NARM Test with 100% Right Answers
What is the general contraction pattern which signals the onset of labor? - ✅✅
Contractions which last one minute
And come every five minutes
What is a good position for a woman in labor whose baby has not yet engaged? -
✅✅ An upright forward leaning position will maximize the effects of gravity and
evenly distribute pressure on the cervix to keep the contractions coordinate and
effective. Walking serves the same purpose.
What are some good positions for a woman in labor who's baby is very high (-2 or
-3) and posterior? - ✅✅ Hands and knees with pelvic rocking or standing and
leaning forward with one foot (on the side the baby's body is lying) on a low stool
can encourage rotation.
How often should blood pressure be checked during labor? - ✅✅ Blood pressure
should be checked hourly or every twenty minutes if it was borderline high in
pregnancy or is elevated in labor.
How often should pulse be checked during labor? - ✅✅ Every few hours.
It should be within 10-15 points of her normal range. If it rises check her
temperature.
How would you diagnose clinical exhaustion during labor? - ✅✅ Elevation of
both temperature and pulse paired with
Ketonuria indicates clinical exhaustion which is threatening to both mother and
baby because the mother's blood has become abnormally acidic and less able to
carry oxygen.
How often should FHT be checked during labor? - ✅✅ FHT should be taken
every half hour.
If anything unusual arises, listen continuously until the problem resolves
spontaneously or treatment is decided upon. To get a full picture of FHT listen
though a contraction and for 15-30 seconds after it ends.
,Name this FHT pattern: FHT are normal throughout first part of the contraction but
dip down at the peak and slowly returns to baseline as the contraction ends. - ✅✅
Late deceleration (type II)
May be linked to placental insufficiency or maternal ketoacidosis.
What are the risks of cesarean section? - ✅✅ Life-threatening sepsis, perforation
of adjacent organs, scarring of the uterine lining that can lead to abnormal
placental implantation and hemorrhage with subsequent childbearing, and
development of adhesions between the uterus and other organs that can cause
problems later
Painless bleeding with intercourse is the prime symptom of _______ - ✅✅
Fibroids. These tend to grow during pregnancy and are
Benign. If they are internal they can cause reduced intrauterine space, disrupted
placental implantation and postpartum hemorrhage
What are some urgent warning signs of preeclampsia? - ✅✅ Persistent headaches
in combination with visual
Disturbances or epigastric (upper abdominal) pain - especially on the right side.
What problems might a woman who has had a cone biopsy encounter? - ✅✅
Scarring from cone biopsy may retard
Cervical dilation.
What precautions might a midwife want to take with her patient who has a history
of LEEP procedure? - ✅✅ Because LEEP has been linked to incompetent cervix
And premature labor, some midwives feel that they should check their patient for
cervical changes throughout pregnancy and that the patient should be carefully
instructed regarding signs of premature labor.
What time period does assessment become especially important in the pregnant
woman? - ✅✅ During the last six weeks of pregnancy. At this point the midwife
can identify certain factors regarding the baby's position, growth rate and size and
relate them to the mother's condition.
What components should a midwife include in prenatal care? - ✅✅ Knowledge of
nutrition, exercise, non allopathic
,Healing options of herbology or homeopathy and mind and body integration
techniques like yoga and meditation.
What conditions/diseases contraindicate home birth? - ✅✅ Preexisting diabetes or
hypertension, thyroid disease
(hyperthyroidism), chronic lung disease, severe asthma, epilepsy, clotting
disorders, congenital heart disease (grades 2-4) and kidney disease
Which conditions arising in pregnancy
Contraindicate home birth? - ✅✅ Rh- with antibodies, severe anemia
unresponsive
To treatment, cancer and acute viral infections such as rubella, cytomegalovirus,
toxoplasmosis, chicken pox or herpes
What complications/conditions can prior use of an IUD cause during pregnancy? -
✅✅ Anemia due to excess menstruation; scarring
Of the uterine lining which predisposes to ectopic pregnancy, irregular
implantation of the placenta and third stage hemorrhage.
Which vitamin might a woman who previously used oral contraceptives be
deficient in? - ✅✅ Folic acid.
What complication should be ruled out if there is chronic brown bleeding? - ✅✅
Molar pregnancy
What condition might fatigue combined with dizziness or nausea beyond the first
trimester indicate? - ✅✅ Anemia
What are the dangers of maternal diabetes during pregnancy? - ✅✅ Fetal demise
after 36 weeks; 5x the normal incidence of
Of fetal abnormalities; increased polyhydramnios; 30-50% higher incidence of
preeclampsia; increased incidence of prematurity and newborn respiratory
difficulties.
Scarring of the uterine lining predisposes a woman to what three things? - ✅✅
Ectopic pregnancy, irregular implantation of the placenta and third-stage
hemorrhage. Scarring can be caused by a previous IUD, Pelvic Inflammatory
Disease and Endometriosis
, What are the classic symptoms of ectopic pregnancy and what is the window of
rupture? - ✅✅ Bleeding or spotting accompanied by nonrhythmic pain, as well as
pelvic pain. Pain becomes severe with rupture and may be referred to the shoulder
area. The window of rupture is 10-13 weeks GA
When during pregnancy is a fetus' risk of vertical transmission of toxoplasmosis
the greatest? - ✅✅ The risk of being infected rises as the pregnancy progresses
although the severity is the greatest if contracted within the first trimester
What might you suspect if your patient reports painful vaginal sores paired with flu
like malaise? - ✅✅ An initial outbreak of herpes. If suspected
Immediately do a visual inspection and take cultures. The cervix should always be
cultured because herpes at this cite can be asymptomatic.
What is the standard care for women who have active herpes lesions at the onset of
labor? - ✅✅ A c-section is performed because neonatal infection can cause
central nervous system damage or death.
What are the dangers of thyroid disease during pregnancy? - ✅✅ Thyroid
medication has the potential for causing severe fetal complications.
Hyperthyroidism can cause miscarriage, premature labor and fetal anomalies.
Untreated hyperthyroidism can lead to cretinism in the newborn.
What are the dangers of active tuberculosis during pregnancy? - ✅✅ Slightly
higher risk of miscarriage and
Premature labor
What are the dangers of chronic lung disease during pregnancy? - ✅✅ The mother
is at risk for pulmonary complications and the baby for fetal acidosis and hypoxia
What are the dangers of severe asthma during pregnancy? - ✅✅ Respiratory
infections and stress may intensify attacks.
Cardiopulmonary function could be reduced, affecting fetal growth and well being.
Certain medications used to treat asthma are contraindicated in pregnancy.
What are the dangers of epilepsy during pregnancy? - ✅✅ Anticonvulsant drugs
may cause folic acid deficiency
What is the general contraction pattern which signals the onset of labor? - ✅✅
Contractions which last one minute
And come every five minutes
What is a good position for a woman in labor whose baby has not yet engaged? -
✅✅ An upright forward leaning position will maximize the effects of gravity and
evenly distribute pressure on the cervix to keep the contractions coordinate and
effective. Walking serves the same purpose.
What are some good positions for a woman in labor who's baby is very high (-2 or
-3) and posterior? - ✅✅ Hands and knees with pelvic rocking or standing and
leaning forward with one foot (on the side the baby's body is lying) on a low stool
can encourage rotation.
How often should blood pressure be checked during labor? - ✅✅ Blood pressure
should be checked hourly or every twenty minutes if it was borderline high in
pregnancy or is elevated in labor.
How often should pulse be checked during labor? - ✅✅ Every few hours.
It should be within 10-15 points of her normal range. If it rises check her
temperature.
How would you diagnose clinical exhaustion during labor? - ✅✅ Elevation of
both temperature and pulse paired with
Ketonuria indicates clinical exhaustion which is threatening to both mother and
baby because the mother's blood has become abnormally acidic and less able to
carry oxygen.
How often should FHT be checked during labor? - ✅✅ FHT should be taken
every half hour.
If anything unusual arises, listen continuously until the problem resolves
spontaneously or treatment is decided upon. To get a full picture of FHT listen
though a contraction and for 15-30 seconds after it ends.
,Name this FHT pattern: FHT are normal throughout first part of the contraction but
dip down at the peak and slowly returns to baseline as the contraction ends. - ✅✅
Late deceleration (type II)
May be linked to placental insufficiency or maternal ketoacidosis.
What are the risks of cesarean section? - ✅✅ Life-threatening sepsis, perforation
of adjacent organs, scarring of the uterine lining that can lead to abnormal
placental implantation and hemorrhage with subsequent childbearing, and
development of adhesions between the uterus and other organs that can cause
problems later
Painless bleeding with intercourse is the prime symptom of _______ - ✅✅
Fibroids. These tend to grow during pregnancy and are
Benign. If they are internal they can cause reduced intrauterine space, disrupted
placental implantation and postpartum hemorrhage
What are some urgent warning signs of preeclampsia? - ✅✅ Persistent headaches
in combination with visual
Disturbances or epigastric (upper abdominal) pain - especially on the right side.
What problems might a woman who has had a cone biopsy encounter? - ✅✅
Scarring from cone biopsy may retard
Cervical dilation.
What precautions might a midwife want to take with her patient who has a history
of LEEP procedure? - ✅✅ Because LEEP has been linked to incompetent cervix
And premature labor, some midwives feel that they should check their patient for
cervical changes throughout pregnancy and that the patient should be carefully
instructed regarding signs of premature labor.
What time period does assessment become especially important in the pregnant
woman? - ✅✅ During the last six weeks of pregnancy. At this point the midwife
can identify certain factors regarding the baby's position, growth rate and size and
relate them to the mother's condition.
What components should a midwife include in prenatal care? - ✅✅ Knowledge of
nutrition, exercise, non allopathic
,Healing options of herbology or homeopathy and mind and body integration
techniques like yoga and meditation.
What conditions/diseases contraindicate home birth? - ✅✅ Preexisting diabetes or
hypertension, thyroid disease
(hyperthyroidism), chronic lung disease, severe asthma, epilepsy, clotting
disorders, congenital heart disease (grades 2-4) and kidney disease
Which conditions arising in pregnancy
Contraindicate home birth? - ✅✅ Rh- with antibodies, severe anemia
unresponsive
To treatment, cancer and acute viral infections such as rubella, cytomegalovirus,
toxoplasmosis, chicken pox or herpes
What complications/conditions can prior use of an IUD cause during pregnancy? -
✅✅ Anemia due to excess menstruation; scarring
Of the uterine lining which predisposes to ectopic pregnancy, irregular
implantation of the placenta and third stage hemorrhage.
Which vitamin might a woman who previously used oral contraceptives be
deficient in? - ✅✅ Folic acid.
What complication should be ruled out if there is chronic brown bleeding? - ✅✅
Molar pregnancy
What condition might fatigue combined with dizziness or nausea beyond the first
trimester indicate? - ✅✅ Anemia
What are the dangers of maternal diabetes during pregnancy? - ✅✅ Fetal demise
after 36 weeks; 5x the normal incidence of
Of fetal abnormalities; increased polyhydramnios; 30-50% higher incidence of
preeclampsia; increased incidence of prematurity and newborn respiratory
difficulties.
Scarring of the uterine lining predisposes a woman to what three things? - ✅✅
Ectopic pregnancy, irregular implantation of the placenta and third-stage
hemorrhage. Scarring can be caused by a previous IUD, Pelvic Inflammatory
Disease and Endometriosis
, What are the classic symptoms of ectopic pregnancy and what is the window of
rupture? - ✅✅ Bleeding or spotting accompanied by nonrhythmic pain, as well as
pelvic pain. Pain becomes severe with rupture and may be referred to the shoulder
area. The window of rupture is 10-13 weeks GA
When during pregnancy is a fetus' risk of vertical transmission of toxoplasmosis
the greatest? - ✅✅ The risk of being infected rises as the pregnancy progresses
although the severity is the greatest if contracted within the first trimester
What might you suspect if your patient reports painful vaginal sores paired with flu
like malaise? - ✅✅ An initial outbreak of herpes. If suspected
Immediately do a visual inspection and take cultures. The cervix should always be
cultured because herpes at this cite can be asymptomatic.
What is the standard care for women who have active herpes lesions at the onset of
labor? - ✅✅ A c-section is performed because neonatal infection can cause
central nervous system damage or death.
What are the dangers of thyroid disease during pregnancy? - ✅✅ Thyroid
medication has the potential for causing severe fetal complications.
Hyperthyroidism can cause miscarriage, premature labor and fetal anomalies.
Untreated hyperthyroidism can lead to cretinism in the newborn.
What are the dangers of active tuberculosis during pregnancy? - ✅✅ Slightly
higher risk of miscarriage and
Premature labor
What are the dangers of chronic lung disease during pregnancy? - ✅✅ The mother
is at risk for pulmonary complications and the baby for fetal acidosis and hypoxia
What are the dangers of severe asthma during pregnancy? - ✅✅ Respiratory
infections and stress may intensify attacks.
Cardiopulmonary function could be reduced, affecting fetal growth and well being.
Certain medications used to treat asthma are contraindicated in pregnancy.
What are the dangers of epilepsy during pregnancy? - ✅✅ Anticonvulsant drugs
may cause folic acid deficiency
