Midwifery National Exam Practice MCQ's
-2 Questions & Answers (rated A)
What you explain to women about GBS screening... - ANSWER-Transient micro-
organism found in the vagina and bowel.
Screening is RISK BASED approach...
o previous GBS-affected infant
o GBS bacteruria this pregnancy
o preterm (< 37 weeks) labour and imminent birth
o intrapartum fever > 380C
o membrane rupture > 18 hrs.
Via HVS/rectal/MSU ?36/40
Early-onset neonatal Group B Streptococcus (GBS) infection is the leading cause of
infectious disease in the newborn.
What details you must discuss with women with GBS risk factors... - ANSWER-- risks &
treatment
- involvement of AB's
- any Hx of penicillin allergy
GBS cases - management... - ANSWER-• All newborn babies showing signs of sepsis
should undergo immediate referral and assessment from a paediatrician. This will
include a full blood count and blood cultures. While waiting for culture results antibiotic
therapy is recommended for at least 48-hours.
• suspected chorioamnionitis - immediate assessment and referral to a paediatrician.
Antibiotic therapy is recommended for babies showing signs of sepsis.
• Healthy-appearing babies born at > 35-weeks gestation to women with GBS risk
factors and who have received appropriate antibiotics > 4-hours before birth require no
investigations or treatment, but should be observed closely for at least 24 hours post-
partum. This includes close observation at home.
• Well-appearing babies born at > 35-weeks gestation to women with GBS risks factors
who have received either no or inadequate (< 4-hours) antibiotics during labour should
be observed closely for at least 24-hours. It is recommended that this be in hospital and
that referral may be considered.
,• Well-appearing babies born at < 35-week gestation to women without
chorioamnionitis, who have not received antibiotics > 4 hours before birth need close
observation for at least 48-hours. It is recommended that this be in hospital and that
referral may be considered.
placenta previa - ANSWER-• bleeding from an abnormally located placenta
Which of the following are associated with placenta previa?
1. Prev C/S
2. Prev uterine curettage
3. Primips
4. Anaemia
5. Male fetus
6. Congentital abnormality
a. 1 and 3
b. 2, 4, 5
c. 1, 2, 4, 5, 6
d. all of the above - ANSWER-c. 1, 2, 4, 5, 6
- Prev C/S
- Prev placenta curettage
- abortion
- Endometriosis
- Multiparty
- Age
-Anaemia
- Smoking (enlarged placenta)
- Multiple preg
- congentital abnorm
- MALE fetus
- placental abnormality: Biparietal
What is the best practice if placenta previa/vasa previa is diagnosed at or beyond
32/40?
a. Consultation
b. USS at 36/40
c. Transfer of care
d. USS in 2 weeks time - ANSWER-c. Transfer of care
Realistically..
, can compromise shared care
What should be your management plan if after a USS you find EFW < 10th percentile
on customised growth chart, or abdominal circumference (AC) < 5th
percentile on ultrasound, or discordancy
of AC with other growth parameters with
normal liquor and normal umbilical doppler?
a. Transfer of care
b. Consultation with obstetrician
c. Consultation with paediatrician
d. Frequent growth scans - ANSWER-b. Consultation with obstetrician
If placenta previa is found at the dating scan, what is the best management?
a. USS at 20/40 and 36/40
b. USS at NT, 20/40 and 36/40
c. USS at 20/40, 32/40 and 34/40
d. USS at NT, 20/40 AND 32/40 and if persists refer to specialist - ANSWER-d. USS at
NT, 20/40 AND 32/40 and if persists refer to specialist
A unbooked woman turns up to the secondary unit that you work at as a core midwife.
Which of the following signs may indicate placenta previa?
1. High head
2. Unstable lie
3. Transverse or oblique lie
4. painless bleeding
a. 4 only
b. 2, 3, 4
c. 2 and 4
d. all of the above - ANSWER-d. all of the above
Which of the following are symptoms of acute placenta previa?
a. painless bleeding, hard abdomen, no history of trauma, unstable lie
b. painful bleeding, soft abdomen, no history of trauma, stable lie
c. Painless bleeding, no hx of trauma, soft abdomen, unstable lie
d. Painful bleeding, may have history of trauma, hard abdomen, unstable lie -
ANSWER-c. Painless bleeding, no hx of trauma, soft abdomen, unstable lie
What should be your management plan if after a USS you find EFW < 10th percentile
on customised growth chart, or abdominal circumference (AC) < 5th
percentile on ultrasound, or discordancy
of AC with other growth parameters with
-2 Questions & Answers (rated A)
What you explain to women about GBS screening... - ANSWER-Transient micro-
organism found in the vagina and bowel.
Screening is RISK BASED approach...
o previous GBS-affected infant
o GBS bacteruria this pregnancy
o preterm (< 37 weeks) labour and imminent birth
o intrapartum fever > 380C
o membrane rupture > 18 hrs.
Via HVS/rectal/MSU ?36/40
Early-onset neonatal Group B Streptococcus (GBS) infection is the leading cause of
infectious disease in the newborn.
What details you must discuss with women with GBS risk factors... - ANSWER-- risks &
treatment
- involvement of AB's
- any Hx of penicillin allergy
GBS cases - management... - ANSWER-• All newborn babies showing signs of sepsis
should undergo immediate referral and assessment from a paediatrician. This will
include a full blood count and blood cultures. While waiting for culture results antibiotic
therapy is recommended for at least 48-hours.
• suspected chorioamnionitis - immediate assessment and referral to a paediatrician.
Antibiotic therapy is recommended for babies showing signs of sepsis.
• Healthy-appearing babies born at > 35-weeks gestation to women with GBS risk
factors and who have received appropriate antibiotics > 4-hours before birth require no
investigations or treatment, but should be observed closely for at least 24 hours post-
partum. This includes close observation at home.
• Well-appearing babies born at > 35-weeks gestation to women with GBS risks factors
who have received either no or inadequate (< 4-hours) antibiotics during labour should
be observed closely for at least 24-hours. It is recommended that this be in hospital and
that referral may be considered.
,• Well-appearing babies born at < 35-week gestation to women without
chorioamnionitis, who have not received antibiotics > 4 hours before birth need close
observation for at least 48-hours. It is recommended that this be in hospital and that
referral may be considered.
placenta previa - ANSWER-• bleeding from an abnormally located placenta
Which of the following are associated with placenta previa?
1. Prev C/S
2. Prev uterine curettage
3. Primips
4. Anaemia
5. Male fetus
6. Congentital abnormality
a. 1 and 3
b. 2, 4, 5
c. 1, 2, 4, 5, 6
d. all of the above - ANSWER-c. 1, 2, 4, 5, 6
- Prev C/S
- Prev placenta curettage
- abortion
- Endometriosis
- Multiparty
- Age
-Anaemia
- Smoking (enlarged placenta)
- Multiple preg
- congentital abnorm
- MALE fetus
- placental abnormality: Biparietal
What is the best practice if placenta previa/vasa previa is diagnosed at or beyond
32/40?
a. Consultation
b. USS at 36/40
c. Transfer of care
d. USS in 2 weeks time - ANSWER-c. Transfer of care
Realistically..
, can compromise shared care
What should be your management plan if after a USS you find EFW < 10th percentile
on customised growth chart, or abdominal circumference (AC) < 5th
percentile on ultrasound, or discordancy
of AC with other growth parameters with
normal liquor and normal umbilical doppler?
a. Transfer of care
b. Consultation with obstetrician
c. Consultation with paediatrician
d. Frequent growth scans - ANSWER-b. Consultation with obstetrician
If placenta previa is found at the dating scan, what is the best management?
a. USS at 20/40 and 36/40
b. USS at NT, 20/40 and 36/40
c. USS at 20/40, 32/40 and 34/40
d. USS at NT, 20/40 AND 32/40 and if persists refer to specialist - ANSWER-d. USS at
NT, 20/40 AND 32/40 and if persists refer to specialist
A unbooked woman turns up to the secondary unit that you work at as a core midwife.
Which of the following signs may indicate placenta previa?
1. High head
2. Unstable lie
3. Transverse or oblique lie
4. painless bleeding
a. 4 only
b. 2, 3, 4
c. 2 and 4
d. all of the above - ANSWER-d. all of the above
Which of the following are symptoms of acute placenta previa?
a. painless bleeding, hard abdomen, no history of trauma, unstable lie
b. painful bleeding, soft abdomen, no history of trauma, stable lie
c. Painless bleeding, no hx of trauma, soft abdomen, unstable lie
d. Painful bleeding, may have history of trauma, hard abdomen, unstable lie -
ANSWER-c. Painless bleeding, no hx of trauma, soft abdomen, unstable lie
What should be your management plan if after a USS you find EFW < 10th percentile
on customised growth chart, or abdominal circumference (AC) < 5th
percentile on ultrasound, or discordancy
of AC with other growth parameters with
