during labor. The midwife is teaching which method to the client?
Mark one answer:
Lamaze method
Bradley method
Psychosexual method
Dick-Read method
Q:6-A client at 20 weeks’ gestation asks the midwife if she will be able to breastfeed her baby
after birth. The client has a history of type 2 diabetes, which has been well-controlled before
and during the pregnancy. The client has a BMI of 34. Which of the following statements by
the midwife is the most appropriate?
Mark one answer:
"Whether or not you can breastfeed your baby will depend on your blood glucose levels after
birth."
"Mothers with type 2 diabetes are encouraged to breastfeed their babies after birth.
Breastfeeding may also lower your need for insulin."
"You may not breastfeed your baby after birth. Insulin can cross into the breast milk and may
cause your baby to develop hypoglycemia. Your baby may be nourished with formula milk."
"Breastfeeding is encouraged for women with type 2 diabetes. However, you may need to
increase your insulin when nursing."
Q:7-A 21-year-old female client comes to the prenatal clinic after a home pregnancy test
indicated a positive result. The client informs the midwife that her last menstrual period was
on October 28, 2010. Using Nagele’s rule, the client’s expected date of birth is on:
Mark one answer:
August 4, 2011
July 21, 2011
July 4, 2011
August 21, 2011
Q:8-A client at 30 weeks’ gestation complains of shortness of breath and an unusually rapid
enlargement of the uterus. A tense uterus is noted by the midwife during assessment.
Palpation of the small parts of the fetus and auscultating the fetal heart rate are difficult. The
midwife suspects severe hydramnios. Which of the following interventions are appropriately
included in the care plan?
[Link] ambulation.
[Link] intake of foods high in fiber.
[Link] amniocentesis.
[Link] indomethacin.
Mark one answer:
I and II
II and III
II, III and IV
All of the above
Q:9-A contraction stress test is ordered to a client at 35 weeks’ gestation. After half an hour,
the client’s uterus begins to contract and the midwife observes three 40-second-long
contractions in a 10-minute window. The client has two contractions within the next five
minutes. The midwife notes that the fetal heart rate decreases toward the end of the
contraction and afterward. This happends during more than 50% of the contractions. After
stopping the oxytocin, which of the following is the next action of the midwife?
Mark one answer:
Administer oxygen.
Turn the client to the left side.
Assess the client’s blood pressure.
Refer the client to a physician for further evaluation.
Q:10-A 20-year-old female client is pregnant for the first time. The client is a marathon runner
and has been on a rigorous exercise and training program. The client asks the midwife if she
could still exercise while pregnant. Which of the following statements by the midwife is the
most appropriate for the client?
Mark one answer:
"You should stop exercising when pregnant as it can cause miscarriage or intrauterine growth
retardation."
"If you are an athlete, you may proceed with your pre-pregnancy exercise program without
limitations."
"You may continue exercising, but make sure to decrease the intensity of exercises. You may
return to your pre-pregnancy exercise program two weeks after delivery."
"You should modify the intensity and type of your exercises. Non-weight-bearing exercises are
recommended."