Practice Quiz

CPM Certified Professional Midwife

Category - Prenatal

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A midwife is estimating the fetal growth for each of four pregnant clients using McDonald’s rule. Which of the following clients requires referral and further evaluation?
  1. A client at 24 weeks’ gestation with a fundal height of 24 cm
  2. A client at 20 weeks’ gestation with a fundus palpated at the level of the umbilicus
  3. A client at 12 weeks’ gestation with a fundus over the symphysis pubis
  4. A client at 36 weeks’ gestation with a fundus reaching between the umbilicus and xiphoid process
Explanation
Answer: D - The client at 36 weeks’ gestation with the fundus between the umbilicus and xiphoid process requires additional tests. The fundus is expected to reach the xiphoid process at 36 weeks. Between the 20th and 31st weeks of gestation, the fundal height in centimeters is usually equal to the week of gestation. The fundus is expected to reach the umbilicus at 20 weeks’ gestation, and over the symphysis pubis at 12 weeks’ gestation.
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