Deck 3: Maternal Health Assessment

Question 1

A 35-year-old visits the midwife after a home pregnancy test indicated a positive result. The client informs the midwife that the pregnancy is not planned and that she has been taking progestin-only birth control pills for the past year. During the history taking, the client informs the midwife that she has been taking isotretinoin for her severe, recalcitrant cystic acne for three months before the pregnancy. The client drinks at least three bottles of beer a day and is taking cocaine on a daily basis. Based on the client's history, which of the following substances is least likely to cause birth defects?

A)Progestin-only pills
B)Isotretinoin
C)Alcohol
D)Cocaine

Answer 1

Progestin-only pills

Question 2

A midwife suspects that a client at 18 weeks' gestation has a hydatidiform mole. Which of the following assessment findings does not support this diagnosis?

A)Vaginal spotting of bright-red blood
B)The fundus height of the uterus is palpated at the umbilicus
C)A sonogram shows a snow-flake pattern
D)Urine test is determined positive for hCG

Answer 2

Vaginal spotting of bright-red blood

Question 3

A female client with an IUD comes to the facility after testing positive in the home pregnancy kit. Physical examination and laboratory tests are ordered to verify the pregnancy. After reviewing the test results, the midwife determines that the client is 8 weeks pregnant. Which of the following is the next action of the midwife?

A)Order a sonogram to rule out birth defects.
B)Notify a physician for removal of the IUD.
C)Inform the client that the IUD may be left in place without complications.
D)Prepare the client for a surgical abortion procedure.

Answer 3

Notify a physician for removal of the IUD.

Question 4

A midwife teaches a client that before palpating her breasts during breast self-examination, she needs to inspect her breasts for abnormalities in which of the following positions?
I.With her arms relaxed at her sides
II.With her arms lifted over her head
III.With her hands pressed against the hips
IV.With her hands pressed against the waist, leaning forward

A)I and II only
B)I, III and IV
C)I, II and III
D)She should inspect her breasts in all of the above positions.

Question 5

A midwife is teaching a female client how to perform a breast self-examination. On return demonstration, which of the following actions by the client indicates that further teaching is necessary?

A)The client uses the tips of her second, third and fourth fingers to press every part of her breast.
B)Using the right hand to examine the left breast, the client examines the entire breast using small circular motions in a spiral pattern.
C)In a supine position, the client places a folded towel under her right shoulder and puts her right hand behind her head. Using the left hand, she palpates her right breast.
D)In a standing position, the client places her hands on her hips and presses down firmly.

Question 6

A 14-year-old comes to the clinic after a home pregnancy test indicated that she is pregnant. Physical examination and laboratory tests confirm that the client is 12 weeks pregnant. The midwife also notes that the client has signs of anorexia nervosa. A series of tests are conducted, revealing anemia. On the second visit, the client informs the midwife that she has decided to have an abortion and she wants to know her options. The midwife tries to encourage the client to talk to her mother, but the client refuses. Which of the following is the next action of the midwife?

A)Inform the client's mother about the pregnancy and the client's plan for abortion.
B)Thoroughly explain the effects of abortion on the adolescent's health and how having anorexia nervosa and anemia greatly increase her risk for life-threatening medical conditions after the procedure.
C)Keep silent about the client's pregnancy and planned abortion, but be sure to work closely with the client to help her mentally and physically before and after the abortion.
D)Inform the state about the client's condition.