Question 1

A 35 - year - old client comes to the facility to inquire about getting her basal mammogram. Which of the following instructions by the midwife is the most appropriate?

Accepted Answer

The client must avoid applying deodorants or creams under the arms or on the breasts before the test. The metallic powders of antiperspirants may be visible on the mammogram as microcalcifications and may result in inaccurate results. A mammogram should be scheduled for either one week before or after the menstrual bleeding. The breasts are tender before the menses. The procedure involves compression of the breasts between two panels, which can be painful. Over - the - counter pain relievers can be taken before the test but the client must inform herpractitioner of any medications she has taken. Caffeine should be avoided during the week before a mammogram.

Question 2

A midwife performs a bimanual pelvic examination on a 25 - year - old client during her annual examination. Which of the following findings indicates a need for further evaluation?

Accepted Answer

Cervical motion tenderness should alert the midwife that further evaluation is necessary. This finding is commonly associated with pelvic inflammatory disease. The fallopian tubes and ovaries are small, and it is normal that they are not palpated in certain patients. If they are palpated, they must be smooth and firm. The uterus is normally freely movable.

Question 3

A midwife is about to assess a client through the use of vaginal speculum. When choosing the size of the speculum, the midwife considers:
I.Age of the client
II.Size of the vagina
III.History of sexual intercourse
IV.Gravidity

Accepted Answer

When choosing the size of the speculum, the midwife should consider the age of the client, the size of the vagina, the client's history of sexual intercourse and gravidity. The Graves speculum is used for examining adult clients. The Pederson speculum, the narrower of the two, is used for younger clients, virgins and postmenopausal clients with vaginal atrophy.

Question 4

A midwife is about to conduct intravaginal assessment through the use of vaginal speculum on a G3P3 client. Cells will be taken for cytologic studies, and cultures are to be obtained. Which of the following actions by the midwife is the least appropriate?

Accepted Answer

The least appropriate action of the midwife is to apply water - based gel to the speculum. If cultures are to be obtained, the midwife should not use water or gel to warm or lubricate the speculum. The other options are appropriate actions. If cytologic studies are to be done, vaginal medications and douching should be avoided before the procedure.

Question 5

A midwife palpates for which of the following anatomic locations when evaluating the Bartholin's glands?

Accepted Answer

The client palpates the posterior labia majora when evaluating the Bartholin's glands. These glands secrete mucus that lubricates the lips of vagina. The Skene's glands can be palpated over and along both sides of the urethra.

Question 6

A client is admitted to the facility due to alcohol abuse. During the first 24 hours, which of following interventions is the least appropriate?

Accepted Answer

Initiating bleeding precautions is not a priority action during the first 24 hours of treatment for alcohol abuse. Signs of alcohol withdrawal occur during this time period. The midwife has to orient the client frequently to alleviate anxiety and to reinforce reality, as hallucinations and illusions are common. Seizures may occur as the withdrawal progresses, so precautions are initiated on admission. A quiet and non - stimulating environment decreases anxiety and prevents seizures.

Question 7

A midwife is managing the care of a G2P3 client who is in treatment for alcohol abuse. Which of the following interventions is the most appropriate?

Accepted Answer

The most appropriate intervention is to focus the client's attention on the substance abuse problem. The midwife should inform the client that she is accountable for all of her actions. Alcohol abuse requires the client to develop her own problem - solving skills. The midwife should help the client to identify situations that precipitate angry feelings and to make her own plan of action to prevent anger. The midwife should set limits on manipulative behaviors.

Quiz 1: General Healthcare Skills