Certified Midwife Exam Prep - Question List

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1. A client is in the second stage of labor and has been pushing for almost an hour. Which of the following interventions is the most appropriate for the client at this stage?
  1. Offer clear fluids in between contractions.
  2. Encourage ambulation.
  3. Instruct the client to push with each contraction.
  4. Encourage frequent changes in position.
2. A client at 38 weeks’ gestation comes to the facility after experiencing leakage of clear fluid from the vagina without contractions. Premature rupture of membranes is suspected. Which of the following actions by the midwife would be inappropriate for a client with this condition?
  1. Perform digital vaginal examination.
  2. Administer ampicillin IV.
  3. Assess the client’s cervix and vaginal cavity through sterile speculum vaginal examination.
  4. Order L/S ratio.
3. A midwife is monitoring a client in labor who is receiving intravenous oxytocin. The fetal heart rate monitor tracing reveals decelerations occurring 35 seconds after the onset of each contraction and continuously past the end of the each contraction. Which of the following is the priority action of the midwife?
  1. Change the client’s position to side-lying position.
  2. Position the client to Trendelenburg position.
  3. Stop the administration of oxytocin.
  4. Administer oxygen.
4. A midwife is assessing a client and her infant one week after delivery. The infant’s birth weight was 7.5 pounds. Which of the following findings indicate that the infant is getting enough milk?

I. The mother reports that the infant is wetting 6 to 8 diapers a day.
II. The mother informs the midwife that the infant appears content between feedings.
III. The infant’s weight is 6.8 pounds.
IV. The mother reports that the infant quietly swallows during breastfeeds.
  1. I and II
  2. I, II and III
  3. I, II and IV
  4. All of the findings indicate sufficient milk intake
5. On assessment, the midwife notes that a female newborn has pink patches at the nape of the neck. The midwife informs the mother that these patches:
  1. Occur more often in males than in females.
  2. Are caused by an injury during labor.
  3. Do not fade.
  4. Disappear by school age without treatment.

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