MIDWIFERY COMPREHENSIVE EXAM QUESTIONS AND
DETAILED ANSWERS|ALREADY GRADED A
Two products of impaired blood flow to the legs are thought to be linked
to cramps? Correct Ans- Pyruvic acid
Lactic acid
Name two prevention techniques for nocturnal leg cramps Correct Ans-
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? Correct
Ans- Deep Vein Thrombosis:
Look for warm red tender swollen leg.
Conflicting evidence supports taking which supplement for leg cramps ?
Correct Ans- Magnesium
True or false. Women with NVP have lower rates of preterm births, low
birth weight babies, congenital anomalies, and stillbirths. Correct Ans-
True
How does progesterone contribute to NVP? Correct Ans- Slows
peristalsis and gastric emptying
,If dietary measures, lifestyle changes, and OTC remedies do not help
with NVP, what medicine has shown to be effective with NVP? Correct
Ans- 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.
Correct Ans- 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. Correct Ans- False. Brushing your
teeth can stimulate the gag reflex, aggravating nausea and vomiting.
What pre-existing conditions can contribute to NVP? Correct Ans- H.
pylori and GERD
What is the most important differential diagnosis to rule out with leg
cramps during pregnancy? Correct Ans- Deep vein thrombosis
True/false: Leg cramps during pregnancy are not normal and should be
reported immediately to provider. Correct Ans- 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)?
,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 Correct Ans- A, B, C, D
True/false: Dorsiflexion of the affected foot when a cramp begins helps
to alleviate the pain. Correct Ans- True
True/false: Magnesium supplements have been found to help with leg
cramps. Correct Ans- 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. Correct Ans- 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
D. All of the above Correct Ans- D
, True or False: Acupuncture is a holistic method that has not been
correlated with effective pain relief. Correct Ans- 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. Correct Ans- True: As long as a patient sees a licensed
chiropractor, studies have shown manual manipulation to be effective.
Why does Round Ligament pain occur? Correct Ans- 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? Correct Ans- 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? Correct Ans-
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? Correct Ans- Avoid sudden movements
Side lying relaxation positions
Flex hips: Bend and flex before coughing, sneezing, or laughing.
DETAILED ANSWERS|ALREADY GRADED A
Two products of impaired blood flow to the legs are thought to be linked
to cramps? Correct Ans- Pyruvic acid
Lactic acid
Name two prevention techniques for nocturnal leg cramps Correct Ans-
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? Correct
Ans- Deep Vein Thrombosis:
Look for warm red tender swollen leg.
Conflicting evidence supports taking which supplement for leg cramps ?
Correct Ans- Magnesium
True or false. Women with NVP have lower rates of preterm births, low
birth weight babies, congenital anomalies, and stillbirths. Correct Ans-
True
How does progesterone contribute to NVP? Correct Ans- Slows
peristalsis and gastric emptying
,If dietary measures, lifestyle changes, and OTC remedies do not help
with NVP, what medicine has shown to be effective with NVP? Correct
Ans- 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.
Correct Ans- 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. Correct Ans- False. Brushing your
teeth can stimulate the gag reflex, aggravating nausea and vomiting.
What pre-existing conditions can contribute to NVP? Correct Ans- H.
pylori and GERD
What is the most important differential diagnosis to rule out with leg
cramps during pregnancy? Correct Ans- Deep vein thrombosis
True/false: Leg cramps during pregnancy are not normal and should be
reported immediately to provider. Correct Ans- 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)?
,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 Correct Ans- A, B, C, D
True/false: Dorsiflexion of the affected foot when a cramp begins helps
to alleviate the pain. Correct Ans- True
True/false: Magnesium supplements have been found to help with leg
cramps. Correct Ans- 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. Correct Ans- 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
D. All of the above Correct Ans- D
, True or False: Acupuncture is a holistic method that has not been
correlated with effective pain relief. Correct Ans- 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. Correct Ans- True: As long as a patient sees a licensed
chiropractor, studies have shown manual manipulation to be effective.
Why does Round Ligament pain occur? Correct Ans- 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? Correct Ans- 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? Correct Ans-
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? Correct Ans- Avoid sudden movements
Side lying relaxation positions
Flex hips: Bend and flex before coughing, sneezing, or laughing.
