Certified Midwife Exam Prep Risk Assessment & Management 2

Question 1

A 34-year-old primigravida at 38 weeks has a BMI of 42. Which intrapartum complication should the midwife prioritize in the risk plan?

Accepted Answer

Shoulder dystocia

Answer

Maternal obesity significantly increases the risk of macrosomia and shoulder dystocia, requiring proactive planning including McRoberts positioning readiness.

Question 2

Which VBAC candidate characteristic most significantly increases the risk of uterine rupture?

Accepted Answer

Inter-delivery interval less than 18 months

Answer

An inter-delivery interval of less than 18 months is associated with significantly higher uterine rupture risk due to incomplete scar healing.

Question 3

A client with gestational diabetes at 36 weeks has a fasting glucose of 110 mg/dL despite dietary modifications. What is the most appropriate risk management step?

Accepted Answer

Initiate insulin therapy

Answer

When dietary modifications fail to achieve target fasting glucose levels in GDM, insulin therapy is indicated to reduce fetal and maternal complications.

Question 4

During active labor, a client's FHR tracing shows late decelerations with reduced variability. After repositioning and O2 administration, the pattern persists. What is the next risk management priority?

Accepted Answer

Prepare for operative delivery

Answer

Persistent late decelerations with reduced variability despite conservative measures indicates Category III tracing requiring prompt delivery.

Question 5

A multigravida presents at 32 weeks with painless vaginal bleeding. Placenta previa is confirmed by ultrasound. Which action is CONTRAINDICATED?

Accepted Answer

Performing a digital cervical exam

Answer

Digital cervical examination is absolutely contraindicated with placenta previa due to the risk of precipitating catastrophic hemorrhage.

Certified Midwife Exam Prep Practice Test

Certified Midwife Exam Prep Practice Test

Certified Midwife Exam Prep Risk Assessment & Management 2