Deck 4: Midwifery Counseling and Education

Question 1

A midwife is teaching a pregnant client safe techniques for exercising. Which of the following teachings is not a safe way of exercising when pregnant?

A)Point the toes when exercising.
B)Avoid exercises that hyperextend the lower back.
C)Avoid practicing second stage pushing.
D)When rising from the floor, roll over to the side first and then push up.

Answer 1

Point the toes when exercising.

Question 2

A midwife is teaching a client at 20 weeks' gestation how to perform abdominal muscle contractions. Which of the following is not a benefit of this exercise?

A)It stretches the perineal muscles.
B)It prevents constipation.
C)It alleviates back pain.
D)It helps restore abdominal muscle tone after pregnancy.

Answer 2

It stretches the perineal muscles.

Question 3

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 birth support partner during the pregnancy, labor and early postpartum period. It also encourages walking during labor. The midwife is teaching which method to the client?

A)Lamaze method
B)Bradley method
C)Psychosexual method
D)Dick-Read method

Answer 3

Bradley method

Question 4

A 25-year-old client at 7 weeks' gestation comes to the clinic for her first prenatal visit. The client tells the midwife that a friend recently gave birth to a baby with Down syndrome and that she is concerned about her baby's chances of developing the same diagnosis. The midwife informs the client that a combined first trimester screening test may be ordered as early as the 11th week of her pregnancy to help evaluate the fetus's risk for chromosomal abnormalities. The midwife informs the client that all of the following tests are included in the combined first trimester screening test except:

A)Nuchal translucency screening through ultrasound test
B)Pregnancy-associated plasma protein screening
C)Human chorionic gonadotropin test
D)Alpha-fetoprotein screening test

Question 5

A client at 8 weeks' gestation comes to the clinic for her first prenatal visit. The client tells the midwife that a cousin of hers gave birth to a femalebaby with Down syndrome a year ago. The client is anxious that her baby may develop the same genetic disorder and is requesting an immediate amniocentesis. Which of the following statements by the midwife is the appropriate?

A)"It is good that you are interested in having an amniocentesis. I will schedule you for an amniocentesis within the week."
B)"We need to schedule your amniocentesis in two months. The fetus is not mature enough to give accurate results at this time."
C)"You can have an amniocentesis between 15 and 16 weeks' gestation. The amount of amniotic fluid is insufficient to be able to obtain an amniotic sample at this time."
D)"You may have a choronic villi sampling in two weeks. Amniocentesis is not performed until the third trimester."

Question 6

A midwife is creating a teaching plan for a group of adolescent clients who are pregnant for the first time. The main purpose of the teaching session is to promote nutritional health during pregnancy. Which of the following consideration is least important when creating the teaching plan?

A)The group's reactions to possible changes that concern their eating habits.
B)The involvement of the clients' families, especially the food preparers.
C)The financial status of the clients.
D)Cultural considerations.

Question 7

A midwife is managing the nutritional status of a 13-year-old client at 12 weeks' gestation. When working with an adolescent client, which of the following interventions is the most effective?

A)Encourage the client to consume least 2,000 calories per day from food intake.
B)Allow the client to reject traditional foods, and respect her decisions.
C)Advise the client to prepare nutritious snacks for the next day before going to bed.
D)Work exclusively with the client, not with her family members or guardians, during dietary planning.

Question 8

A client is in her 18th week of pregnancy. Which of the following psychosocial changes is expected at this time?

A)The client is ambivalent about being pregnant.
B)The client begins to imagine how she will feel during the delivery.
C)The client is excited to attend childbirth educational classes.
D)The client engages in nest-building activities.

Question 9

A midwife is teaching a group of clients about the importance of performing breast self-examination every month. The midwife is most concerned about increasing the awareness of its importance in which group of clients?

A)Clients who are infected with human immunodeficiency virus.
B)Clients with endometrial polyps.
C)Clients with ovarian cancer.
D)Clients with colorectal cancer.

Question 10

A client had a miscarriage and underwent a cervical dilatation and curettage procedure. Before discharge, the midwife instructs the client about certain activities that have to be limited or avoided in the next few weeks. The midwife determines that the health teaching has been successful if the client says:

A)"I can engage in vaginal intercourse after a week."
B)"I will avoid tub baths for a week."
C)"I should use tampons instead of sanitary pads."
D)"I need to be on bed rest for a week"

Question 11

A midwife is teaching a group of clients about Norplant as a contraceptive method. Norplant is contraindicated for which of the following clients?

A)A client who is suspected of having breast cancer.
B)An adolescent who is sexually active.
C)A client who is breastfeeding.
D)A client in need of a reversible contraceptive method.

Question 12

A 15-year-old comes to the facility and asks the midwife about her contraceptive options. Which of the following is the least appropriate method of contraception for this client?

A)Periodic abstinence
B)Subcutaneous implants
C)Oral contraceptives
D)Diaphragms

Question 13

The following clients are contraindicated for diaphragm use except for:

A)A client with a history of toxic shock syndrome.
B)A client with allergy to rubber.
C)A client with umbilical hernia.
D)A client with recurrent UTI.

Question 14

A midwife is creating a teaching plan for a client who is scheduled for tubal ligation. Which of the following teachings should not be included in the plan?

A)Avoid unprotected coitus before the surgical procedure.
B)The procedure will not affect the menstrual cycle.
C)Coitus may be resumed 3 days after the procedure.
D)Occurrence of sharp shoulder pain necessitates immediate medical intervention.

Question 15

A couple visits the facility for a fertility assessment. A semen analysis is ordered. Which of the following suggests a likely fertility problem?
I.Sperm count = 15 million per milliliter of seminal fluid.
II.Sperm motility = 80%
III.Sperm progressive motility = 35%
IV.Ejaculation volume = 1.2 cc

A)I
B)I and IV
C)I, III and IV
D)All of above

Question 16

A midwife is assessing the fertility of couples who have been trying to conceive for a period of time without success. Which of the following couples has primary infertility?

A)A couple engaging in unprotected sex for half a year. No previous conceptions are reported.
B)A couple engaging in unprotected sex for one year. A previous conception is reported.
C)A couple engaging in unprotected sex for one year. No previous conceptions are reported.
D)A couple engaging in unprotected sex for half a year. A previous conception is reported.

Question 17

A midwife is teaching a group of clients between the ages of 19 and 20 about breast examination. Which of the following statements made by one of the participants indicates that further teaching is needed?

A)"Females should conduct a monthly breast examination starting at age 20."
B)"Females should have a clinical breast examination every three years from ages 20 to 39."
C)"Starting at age 40, females should have a yearly mammogram."
D)"Starting at age 40, clinical breast examination should be done every other year."

Question 18

There are many reasons why midwives should be concerned with professional ethics. Which of the following is the main and critical purpose of applied professional ethics?

A)To foster professional identity.
B)To protect consumers and care providers.
C)To maintain internal regulation and avoid external regulation.
D)To signal professional maturity.

Question 19

A 43-year-old client comes to the clinic with her partner for a series of fertility tests. The client's partner used to be the midwife's patient from another facility, and the midwife is certain that he tested positive for HIV. The client is unaware of her partner's diagnosis. The midwife talks to the partner in private, and, although he acknowledges that that he used to be her patient, he denies that he tested positive for HIV and refuses to talk to his partener about his diagnosis. What should the midwife's next action be?

A)Decide not to inform the client but document that an attempt was made to convince the partner to reveal the diagnosis to the client.
B)Inform the client that her partner has HIV.
C)Obtain information from the partner's past medical record without his permission.
D)Urge the client to persuade her partner to get an HIV test with her.

Question 20

Before discharging a pregnant client against medical advice (AMA), which of the following actions by the midwife is the most appropriate?

A)Inform the client that she may not come back to the facility if complications occur.
B)Ensure that the client is aware of the risks of leaving the facility.
C)Inform the ethics committee about the client's case.
D)Inform the client that follow-up care is not possible after discharge.

Question 21

Pre-conception (family planning) counseling is a part of preventive healthcare. Which of the following is an aim of family planning counseling in women in wish to become pregnant?

A)Identification of high risk factors
B)Immunization
C)Concern about family history and existing medical illnesses
D)All of the above

Question 22

To ensure that a woman enters pregnancy in an optimal state of health (that will be safe both to the woman and her fetus), which of the following options is the perferable time for her to receive pregnancy counseling?

A)Late 1st trimester
B)End of the 1st trimester
C)Early in the 1st trimester
D)None of the above

Question 23

Maternal and child health (MCH) refers to the promotion of healthcare for mother and child. Which of the following is a component of MCH?

A)Family planning
B)Child health
C)Infectious diseases
D)None of the above

Question 24

Antenatal care is the care of a woman during pregnancy. Which of the following is an objective of antenatal care?

A)To promote health of mother
B)To detect high risk cases
C)To reduce maternal and infant mortality
D)All of the above

Question 25

A primigravida with 10 weeks of amenorrhea presents for an antenatal visit. Which of following will you investigate to perform a history intake?

A)Duration of marriage
B)Menstrual cycle
C)Age of last child
D)All of the above

Question 26

Ankle edema is a major problem during pregnancy. Which of the following is a cause of ankle edema?

A)Preeclampsia
B)Heart failure
C)Renal failure
D)None of the above

Question 27

A 25 years old pregnant female presents with obstetric abnormalities. Examination reveals this is a case of heart burn. Which of the following is a cause of heart burn in a healthy pregnant woman with no pre-existing conditions?

A)Excessive stress
B)Anemia
C)Faulty posture
D)Edema

Question 28

Constipation during pregnancy is one of the most common minor complications. Which of the following is a probable cause of constipation?

A)Progesterone
B)Diminished physical activity
C)Pressure of gravid uterus
D)All of the above

Question 29

Cesarean section is an operative procedure whereby the fetus is delivered after the end of 28th week of pregnancy through an incision in the abdominal and uterine wall. Of the following, which is the most probable fetal complication of cesarean section?

A)Respiratory distress syndrome
B)Hemorrhage
C)Infection
D)Pelvic pain

Question 30

Cesarean section is an operative procedure whereby the fetus is delivered after the end of 28th week of pregnancy through an incision in the abdominal and uterine wall. Of the following, which is a probable maternal complication of cesarean section?

A)Asphyxia
B)RDS
C)Pelvic pain
D)Prematurity

Question 31

Zinc is an essential mineral for maternal health. Which of the following is a complication of zinc deficiency?

A)Growth failure
B)Loss of taste
C)Delayed wound healing
D)All of the above