Mixed Deck — All NARM Topics Flashcards

What are the three stages of labor?

Answer: Cervical dilation, delivery of baby, delivery of placenta

Labor has three distinct stages from start to completion.

What is normal fetal heart rate during labor?

Answer: 110-160 beats per minute

Normal range is faster than an adult heart rate.

Which screening tool is most widely validated and recommended for postpartum depression screening in midwifery practice?

Answer: Edinburgh Postnatal Depression Scale (EPDS)

The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used and validated screening tool specifically designed and normed for the postpartum population.

A CPM practicing in a state where CPMs are not licensed receives a complaint from a client. Which entity has jurisdiction to investigate the complaint?

Answer: NARM, through its ethics and discipline process

NARM has jurisdiction over CPM credential holders regardless of state licensure status through its own ethics and disciplinary process.

Cultural competency in midwifery?

Answer: Respect diverse practices and beliefs while maintaining safety

Respecting diversity while maintaining safety is essential.

What is informed consent in midwifery?

Answer: Comprehensive information for voluntary, knowledgeable decisions

Clients must understand information before deciding.

When assessing a newborn's Apgar score at 1 minute and 5 minutes after birth, which of the following is NOT a criterion used in the scoring?

Answer: Birth weight

The Apgar score assesses five criteria: Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration (breathing effort). Each criterion is scored from 0-2, with a total score indicating the newborn's overall condition. Birth weight is an important measurement for newborn health but is not one of the components of the Apgar scoring system.

By about what age do most healthy breastfed newborns regain their birth weight?

Answer: 10-14 days

Newborns commonly lose up to 7-10% of birth weight in the first days, then regain it by about 10-14 days of life. Failure to do so warrants a feeding assessment.

After a normal birth, by approximately when should the uterus no longer be palpable abdominally?

Answer: 10 to 14 days postpartum

The fundus descends about 1 cm per day and normally drops below the symphysis pubis by about 10 to 14 days.

Obligation when client refuses recommended care?

Answer: Respect autonomy, ensure understanding of risks, document refusal, continue care

Client autonomy must be respected.

Which of these is a criterion for the Lactational Amenorrhea Method (LAM)?

Answer: Baby under 6 months, exclusively breastfeeding, and mother amenorrheic

LAM is about 98% effective if the baby is under 6 months, fully or nearly fully breastfed, and the mother has not had a return of menses.

Which describes colostrum?

Answer: Low in volume and rich in protein and immunoglobulins

Colostrum is produced in small volumes in the first days, is rich in secretory IgA and protein, and meets the newborn's needs while the mother's milk comes in.

Umbilical cord care for newborns?

Answer: Keep clean and dry until natural detachment in 1-3 weeks

Current evidence supports simple dry care.

On day 3 postpartum, a client is tearful and irritable but sleeps when the baby sleeps, bonds well, and functions normally. What is the most likely explanation?

Answer: Postpartum blues

Postpartum blues typically begin within 2 to 3 days of birth and resolve on their own within about 2 weeks.

What is cervical insufficiency?

Answer: Premature cervical dilation potentially causing preterm birth

The cervix opens too early in pregnancy.

Normal newborn respiratory rate?

Answer: 30-60 breaths per minute

Newborns breathe much faster than adults.

On postpartum day 6, a client describes her lochia as pinkish-brown and watery with no clots. How should the midwife interpret this?

Answer: Normal lochia serosa

Lochia serosa is pinkish-brown and typically lasts from about day 4 to day 10.

What is Rh factor importance in pregnancy?

Answer: Rh-negative mothers may develop antibodies against Rh-positive babies, requiring RhoGAM

Blood protein mismatch can cause serious complications.

Which of the following is the correct technique for performing Leopold's maneuver to determine fetal lie?

Answer: Palpate the fundal area with both hands to identify the presenting pole

The first Leopold maneuver involves palpating the uterine fundus with both hands to determine which fetal pole occupies the fundus, establishing fetal lie.

Which intervention is most effective in preventing postpartum hemorrhage?

Answer: Active management of the third stage of labor including uterotonics and controlled cord traction

Active management of the third stage of labor — encompassing uterotonic administration, controlled cord traction, and uterine massage — is the evidence-based standard for significantly reducing postpartum hemorrhage.