H&H NARM study cards
The midwife's most basic task is to do everything she can to promote... - answer a
mother's relaxation and peace of mind. 7
The midwife's most precious tool: - answer her hands 7
A tenet of woman-centered care: - answer surrendering expectations to whatever the
mother and her supporters need or desire 7
What must we never forget to do in crisis situations or when we are trying to facilitate
progress? - answer Ask the mother's opinion and perceptions 7
What is the cornerstone of effective midwifery practice? - answer prenatal assessment;
the better we do our work prenatally, the less we are surprised by long, drawn-out
labors 11
Assessment is particularly crucial during what period of pregnancy? - answerthe last 6
weeks 11
What is crucial to establish from the very beginning of your relationship with a client? -
answerthe mother's responsibility for her own experience 12
What is your most important task in the initial interview? - answerTo determine whether
you and the mother are suited to work together 12
Social instincts include: - answerthe need to belong, to be a member of a group and to
be recognized by that group. These instincts lead us to make socially recognized
choices 12
Biological instincts include: - answerneed for survival and self-realization 12
What must you disclose to your client at the initial prenatal visit? - answerYour training,
philosophy, style of practice and expectations of clients 13
Early in caregiving, the two most serious emergencies ___ and ___, require detailed
discussion. - answerHemorrhage and fetal distress 14
Medical history can be taken by ___ or provided by the mother via a ____. -
answerInterview, take-home form 14
,Preexisting conditions that contraindicate home birth: - answerpreexisting diabetes,
hypertension, thyroid disease (hyper), chronic lung disease, severe asthma, epilepsy,
clotting disorders, congenital heart disease (grades 2-4) and kidney disease 14
Conditions arising in pregnancy that rule out home birth: - answerRh- with antibodies,
severe anemia unresponsive to treatment and acute viral infections (depending on
when they occur) such as rubella, cytomegalovirus, toxoplasmosis, chicken pox or
herpes 14
History of previous childbirth losses requires attention to ___ and ___. - answerphysical
factors and mother's emotional recovery 14
Any history of abortion should be discussed (when)... - answeras soon as the mother is
ready 14
Psychological issues for a mother desiring a VBAC are.. - answerformidable. She may
have been told she needed surgery because her bones were too small, her hormone
levels too low, or she simply failed to progress. Such comments leave devastating scars
and before vaginal birth is attempted, some healing must take place 15
Prime symptom of fibroids: - answerpainless bleeding with intercourse 15
Which benign uterine masses vary in size but tend to grow considerably during
pregnancy? - answerFibroids 15
Depending on whether they are external or internal, fibroids may affect a pregnancy in
the following ways: - answerreduced intrauterine space, disrupted placental implantation
and immediate postpartum may be complicated by hemorrhage 15
If the mother has had a cone biopsy, _____ may retard dilation. - answerconsiderable
scarring 15
Cervical cauterization and cryosurgery are less traumatic than cone biopsy, but the
cervix should still be check for ____. - answerscarring 15
Scar tissue may be softened by _____ massaged gently onto the cervix in the last few
weeks of pregnancy. - answerevening primrose oil 15
LEEP, a laser procedure similar in effect to cone biopsy, has been correlated to ____
and ___. - answerincompetent cervix and premature labor 15
If a mother had an IUD prior to conception, she may be ____ due to excess
menstruation and should be checked for this as soon as possible. - answeranemic 15
IUD can cause scarring of _____ which predisposes to ectopic pregnancy, irregular
implantation of the placenta and third-stage hemorrhage. - answerthe uterine lining 16
,Pelvic inflammatory disease has been correlated to - answerectopic pregnancy,
irregular implantation of the placenta and third-stage hemorrhage 16
If the mother used hormonal contraception immediately prior to pregnancy, she may be
deficient in _____ and should be advised to begin supplementation at once. -
answerfolic acid 16
Any incidence of _____ or ____ is significant and should be closely tracked by both
mother and midwife. - answerbleeding or spotting 16
The window for ectopic rupture is _____ weeks gestation. - answer10-13 weeks page
16
If a woman reports bleeding or spotting combined with nonrhythmic pain, the midwife
should... - answerimmediately consult with backup to rule out tubal pregnancy 16
Generalized edema experienced before conception or prior to 24 weeks should be... -
answermedically evaluated 16
If bleeding during pregnancy becomes chronic, ___ and ___ must be ruled out. -
answermissed abortion and molar pregnancy 16
If a woman experiences bleeding in late pregnancy, _____ must be ruled out. -
answerplacental problems 16
Generalized edema occurring late in pregnancy indicates possible... -
answerpreeclampsia 16
In the case of generalized edema at any stage of pregnancy, immediately have the
mother change her diet in the following ways: - answereliminate heavily processed
foods, suggest plenty of high-quality protein, fresh veggies, salt to taste and ample
fluids 16
______ and _____ may cause occasional headaches. - answerHormones and
circulatory changes 16
A persistent headache, particularly in combination with signs of preeclampsia,
indicates... - answera medical crisis and the need for immediate referral 16
Urgent warning signs of preeclampsia: - answervisual problems, upper abdominal pain,
epigastric pain - especially on the right side 16
Any history of flu-like symptoms such as swollen glands, extreme fatigue or generalized
body aches should be noted, as they could indicate... - answeran acute viral infection 16
, A fairly common infection (60% of the general population has antibodies) that is most
damaging in the first trimester. - answerCytomegalovirus 16
Toxoplasmosis is known to cause severe neurological damage to the fetus but only if
contracted after ____ weeks. - answer10 weeks 16
Mothers can minimize their risk of contracting toxoplasmosis by avoiding ____ and ___.
- answeruncooked meat and any contact with cat feces 16
A report of painful vaginal sores combined with flu-like malaise in early pregnancy may
indicate an initial outbreak of... - answerherpes 16
In case of a suspected initial herpes outbreak what should the midwife do? -
answerCheck the mother's history, do a visual inspection and take cultures, immediately
consult backup 16
What is the standard of care for delivery if a mother has active herpes lesions at the
onset of labor? - answercesarean section, as neonatal infection can lead to CNS
damage and death 16
Any history of vomiting with the pregnancy should be carefully explored to rule out -
answerhyperemesis gravidarum 17
A mother with _____ cannot retain either food or liquid and must be restabilized with
intravenous replacement therapy before she can eat or drink again. -
answerhyperemesis gravidarum 17
If chronic vomiting persists beyond the first trimester the midwife should... -
answerconsult with a colleague or physician backup 17
_____ is one of the only conditions for which conventional medicine acknowledges
emotional underpinnings. - answerHyperemesis gravidarum 17
___ combined with dizziness or nausea beyond the first trimester may indicate anemia.
- answerFatigue 17
During pregnancy characteristic signs of UTI may be nearly absent due to... -
answerprogesterone's softening effect on the urethra 17
UTI can lead to pyelonephritis (kidney infection) which can lead to... - answerpremature
labor 17
The blood-brain barrier, which ordinarily protects the brain from harmful substances, is
____ in the fetus. - answerundeveloped 17
The midwife's most basic task is to do everything she can to promote... - answer a
mother's relaxation and peace of mind. 7
The midwife's most precious tool: - answer her hands 7
A tenet of woman-centered care: - answer surrendering expectations to whatever the
mother and her supporters need or desire 7
What must we never forget to do in crisis situations or when we are trying to facilitate
progress? - answer Ask the mother's opinion and perceptions 7
What is the cornerstone of effective midwifery practice? - answer prenatal assessment;
the better we do our work prenatally, the less we are surprised by long, drawn-out
labors 11
Assessment is particularly crucial during what period of pregnancy? - answerthe last 6
weeks 11
What is crucial to establish from the very beginning of your relationship with a client? -
answerthe mother's responsibility for her own experience 12
What is your most important task in the initial interview? - answerTo determine whether
you and the mother are suited to work together 12
Social instincts include: - answerthe need to belong, to be a member of a group and to
be recognized by that group. These instincts lead us to make socially recognized
choices 12
Biological instincts include: - answerneed for survival and self-realization 12
What must you disclose to your client at the initial prenatal visit? - answerYour training,
philosophy, style of practice and expectations of clients 13
Early in caregiving, the two most serious emergencies ___ and ___, require detailed
discussion. - answerHemorrhage and fetal distress 14
Medical history can be taken by ___ or provided by the mother via a ____. -
answerInterview, take-home form 14
,Preexisting conditions that contraindicate home birth: - answerpreexisting diabetes,
hypertension, thyroid disease (hyper), chronic lung disease, severe asthma, epilepsy,
clotting disorders, congenital heart disease (grades 2-4) and kidney disease 14
Conditions arising in pregnancy that rule out home birth: - answerRh- with antibodies,
severe anemia unresponsive to treatment and acute viral infections (depending on
when they occur) such as rubella, cytomegalovirus, toxoplasmosis, chicken pox or
herpes 14
History of previous childbirth losses requires attention to ___ and ___. - answerphysical
factors and mother's emotional recovery 14
Any history of abortion should be discussed (when)... - answeras soon as the mother is
ready 14
Psychological issues for a mother desiring a VBAC are.. - answerformidable. She may
have been told she needed surgery because her bones were too small, her hormone
levels too low, or she simply failed to progress. Such comments leave devastating scars
and before vaginal birth is attempted, some healing must take place 15
Prime symptom of fibroids: - answerpainless bleeding with intercourse 15
Which benign uterine masses vary in size but tend to grow considerably during
pregnancy? - answerFibroids 15
Depending on whether they are external or internal, fibroids may affect a pregnancy in
the following ways: - answerreduced intrauterine space, disrupted placental implantation
and immediate postpartum may be complicated by hemorrhage 15
If the mother has had a cone biopsy, _____ may retard dilation. - answerconsiderable
scarring 15
Cervical cauterization and cryosurgery are less traumatic than cone biopsy, but the
cervix should still be check for ____. - answerscarring 15
Scar tissue may be softened by _____ massaged gently onto the cervix in the last few
weeks of pregnancy. - answerevening primrose oil 15
LEEP, a laser procedure similar in effect to cone biopsy, has been correlated to ____
and ___. - answerincompetent cervix and premature labor 15
If a mother had an IUD prior to conception, she may be ____ due to excess
menstruation and should be checked for this as soon as possible. - answeranemic 15
IUD can cause scarring of _____ which predisposes to ectopic pregnancy, irregular
implantation of the placenta and third-stage hemorrhage. - answerthe uterine lining 16
,Pelvic inflammatory disease has been correlated to - answerectopic pregnancy,
irregular implantation of the placenta and third-stage hemorrhage 16
If the mother used hormonal contraception immediately prior to pregnancy, she may be
deficient in _____ and should be advised to begin supplementation at once. -
answerfolic acid 16
Any incidence of _____ or ____ is significant and should be closely tracked by both
mother and midwife. - answerbleeding or spotting 16
The window for ectopic rupture is _____ weeks gestation. - answer10-13 weeks page
16
If a woman reports bleeding or spotting combined with nonrhythmic pain, the midwife
should... - answerimmediately consult with backup to rule out tubal pregnancy 16
Generalized edema experienced before conception or prior to 24 weeks should be... -
answermedically evaluated 16
If bleeding during pregnancy becomes chronic, ___ and ___ must be ruled out. -
answermissed abortion and molar pregnancy 16
If a woman experiences bleeding in late pregnancy, _____ must be ruled out. -
answerplacental problems 16
Generalized edema occurring late in pregnancy indicates possible... -
answerpreeclampsia 16
In the case of generalized edema at any stage of pregnancy, immediately have the
mother change her diet in the following ways: - answereliminate heavily processed
foods, suggest plenty of high-quality protein, fresh veggies, salt to taste and ample
fluids 16
______ and _____ may cause occasional headaches. - answerHormones and
circulatory changes 16
A persistent headache, particularly in combination with signs of preeclampsia,
indicates... - answera medical crisis and the need for immediate referral 16
Urgent warning signs of preeclampsia: - answervisual problems, upper abdominal pain,
epigastric pain - especially on the right side 16
Any history of flu-like symptoms such as swollen glands, extreme fatigue or generalized
body aches should be noted, as they could indicate... - answeran acute viral infection 16
, A fairly common infection (60% of the general population has antibodies) that is most
damaging in the first trimester. - answerCytomegalovirus 16
Toxoplasmosis is known to cause severe neurological damage to the fetus but only if
contracted after ____ weeks. - answer10 weeks 16
Mothers can minimize their risk of contracting toxoplasmosis by avoiding ____ and ___.
- answeruncooked meat and any contact with cat feces 16
A report of painful vaginal sores combined with flu-like malaise in early pregnancy may
indicate an initial outbreak of... - answerherpes 16
In case of a suspected initial herpes outbreak what should the midwife do? -
answerCheck the mother's history, do a visual inspection and take cultures, immediately
consult backup 16
What is the standard of care for delivery if a mother has active herpes lesions at the
onset of labor? - answercesarean section, as neonatal infection can lead to CNS
damage and death 16
Any history of vomiting with the pregnancy should be carefully explored to rule out -
answerhyperemesis gravidarum 17
A mother with _____ cannot retain either food or liquid and must be restabilized with
intravenous replacement therapy before she can eat or drink again. -
answerhyperemesis gravidarum 17
If chronic vomiting persists beyond the first trimester the midwife should... -
answerconsult with a colleague or physician backup 17
_____ is one of the only conditions for which conventional medicine acknowledges
emotional underpinnings. - answerHyperemesis gravidarum 17
___ combined with dizziness or nausea beyond the first trimester may indicate anemia.
- answerFatigue 17
During pregnancy characteristic signs of UTI may be nearly absent due to... -
answerprogesterone's softening effect on the urethra 17
UTI can lead to pyelonephritis (kidney infection) which can lead to... - answerpremature
labor 17
The blood-brain barrier, which ordinarily protects the brain from harmful substances, is
____ in the fetus. - answerundeveloped 17
