NARM STUDY QUESTIONS EXAM
WITH COMPLETE SOLUTIONS
"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: -ANSPhilosophy of Care
In which portion of the fallopian tubes does fertilization normally occur? -ANSthe
ampulla
A prenatal factor that may cause a hemorrhage is -ANSgrand multipara
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 -ANSvertex (occipital) presentation
The increased activity of the endometrial glands during the luteal phase of the female
reproductive cycle is stimulated by: -ANSprogesterone
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? -
ANShigh levels of human chorionic gonadotropin
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: -ANSNewborn's first growth spurt
Fetal heart rate variability is not affected by -ANSMaternal Sleep
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 -ANSask for some time alone with her and
inquire whether the crowd is bothering her
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? -ANSa positive Ortolani's
sign
What is the largest diameter of the fetal head? -ANSoccipitomental
,During the first 10-12 weeks of pregnancy, the corpus luteum: -ANSsecretes
progesterone to maintain the pregnancy
Constipation during pregnancy is usually the result of: -ANSprolonged stomach
emptying time and decreased intestinal motility
What is a positive sign of pregnancy: -ANSultrasound
A child born to a woman over the age of 35 has an increased risk of: -ANSTrisomy 21
What is the best recommendation for a woman with morning sickness? -ANSeat a dry
carbohydrate, such as crackers, before getting out of bed
The definition of pica is -ANSthe craving for non-food, non-nutritive substances such as
ice, clay, dirt, starch or plaster
Which of the common discomforts of pregnancy generally have their initial onset during
the first trimester of pregnancy? -ANSfatigue
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: -ANSThreatened
Abortion
Dangerous complication of pregnancy would be characterized by shoulder pain? -
ANSruptured tubal pregnancy, or ruptured uterus
Women with a diagnosis of severe preeclampsia have an increased risk of: -
ANSplacental abruption
Thrush in the newborn is directly related to contact in the birth canal with which of the
following organisms? -ANScandida albicans
To protect her unborn child from toxoplasmosis, a pregnant woman should: -ANSavoid
eating under cooked meets, and handling cat feces
An example of a sex chromosome abnormality is: -ANSTurner Syndrome
A typical gynecoid pelvis has which of the following characteristics? -ANSrounded inlet,
nonprominenant ischial spines and wide, round pubic arch
A cephalic presentation includes all of the following, except: -ANSBrow, Face, Vertex
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? -ANSbreastfeeding 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: -ANSSymptoms-thermal method
The midwife is performing Leopold's maneuvers and determines that the fetus is ROA.
Which of the following did she find? -ANSround, firm object low in the pelvis, small parts
on the mother's left side, and a soft rounded shape in the fundus
What describes contractions with a frequency of 3 minutes? -ANScontractions 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. What action is
appropriate? -ANSinform 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: -ANS0 (zero station)
A laboring woman's membranes rupture at the end of a contraction. The midwife's first
action would be to: -ANSAssess FHT
What is descriptive of a cephalohematoma: -ANSblood 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 -ANScontraction
every 2 minutes, lasting 90 seconds, rapid progressive cervical dilation, discomfort that
seems out of proportion to the dilation
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: -ANSprolonged, 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: -
ANShemorrhage
The midwife notes a cord protruding from a laboring woman's vagina. The first action
would be to: -ANSapply 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 -ANSabdominal with
synchronous chest movements
The average heart beat range for a full-term, quiet and awake newborn is -ANS120-140
BPM
WITH COMPLETE SOLUTIONS
"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: -ANSPhilosophy of Care
In which portion of the fallopian tubes does fertilization normally occur? -ANSthe
ampulla
A prenatal factor that may cause a hemorrhage is -ANSgrand multipara
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 -ANSvertex (occipital) presentation
The increased activity of the endometrial glands during the luteal phase of the female
reproductive cycle is stimulated by: -ANSprogesterone
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? -
ANShigh levels of human chorionic gonadotropin
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: -ANSNewborn's first growth spurt
Fetal heart rate variability is not affected by -ANSMaternal Sleep
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 -ANSask for some time alone with her and
inquire whether the crowd is bothering her
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? -ANSa positive Ortolani's
sign
What is the largest diameter of the fetal head? -ANSoccipitomental
,During the first 10-12 weeks of pregnancy, the corpus luteum: -ANSsecretes
progesterone to maintain the pregnancy
Constipation during pregnancy is usually the result of: -ANSprolonged stomach
emptying time and decreased intestinal motility
What is a positive sign of pregnancy: -ANSultrasound
A child born to a woman over the age of 35 has an increased risk of: -ANSTrisomy 21
What is the best recommendation for a woman with morning sickness? -ANSeat a dry
carbohydrate, such as crackers, before getting out of bed
The definition of pica is -ANSthe craving for non-food, non-nutritive substances such as
ice, clay, dirt, starch or plaster
Which of the common discomforts of pregnancy generally have their initial onset during
the first trimester of pregnancy? -ANSfatigue
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: -ANSThreatened
Abortion
Dangerous complication of pregnancy would be characterized by shoulder pain? -
ANSruptured tubal pregnancy, or ruptured uterus
Women with a diagnosis of severe preeclampsia have an increased risk of: -
ANSplacental abruption
Thrush in the newborn is directly related to contact in the birth canal with which of the
following organisms? -ANScandida albicans
To protect her unborn child from toxoplasmosis, a pregnant woman should: -ANSavoid
eating under cooked meets, and handling cat feces
An example of a sex chromosome abnormality is: -ANSTurner Syndrome
A typical gynecoid pelvis has which of the following characteristics? -ANSrounded inlet,
nonprominenant ischial spines and wide, round pubic arch
A cephalic presentation includes all of the following, except: -ANSBrow, Face, Vertex
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? -ANSbreastfeeding 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: -ANSSymptoms-thermal method
The midwife is performing Leopold's maneuvers and determines that the fetus is ROA.
Which of the following did she find? -ANSround, firm object low in the pelvis, small parts
on the mother's left side, and a soft rounded shape in the fundus
What describes contractions with a frequency of 3 minutes? -ANScontractions 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. What action is
appropriate? -ANSinform 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: -ANS0 (zero station)
A laboring woman's membranes rupture at the end of a contraction. The midwife's first
action would be to: -ANSAssess FHT
What is descriptive of a cephalohematoma: -ANSblood 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 -ANScontraction
every 2 minutes, lasting 90 seconds, rapid progressive cervical dilation, discomfort that
seems out of proportion to the dilation
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: -ANSprolonged, 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: -
ANShemorrhage
The midwife notes a cord protruding from a laboring woman's vagina. The first action
would be to: -ANSapply 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 -ANSabdominal with
synchronous chest movements
The average heart beat range for a full-term, quiet and awake newborn is -ANS120-140
BPM
