H & H NARM STUDY QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS 100%
CORRECT | LATEST UPDATE
What are the risks of cesarean section? - ANSWER Life-threatening sepsis,
perforation of adjacent organs, scarring of the uterine lining that can lead to
abnormal placental implantation and hemorrhage with subsequent childbearing,
and development of adhesions between the uterus and other organs that can
cause problems later
Painless bleeding with intercourse is the prime symptom of _______ - ANSWER
Fibroids. These tend to grow during pregnancy and are
benign.If they are internal they can cause reduced intrauterine space, disrupted
placental implantation and postpartum hemorrhage
What are some urgent warning signs of preeclampsia? - ANSWER Persistent
headaches in combination with visual
disturbances or epigastric (upper abdominal) pain - especially on the right side.
What problems might a woman who has had a cone biopsy encounter? -
ANSWER Scarring from cone biopsy may retard
cervical dilation.
What precautions might a midwife want to take with her patient who has a history
of LEEP procedure? - ANSWER Because LEEP has been linked to incompetent
cervix
,and premature labor, some midwives feel that they should check their patient for
cervical changes throughout pregnancy and that the patient should be carefully
instructed regarding signs of premature labor.
What time period does assessment become especially important in the pregnant
woman? - ANSWER During the last six weeks of pregnancy.At this point the
midwife can identify certain factors regarding the baby's position, growth rate and
size and relate them to the mother's condition.
What components should a midwife include in prenatal care? - ANSWER
Knowledge of nutrition, exercise, non allopathic
healing options of herbology or homeopathy and mind and body integration
techniques like yoga and meditation.
What conditions/diseases contraindicate home birth? - ANSWER Preexisting
diabetes or hypertension, thyroid disease
(hyperthyroidism), chronic lung disease, severe asthma, epilepsy, clotting
disorders, congenital heart disease (grades 2-4) and kidney disease
Which conditions arising in pregnancy
contraindicate home birth? - ANSWER Rh- with antibodies, severe anemia
unresponsive
to treatment, cancer and acute viral infections such as rubella, cytomegalovirus,
toxoplasmosis, chicken pox or herpes
What complications/conditions can prior use of an IUD cause during pregnancy? -
ANSWER Anemia due to excess menstruation; scarring
,of the uterine lining which predisposes to ectopic pregnancy, irregular
implantation of the placenta and third stage hemorrhage.
Which vitamin might a woman who previously used oral contraceptives be
deficient in? - ANSWER Folic acid.
What complication should be ruled out if there is chronic brown bleeding? -
ANSWER Molar pregnancy
What condition might fatigue combined with dizziness or nausea beyond the first
trimester indicate? - ANSWER Anemia
What are the dangers of maternal diabetes during pregnancy? - ANSWER Fetal
demise after 36 weeks; 5x the normal incidence of
of fetal abnormalities; increased polyhydramnios; 30-50% higher incidence of
preeclampsia; increased incidence of prematurity and newborn respiratory
difficulties.
Scarring of the uterine lining predisposes a woman to what three things? -
ANSWER Ectopic pregnancy, irregular implantation of the placenta and third-
stage hemorrhage. Scarring can be caused by a previous IUD, Pelvic Inflammatory
Disease and Endometriosis
What are the classic symptoms of ectopic pregnancy and what is the window of
rupture? - ANSWER Bleeding or spotting accompanied by nonrhythmic pain, as
well as pelvic pain.Pain becomes severe with rupture and may be referred to the
shoulder area.The window of rupture is 10-13 weeks GA
, When during pregnancy is a fetus' risk of vertical transmission of toxoplasmosis
the greatest? - ANSWER The risk of being infected rises as the pregnancy
progresses although the severity is the greatest if contracted within the first
trimester
What might you suspect if your patient reports painful vaginal sores paired with
flu like malaise? - ANSWER An initial outbreak of herpes. If suspected
immediately do a visual inspection and take cultures. The cervix should always be
cultured because herpes at this cite can be asymptomatic.
What is the standard care for women who have active herpes lesions at the onset
of labor? - ANSWER A c-section is performed because neonatal infection can
cause central nervous system damage or death.
What are the dangers of thyroid disease during pregnancy? - ANSWER Thyroid
medication has the potential for causing severe fetal complications.
Hyperthyroidism can cause miscarriage, premature labor and fetal anomalies.
Untreated hyperthyroidism can lead to cretinism in the newborn.
What are the dangers of active tuberculosis during pregnancy? - ANSWER
Slightly higher risk of miscarriage and
premature labor
What are the dangers of chronic lung disease during pregnancy? - ANSWER
The mother is at risk for pulmonary complications and the baby for fetal acidosis
and hypoxia
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