NURSING
Midwifery CBT
Review Exam
Q&A
2024
,1. A pregnant woman at 32 weeks of gestation is diagnosed with pre-
eclampsia. She is admitted to the hospital for close monitoring and
treatment. Which of the following interventions is most appropriate for
this woman?
a) Administer magnesium sulfate intravenously to prevent seizures.
b) Induce labor with oxytocin to deliver the baby as soon as possible.
c) Perform a cesarean section to avoid the risk of placental abruption.
d) Give antihypertensive drugs to lower the blood pressure and reduce the
proteinuria.
*Answer: a) Administer magnesium sulfate intravenously to prevent
seizures.*
Rationale: Magnesium sulfate is the drug of choice for preventing and
treating eclamptic seizures in women with pre-eclampsia. It also has a
mild antihypertensive effect and may reduce the risk of cerebral edema
and hemorrhage. Inducing labor or performing a cesarean section may be
necessary if the condition worsens or if there are signs of fetal distress, but
they are not the first-line interventions. Antihypertensive drugs may be
used to lower the blood pressure, but they do not prevent seizures or
improve the outcome of pre-eclampsia.
2. A woman in labor is experiencing severe back pain due to an occiput
posterior position of the fetus. Which of the following nursing actions is
most likely to relieve her pain and facilitate the rotation of the fetal head?
a) Encourage her to walk around and change positions frequently.
b) Apply counterpressure to her sacrum with a tennis ball or a fist.
c) Perform a sterile vaginal examination to assess the progress of labor.
d) Administer an epidural anesthesia to block the pain signals from the
lower back.
*Answer: b) Apply counterpressure to her sacrum with a tennis ball or a
fist.*
Rationale: Applying counterpressure to the sacrum can help relieve the
back pain caused by an occiput posterior position and may also stimulate
the fetal head to rotate to an anterior position. Walking and changing
positions may also help, but they are not as effective as counterpressure. A
sterile vaginal examination may be indicated to assess the dilation and
station of the cervix, but it does not relieve pain or facilitate rotation.
Epidural anesthesia may provide pain relief, but it may also interfere with
, the woman's ability to push and increase the risk of instrumental delivery.
3. A woman who had a spontaneous vaginal delivery two hours ago is
bleeding heavily from her uterus. The nurse palpates her fundus and finds
it soft and boggy. Which of the following actions should the nurse take
first?
a) Massage the fundus until it becomes firm and contracted.
b) Check the perineum for any lacerations or hematomas.
c) Administer oxytocin intramuscularly or intravenously.
d) Notify the physician or midwife immediately.
*Answer: a) Massage the fundus until it becomes firm and contracted.*
Rationale: The most common cause of postpartum hemorrhage is uterine
atony, which is a failure of the uterus to contract after delivery. Massaging
the fundus can stimulate uterine contractions and reduce bleeding.
Checking the perineum for lacerations or hematomas is also important, but
it is not the first priority. Administering oxytocin can enhance uterine
contractions and prevent further bleeding, but it should be done after
massaging the fundus. Notifying the physician or midwife is necessary if
bleeding persists or if there are signs of shock, but it is not the first action.
4. A newborn baby has an Apgar score of 7 at one minute and 9 at five
minutes after birth. The nurse observes that he has central cyanosis,
tachypnea, grunting, and intercostal retractions. Which of
the following conditions is most likely responsible for these signs?
a) Transient tachypnea of the newborn (TTN).
b) Meconium aspiration syndrome (MAS).
c) Respiratory distress syndrome (RDS).
d) Persistent pulmonary hypertension of the newborn (PPHN).
*Answer: c) Respiratory distress syndrome (RDS).*
Rationale: RDS is caused by a deficiency of surfactant in the lungs, which
leads to alveolar collapse and impaired gas exchange. It typically affects
premature infants, especially those born before 34 weeks of gestation. The
signs of RDS include central cyanosis, tachypnea, grunting, intercostal
retractions, nasal flaring, and expiratory wheezes. TTN is a mild
respiratory disorder caused by delayed absorption of fetal lung fluid. It
usually resolves within 24 to 48 hours after birth. The signs of TTN
include tachypnea, mild retractions, and occasional grunting, but no
cyanosis. MAS is a serious respiratory disorder caused by the aspiration of
Midwifery CBT
Review Exam
Q&A
2024
,1. A pregnant woman at 32 weeks of gestation is diagnosed with pre-
eclampsia. She is admitted to the hospital for close monitoring and
treatment. Which of the following interventions is most appropriate for
this woman?
a) Administer magnesium sulfate intravenously to prevent seizures.
b) Induce labor with oxytocin to deliver the baby as soon as possible.
c) Perform a cesarean section to avoid the risk of placental abruption.
d) Give antihypertensive drugs to lower the blood pressure and reduce the
proteinuria.
*Answer: a) Administer magnesium sulfate intravenously to prevent
seizures.*
Rationale: Magnesium sulfate is the drug of choice for preventing and
treating eclamptic seizures in women with pre-eclampsia. It also has a
mild antihypertensive effect and may reduce the risk of cerebral edema
and hemorrhage. Inducing labor or performing a cesarean section may be
necessary if the condition worsens or if there are signs of fetal distress, but
they are not the first-line interventions. Antihypertensive drugs may be
used to lower the blood pressure, but they do not prevent seizures or
improve the outcome of pre-eclampsia.
2. A woman in labor is experiencing severe back pain due to an occiput
posterior position of the fetus. Which of the following nursing actions is
most likely to relieve her pain and facilitate the rotation of the fetal head?
a) Encourage her to walk around and change positions frequently.
b) Apply counterpressure to her sacrum with a tennis ball or a fist.
c) Perform a sterile vaginal examination to assess the progress of labor.
d) Administer an epidural anesthesia to block the pain signals from the
lower back.
*Answer: b) Apply counterpressure to her sacrum with a tennis ball or a
fist.*
Rationale: Applying counterpressure to the sacrum can help relieve the
back pain caused by an occiput posterior position and may also stimulate
the fetal head to rotate to an anterior position. Walking and changing
positions may also help, but they are not as effective as counterpressure. A
sterile vaginal examination may be indicated to assess the dilation and
station of the cervix, but it does not relieve pain or facilitate rotation.
Epidural anesthesia may provide pain relief, but it may also interfere with
, the woman's ability to push and increase the risk of instrumental delivery.
3. A woman who had a spontaneous vaginal delivery two hours ago is
bleeding heavily from her uterus. The nurse palpates her fundus and finds
it soft and boggy. Which of the following actions should the nurse take
first?
a) Massage the fundus until it becomes firm and contracted.
b) Check the perineum for any lacerations or hematomas.
c) Administer oxytocin intramuscularly or intravenously.
d) Notify the physician or midwife immediately.
*Answer: a) Massage the fundus until it becomes firm and contracted.*
Rationale: The most common cause of postpartum hemorrhage is uterine
atony, which is a failure of the uterus to contract after delivery. Massaging
the fundus can stimulate uterine contractions and reduce bleeding.
Checking the perineum for lacerations or hematomas is also important, but
it is not the first priority. Administering oxytocin can enhance uterine
contractions and prevent further bleeding, but it should be done after
massaging the fundus. Notifying the physician or midwife is necessary if
bleeding persists or if there are signs of shock, but it is not the first action.
4. A newborn baby has an Apgar score of 7 at one minute and 9 at five
minutes after birth. The nurse observes that he has central cyanosis,
tachypnea, grunting, and intercostal retractions. Which of
the following conditions is most likely responsible for these signs?
a) Transient tachypnea of the newborn (TTN).
b) Meconium aspiration syndrome (MAS).
c) Respiratory distress syndrome (RDS).
d) Persistent pulmonary hypertension of the newborn (PPHN).
*Answer: c) Respiratory distress syndrome (RDS).*
Rationale: RDS is caused by a deficiency of surfactant in the lungs, which
leads to alveolar collapse and impaired gas exchange. It typically affects
premature infants, especially those born before 34 weeks of gestation. The
signs of RDS include central cyanosis, tachypnea, grunting, intercostal
retractions, nasal flaring, and expiratory wheezes. TTN is a mild
respiratory disorder caused by delayed absorption of fetal lung fluid. It
usually resolves within 24 to 48 hours after birth. The signs of TTN
include tachypnea, mild retractions, and occasional grunting, but no
cyanosis. MAS is a serious respiratory disorder caused by the aspiration of
