Midwifery – Comprehensive Exam – Study Guide & Practice Questions
Two products of impaired blood flow to the legs are thought to be linked to cramps? - ANS
✔✔Pyruvic acid
Lactic acid
Name two prevention techniques for nocturnal leg cramps - ANS ✔✔Hydration, stretching,
avoid long periods of sitting or standing, warm baths, exercise
What is the most important differential diagnosis to rule out when a pregnant patient comes in
with complaints of leg cramping? - ANS ✔✔Deep Vein Thrombosis:
Look for warm red tender swollen leg.
Conflicting evidence supports taking which supplement for leg cramps ? - ANS ✔✔Magnesium
True or false. Women with NVP have lower rates of preterm births, low birth weight babies,
congenital anomalies, and stillbirths. - ANS ✔✔True
How does progesterone contribute to NVP? - ANS ✔✔Slows peristalsis and gastric emptying
If dietary measures, lifestyle changes, and OTC remedies do not help with NVP, what medicine
has shown to be effective with NVP? - ANS ✔✔Antiemetics such Zofran (Ondansetron). Note:
Not mentioned in Varney's
True of False. Effective therapy for NVP will always remain the same for a woman throughout
her pregnancy and subsequent pregnancies. - ANS ✔✔False. Effectiveness of therapy may
fluctuate over the course of pregnancy and varies greatly from pregnancy to pregnancy.
,True or False. To combat nausea during pregnancy, one should brush their teeth immediately
after they eat. - ANS ✔✔False. Brushing your teeth can stimulate the gag reflex, aggravating
nausea and vomiting.
What pre-existing conditions can contribute to NVP? - ANS ✔✔H. pylori and GERD
What is the most important differential diagnosis to rule out with leg cramps during pregnancy?
- ANS ✔✔Deep vein thrombosis
True/false: Leg cramps during pregnancy are not normal and should be reported immediately to
provider. - ANS ✔✔False. Leg cramps are completely normal during pregnancy and occur more
frequently during the 2nd and 3rd trimesters.
How can your pregnant patient prevent leg cramps (select all that apply)?
a. Walking or other exercise
b. Drink plenty of water
c. Stretch before bed
d. Taking a warm bath
e. Sitting for long periods of time - ANS ✔✔A, B, C, D
True/false: Dorsiflexion of the affected foot when a cramp begins helps to alleviate the pain. -
ANS ✔✔True
True/false: Magnesium supplements have been found to help with leg cramps. - ANS ✔✔False.
Research is mixed and taking magnesium supplements seem to have little effect on preventing
leg cramps in pregnant women.
,True or False: Back pain may be a sign of preterm labor only if cramping is present. - ANS
✔✔False: Cramping may or may not accompany preterm labor.
What are some of the contributing factors causing back pain during pregnancy?
A. The weight of a growing uterus
B. A shift in her center of gravity
C. Relaxation of sacroiliac ligaments
D. All of the above - ANS ✔✔D
True or False: Acupuncture is a holistic method that has not been correlated with effective pain
relief. - ANS ✔✔False: One study found that 60% of women reported a decrease in back pain
after receiving acupuncture.
True or False: It is safe to receive chiropractic manipulation during pregnancy. - ANS ✔✔True: As
long as a patient sees a licensed chiropractor, studies have shown manual manipulation to be
effective.
Why does Round Ligament pain occur? - ANS ✔✔As the uterus grows during pregnancy the
ligaments stretch and thicken to accommodate and support it. These changes can occasionally
cause pains.
Where are Round Ligament pains felt? - ANS ✔✔Round Ligament pain is a sharp pain or jabbing
feeling often felt in the lower belly or groin area on one or both sides.
What are some of the triggers of Round Ligament pains? - ANS ✔✔Round Ligament pains can
occur with position changes, getting up from a sitting, lying down, coughing, sneezing, and
laughing.
What non-pharmacological methods can be used to alleviate Round Ligament pains? - ANS
✔✔Avoid sudden movements
, Side lying relaxation positions
Flex hips: Bend and flex before coughing, sneezing, or laughing.
Apply warmth: Heat or warm bath.
Exercise: Walking
True/False:
Round Ligament pains lasting for more than 1 minute is normal. - ANS ✔✔False: Round
Ligament pain should only last for a few seconds. See your health care provider for pains lasting
longer or not alleviate after a short rest.
What are "dermatoses of pregnancy"? - ANS ✔✔Dermatoses of pregnancy are rare severe
pruritic inflammatory skin diseases that are specific to women during pregnant or postpartum
period.
MATCH the dermatoses of pregnancy with its clinical presentation.
1. Pruritic Urticarial papules and plaques of preganancy
2. Pemphigiod gastationis
3. Intrahepatic cholestasis of pregnancy
4. Atopic eruption of pregnancy
A. Red painful itchy rash that begins as erythematous papules within the striae
B. Eczematous type on face, neck and flexure surfaces
C. Papules that begins around the umbilicus and spreads centrifugally.
D. Intense pruritus on palms of hands and soles of feet, but with an absence of lesions. - ANS
✔✔1. Pruritic Urticarial papules and plaques of preganancy= A
2. Pemphigiod gastationis=C
3. Intrahepatic cholestasis of pregnancy=D
4. Atopic eruption of pregnancy=B
Two products of impaired blood flow to the legs are thought to be linked to cramps? - ANS
✔✔Pyruvic acid
Lactic acid
Name two prevention techniques for nocturnal leg cramps - ANS ✔✔Hydration, stretching,
avoid long periods of sitting or standing, warm baths, exercise
What is the most important differential diagnosis to rule out when a pregnant patient comes in
with complaints of leg cramping? - ANS ✔✔Deep Vein Thrombosis:
Look for warm red tender swollen leg.
Conflicting evidence supports taking which supplement for leg cramps ? - ANS ✔✔Magnesium
True or false. Women with NVP have lower rates of preterm births, low birth weight babies,
congenital anomalies, and stillbirths. - ANS ✔✔True
How does progesterone contribute to NVP? - ANS ✔✔Slows peristalsis and gastric emptying
If dietary measures, lifestyle changes, and OTC remedies do not help with NVP, what medicine
has shown to be effective with NVP? - ANS ✔✔Antiemetics such Zofran (Ondansetron). Note:
Not mentioned in Varney's
True of False. Effective therapy for NVP will always remain the same for a woman throughout
her pregnancy and subsequent pregnancies. - ANS ✔✔False. Effectiveness of therapy may
fluctuate over the course of pregnancy and varies greatly from pregnancy to pregnancy.
,True or False. To combat nausea during pregnancy, one should brush their teeth immediately
after they eat. - ANS ✔✔False. Brushing your teeth can stimulate the gag reflex, aggravating
nausea and vomiting.
What pre-existing conditions can contribute to NVP? - ANS ✔✔H. pylori and GERD
What is the most important differential diagnosis to rule out with leg cramps during pregnancy?
- ANS ✔✔Deep vein thrombosis
True/false: Leg cramps during pregnancy are not normal and should be reported immediately to
provider. - ANS ✔✔False. Leg cramps are completely normal during pregnancy and occur more
frequently during the 2nd and 3rd trimesters.
How can your pregnant patient prevent leg cramps (select all that apply)?
a. Walking or other exercise
b. Drink plenty of water
c. Stretch before bed
d. Taking a warm bath
e. Sitting for long periods of time - ANS ✔✔A, B, C, D
True/false: Dorsiflexion of the affected foot when a cramp begins helps to alleviate the pain. -
ANS ✔✔True
True/false: Magnesium supplements have been found to help with leg cramps. - ANS ✔✔False.
Research is mixed and taking magnesium supplements seem to have little effect on preventing
leg cramps in pregnant women.
,True or False: Back pain may be a sign of preterm labor only if cramping is present. - ANS
✔✔False: Cramping may or may not accompany preterm labor.
What are some of the contributing factors causing back pain during pregnancy?
A. The weight of a growing uterus
B. A shift in her center of gravity
C. Relaxation of sacroiliac ligaments
D. All of the above - ANS ✔✔D
True or False: Acupuncture is a holistic method that has not been correlated with effective pain
relief. - ANS ✔✔False: One study found that 60% of women reported a decrease in back pain
after receiving acupuncture.
True or False: It is safe to receive chiropractic manipulation during pregnancy. - ANS ✔✔True: As
long as a patient sees a licensed chiropractor, studies have shown manual manipulation to be
effective.
Why does Round Ligament pain occur? - ANS ✔✔As the uterus grows during pregnancy the
ligaments stretch and thicken to accommodate and support it. These changes can occasionally
cause pains.
Where are Round Ligament pains felt? - ANS ✔✔Round Ligament pain is a sharp pain or jabbing
feeling often felt in the lower belly or groin area on one or both sides.
What are some of the triggers of Round Ligament pains? - ANS ✔✔Round Ligament pains can
occur with position changes, getting up from a sitting, lying down, coughing, sneezing, and
laughing.
What non-pharmacological methods can be used to alleviate Round Ligament pains? - ANS
✔✔Avoid sudden movements
, Side lying relaxation positions
Flex hips: Bend and flex before coughing, sneezing, or laughing.
Apply warmth: Heat or warm bath.
Exercise: Walking
True/False:
Round Ligament pains lasting for more than 1 minute is normal. - ANS ✔✔False: Round
Ligament pain should only last for a few seconds. See your health care provider for pains lasting
longer or not alleviate after a short rest.
What are "dermatoses of pregnancy"? - ANS ✔✔Dermatoses of pregnancy are rare severe
pruritic inflammatory skin diseases that are specific to women during pregnant or postpartum
period.
MATCH the dermatoses of pregnancy with its clinical presentation.
1. Pruritic Urticarial papules and plaques of preganancy
2. Pemphigiod gastationis
3. Intrahepatic cholestasis of pregnancy
4. Atopic eruption of pregnancy
A. Red painful itchy rash that begins as erythematous papules within the striae
B. Eczematous type on face, neck and flexure surfaces
C. Papules that begins around the umbilicus and spreads centrifugally.
D. Intense pruritus on palms of hands and soles of feet, but with an absence of lesions. - ANS
✔✔1. Pruritic Urticarial papules and plaques of preganancy= A
2. Pemphigiod gastationis=C
3. Intrahepatic cholestasis of pregnancy=D
4. Atopic eruption of pregnancy=B
