Certified Midwife Exam Prep Communication & Stakeholder Relations 2 — Questions and Answers
Question 1: A client expresses fear about labor pain but says her partner dismisses her concerns. What is the midwife's best approach?
- Reassure the client that labor pain is manageable without addressing the partner
- Acknowledge the client's feelings and offer to include the partner in a joint conversation (Correct answer)
- Advise the client to discuss this with her OB instead
- Document the concern and proceed with the appointment
Correct answer: Acknowledge the client's feelings and offer to include the partner in a joint conversation
Involving the partner in a facilitated conversation validates the client's feelings while improving the support system.
Question 2: During a postpartum home visit, the midwife notices the patient appears withdrawn and avoids eye contact. Which communication technique is most appropriate to use first?
- Ask direct yes/no questions to get quick answers
- Use open-ended questions and sit at eye level to reduce barriers (Correct answer)
- Immediately screen for postpartum depression using a standardized tool
- Contact the patient's partner for collateral information
Correct answer: Use open-ended questions and sit at eye level to reduce barriers
Open-ended questions and reducing physical barriers create a safe environment that encourages the patient to open up.
Question 3: A midwife must consult a physician about a client who has developed preeclampsia. Which element is most critical in the handoff communication?
- The client's personal preferences about her birth plan
- Current vital signs, symptom onset, and interventions already taken (Correct answer)
- The client's insurance status and payment history
- A detailed birth history from previous pregnancies
Correct answer: Current vital signs, symptom onset, and interventions already taken
SBAR-style communication requires current clinical status, onset, and actions taken to enable safe, timely physician response.
Question 4: A teenager presents for prenatal care without parental consent in a state that allows minors to consent for pregnancy care. How should the midwife handle documentation?
- Refuse to document until a parent is present
- Document normally, treating the minor as having full decision-making authority for this care (Correct answer)
- Note 'minor patient' and flag for legal review before proceeding
- Obtain a court order before providing care
Correct answer: Document normally, treating the minor as having full decision-making authority for this care
In states permitting minors to consent to pregnancy-related care, they are treated as autonomous patients and documentation follows standard practice.
Question 5: A client who is deaf and uses American Sign Language arrives for an appointment without an interpreter. What is the correct action?
- Use written notes and proceed with the appointment
- Ask a family member who knows some sign language to interpret
- Arrange for a qualified ASL interpreter before conducting the appointment (Correct answer)
- Reschedule the appointment for when the client can bring an interpreter
Correct answer: Arrange for a qualified ASL interpreter before conducting the appointment
Federal law (ADA and Section 504) requires healthcare providers to arrange qualified interpreters; using family members or rescheduling is inadequate.
Question 6: A client refuses a recommended Group B Streptococcus (GBS) test. After counseling, she still declines. What should the midwife do?
- Order the test anyway because it is standard of care
- Document the refusal, the counseling provided, and respect the client's decision (Correct answer)
- Refer the client to another provider who will insist on the test
- Notify child protective services of the refusal
Correct answer: Document the refusal, the counseling provided, and respect the client's decision
Informed refusal is a patient right; the midwife must document the education provided and the client's autonomous decision.
Question 7: Which behavior best demonstrates therapeutic presence during a difficult conversation about fetal anomaly?
- Filling silences with clinical information to keep the client occupied
- Sitting quietly with the client, allowing pauses, and following her emotional lead (Correct answer)
- Immediately providing a referral list to avoid dwelling on bad news
- Maintaining a professional tone and limiting emotional expression
Correct answer: Sitting quietly with the client, allowing pauses, and following her emotional lead
Therapeutic presence involves being fully attentive, tolerating silence, and letting the patient set the emotional pace of the conversation.
Certified Midwife Exam Prep Communication & Stakeholder Relations 2
A client expresses fear about labor pain but says her partner dismisses her concerns.
What is the midwife's best approach?