Midwifery National Exam Practice MCQ's -2 Solved 100%

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 abnormal liquor or abnormal umbilical doppler? a. Transfer of care b. Consultation with obstetrician c. Consultation with paediatrician d. Frequent growth scans - Answer a. Transfer of care If a woman reports a previous LGA birth weight, what percentile must it be OVER before a consultation is required? a. >98th b. >97th c >90th d. >95th - Answer b. >97th What amount requires consultation if a woman has a history of PPH? a. >500 mls b. 100mls c. >1000mls d. 500mls - Answer c. >1000mls What amount of miscarriages calls for a consultation? a. 5 or more b. 3 or more c. 2 or more d. 4 or more - Answer b. 3 or more If a woman has a hx of SUDI, what type of referral is required? a. primary b. consultation c. transfer of care d. not required - Answer a. primary What is the prinicple purpose for the NZMC? a. to protect the health and safety of members of the public by providing for mechanisms to ensure that health professionals are competent and fit to practise their professions b. Professional Organisation of Midwives and recognised 'voice' for midwives and student midwives in New Zealand c. To set standards of clinical competence, cultural competence, and ethical conduct to be observed by health professionals of the profession - Answer c. To set standards of clinical competence, cultural competence, and ethical conduct to be observed by health professionals of the profession What are the functions of the Midwifery Council? 1. Prescribe qualifications 2. Authorise registration 3. Review and Promote competence 4 Address concerns about competence 5. notify employers, ACC, the Director General of Health, HDC a. 1 and 2 b. 1,2 and 3 c. 1, 4,5 d. all of the above - Answer a. 1 and 2 b. 1,2 and 3 c. 1, 4,5 d. all of the above 4 Address concerns about competence Including... Complaints and procedures* Establish a Professional Conduct Committee * Refer Midwives to Disciplinary Tribunal What does midwifery council NOT do? a. promote their responsibilities b. discipline for misconduct c. Authorise registration d. Address concerns about competence - Answer b. discipline for misconduct They are responsible to refer cases of concern to > PPC who either... 1. refer back to NZMC with advice 2. no further action required 3. IF SERIOUS > Refer to HPDT (who decides discipline)