Midwifery Comprehensive Exam
Questions and Answers 100% Solved
Two products of impaired blood flow to the legs are thought to be linked to
cramps? - ✔✔Pyruvic acid
Lactic acid
Name two prevention techniques for nocturnal leg cramps - ✔✔Hydration,
stretching, avoid long periods of sitting or standing, warm baths, exercise
What is the most important differential diagnosis to rule out when a
pregnant patient comes in with complaints of leg cramping? - ✔✔Deep
Vein Thrombosis:
Look for warm red tender swollen leg.
Conflicting evidence supports taking which supplement for leg cramps ? -
✔✔Magnesium
True or false. Women with NVP have lower rates of preterm births, low
birth weight babies, congenital anomalies, and stillbirths. - ✔✔True
How does progesterone contribute to NVP? - ✔✔Slows peristalsis and
gastric emptying
1
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,If dietary measures, lifestyle changes, and OTC remedies do not help with
NVP, what medicine has shown to be effective with NVP? - ✔✔Antiemetics
such Zofran (Ondansetron). Note: Not mentioned in Varney's
True of False. Effective therapy for NVP will always remain the same for a
woman throughout her pregnancy and subsequent pregnancies. -
✔✔False. Effectiveness of therapy may fluctuate over the course of
pregnancy and varies greatly from pregnancy to pregnancy.
True or False. To combat nausea during pregnancy, one should brush their
teeth immediately after they eat. - ✔✔False. Brushing your teeth can
stimulate the gag reflex, aggravating nausea and vomiting.
What pre-existing conditions can contribute to NVP? - ✔✔H. pylori and
GERD
What is the most important differential diagnosis to rule out with leg cramps
during pregnancy? - ✔✔Deep vein thrombosis
True/false: Leg cramps during pregnancy are not normal and should be
reported immediately to provider. - ✔✔False. Leg cramps are completely
normal during pregnancy and occur more frequently during the 2nd and 3rd
trimesters.
How can your pregnant patient prevent leg cramps (select all that apply)?
2
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,a. Walking or other exercise
b. Drink plenty of water
c. Stretch before bed
d. Taking a warm bath
e. Sitting for long periods of time - ✔✔A, B, C, D
True/false: Dorsiflexion of the affected foot when a cramp begins helps to
alleviate the pain. - ✔✔True
True/false: Magnesium supplements have been found to help with leg
cramps. - ✔✔False. Research is mixed and taking magnesium
supplements seem to have little effect on preventing leg cramps in
pregnant women.
True or False: Back pain may be a sign of preterm labor only if cramping is
present. - ✔✔False: Cramping may or may not accompany preterm labor.
What are some of the contributing factors causing back pain during
pregnancy?
A. The weight of a growing uterus
B. A shift in her center of gravity
C. Relaxation of sacroiliac ligaments
3
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
, D. All of the above - ✔✔D
True or False: Acupuncture is a holistic method that has not been
correlated with effective pain relief. - ✔✔False: One study found that 60%
of women reported a decrease in back pain after receiving acupuncture.
True or False: It is safe to receive chiropractic manipulation during
pregnancy. - ✔✔True: As long as a patient sees a licensed chiropractor,
studies have shown manual manipulation to be effective.
Why does Round Ligament pain occur? - ✔✔As the uterus grows during
pregnancy the ligaments stretch and thicken to accommodate and support
it. These changes can occasionally cause pains.
Where are Round Ligament pains felt? - ✔✔Round Ligament pain is a
sharp pain or jabbing feeling often felt in the lower belly or groin area on
one or both sides.
What are some of the triggers of Round Ligament pains? - ✔✔Round
Ligament pains can occur with position changes, getting up from a sitting,
lying down, coughing, sneezing, and laughing.
What non-pharmacological methods can be used to alleviate Round
Ligament pains? - ✔✔Avoid sudden movements
Side lying relaxation positions
4
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
Questions and Answers 100% Solved
Two products of impaired blood flow to the legs are thought to be linked to
cramps? - ✔✔Pyruvic acid
Lactic acid
Name two prevention techniques for nocturnal leg cramps - ✔✔Hydration,
stretching, avoid long periods of sitting or standing, warm baths, exercise
What is the most important differential diagnosis to rule out when a
pregnant patient comes in with complaints of leg cramping? - ✔✔Deep
Vein Thrombosis:
Look for warm red tender swollen leg.
Conflicting evidence supports taking which supplement for leg cramps ? -
✔✔Magnesium
True or false. Women with NVP have lower rates of preterm births, low
birth weight babies, congenital anomalies, and stillbirths. - ✔✔True
How does progesterone contribute to NVP? - ✔✔Slows peristalsis and
gastric emptying
1
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,If dietary measures, lifestyle changes, and OTC remedies do not help with
NVP, what medicine has shown to be effective with NVP? - ✔✔Antiemetics
such Zofran (Ondansetron). Note: Not mentioned in Varney's
True of False. Effective therapy for NVP will always remain the same for a
woman throughout her pregnancy and subsequent pregnancies. -
✔✔False. Effectiveness of therapy may fluctuate over the course of
pregnancy and varies greatly from pregnancy to pregnancy.
True or False. To combat nausea during pregnancy, one should brush their
teeth immediately after they eat. - ✔✔False. Brushing your teeth can
stimulate the gag reflex, aggravating nausea and vomiting.
What pre-existing conditions can contribute to NVP? - ✔✔H. pylori and
GERD
What is the most important differential diagnosis to rule out with leg cramps
during pregnancy? - ✔✔Deep vein thrombosis
True/false: Leg cramps during pregnancy are not normal and should be
reported immediately to provider. - ✔✔False. Leg cramps are completely
normal during pregnancy and occur more frequently during the 2nd and 3rd
trimesters.
How can your pregnant patient prevent leg cramps (select all that apply)?
2
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,a. Walking or other exercise
b. Drink plenty of water
c. Stretch before bed
d. Taking a warm bath
e. Sitting for long periods of time - ✔✔A, B, C, D
True/false: Dorsiflexion of the affected foot when a cramp begins helps to
alleviate the pain. - ✔✔True
True/false: Magnesium supplements have been found to help with leg
cramps. - ✔✔False. Research is mixed and taking magnesium
supplements seem to have little effect on preventing leg cramps in
pregnant women.
True or False: Back pain may be a sign of preterm labor only if cramping is
present. - ✔✔False: Cramping may or may not accompany preterm labor.
What are some of the contributing factors causing back pain during
pregnancy?
A. The weight of a growing uterus
B. A shift in her center of gravity
C. Relaxation of sacroiliac ligaments
3
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
, D. All of the above - ✔✔D
True or False: Acupuncture is a holistic method that has not been
correlated with effective pain relief. - ✔✔False: One study found that 60%
of women reported a decrease in back pain after receiving acupuncture.
True or False: It is safe to receive chiropractic manipulation during
pregnancy. - ✔✔True: As long as a patient sees a licensed chiropractor,
studies have shown manual manipulation to be effective.
Why does Round Ligament pain occur? - ✔✔As the uterus grows during
pregnancy the ligaments stretch and thicken to accommodate and support
it. These changes can occasionally cause pains.
Where are Round Ligament pains felt? - ✔✔Round Ligament pain is a
sharp pain or jabbing feeling often felt in the lower belly or groin area on
one or both sides.
What are some of the triggers of Round Ligament pains? - ✔✔Round
Ligament pains can occur with position changes, getting up from a sitting,
lying down, coughing, sneezing, and laughing.
What non-pharmacological methods can be used to alleviate Round
Ligament pains? - ✔✔Avoid sudden movements
Side lying relaxation positions
4
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
