Nurse Midwife Exam Prep - Question List

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26. A client at 20 weeks’ gestation asks the nurse midwife if she will be able to breastfeed her baby after birth. The client has a history of type 2 diabetes, which has been well-controlled before and during the pregnancy. The client has a BMI of 34. Which of the following statements by the nurse midwife is the most appropriate?
  1. “Whether or not you can breastfeed your baby will depend on your blood glucose levels after birth.”
  2. “Mothers with type 2 diabetes are encouraged to breastfeed their babies after birth. Breastfeeding may also lower your need for insulin.”
  3. “You may not breastfeed your baby after birth. Insulin can cross into the breast milk and may cause your baby to develop hypoglycemia. Your baby may be nourished with formula milk.”
  4. “Breastfeeding is encouraged for women with type 2 diabetes. However, you may need to increase your insulin when nursing.”
27. A 21-year-old female client comes to the prenatal clinic after a home pregnancy test indicated a positive result. The client informs the nurse midwife that her last menstrual period was on October 28, 2010. Using Nagele’s rule, the client’s expected date of birth is on:
  1. August 4, 2011
  2. July 21, 2011
  3. July 4, 2011
  4. August 21, 2011
28. A client at 30 weeks’ gestation complains of shortness of breath and an unusually rapid enlargement of the uterus. A tense uterus is noted by the nurse midwife during assessment. Palpation of the small parts of the fetus and auscultating the fetal heart rate are difficult. The nurse midwife suspects severe hydramnios. Which of the following interventions are appropriately included in the care plan?I.Encourage ambulation.II.Increase intake of foods high in fiber.III.Perform amniocentesis.IV.Administer indomethacin.
  1. I and II
  2. II and III
  3. II, III and IV
  4. All of the above
29. A contraction stress test is ordered to a client at 35 weeks’ gestation. After half an hour, the client’s uterus begins to contract and the nurse midwife observes three 40-second-long contractions in a 10-minute window. The client has two contractions within the next five minutes. The nurse midwife notes that the fetal heart rate decreases toward the end of the contraction and afterward. This happends during more than 50% of the contractions. After stopping the oxytocin, which of the following is the next action of the midwife?
  1. Administer oxygen.
  2. Turn the client to the left side.
  3. Assess the client’s blood pressure.
  4. Refer the client to a physician for further evaluation.
30. A 20-year-old female client is pregnant for the first time. The client is a marathon runner and has been on a rigorous exercise and training program. The client asks the nurse midwife if she could still exercise while pregnant. Which of the following statements by the nurse midwife is the most appropriate for the client?
  1. “You should stop exercising when pregnant as it can cause miscarriage or intrauterine growth retardation.”
  2. “If you are an athlete, you may proceed with your pre-pregnancy exercise program without limitations.”
  3. “You may continue exercising, but make sure to decrease the intensity of exercises. You may return to your pre-pregnancy exercise program two weeks after delivery.”
  4. “You should modify the intensity and type of your exercises. Non-weight-bearing exercises are recommended.”

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