NARM Clinical Knowledge and Skills 2

Question 1

A client at 34 weeks gestation presents with sudden-onset severe headache, visual disturbances, and a BP of 162/110 mmHg. What is the priority action?

Accepted Answer

Administer magnesium sulfate and transfer immediately

Answer

Recheck blood pressure in 30 minutes

Answer

Encourage bed rest and increased fluid intake

Answer

Perform non-stress test and observe for one hour

Question 2

During auscultation at 28 weeks, the fetal heart rate baseline is 175 bpm over two consecutive 10-minute segments. This finding is best classified as:

Accepted Answer

Fetal tachycardia

Answer

Normal variation for gestational age

Answer

Fetal bradycardia

Answer

Sinusoidal pattern

Question 3

Which assessment finding most reliably confirms that the placenta has separated before applying cord traction?

Accepted Answer

Lengthening of the umbilical cord at the introitus

Answer

Firm uterine fundus at the umbilicus

Answer

Cessation of vaginal bleeding

Answer

Maternal urge to push

Question 4

A newborn at 5 minutes of life has a heart rate of 95 bpm, grimaces with stimulation, has blue extremities with a pink trunk, and shows weak flexion. What is the Apgar score?

Accepted Answer

6

Answer

5

Answer

7

Answer

4

Question 5

A primigravida at 41+3 weeks has a Bishop score of 3. Which cervical ripening method is most appropriate prior to induction?

Accepted Answer

Prostaglandin E2 gel or misoprostol

Answer

Oxytocin infusion alone

Answer

Artificial rupture of membranes

Answer

Membrane sweep only

Question 6

When performing a bimanual examination to estimate uterine size at 8 weeks gestation, the uterus is most likely to feel approximately the size of a:

Accepted Answer

Large orange

Answer

Grapefruit

Answer

Tennis ball

Answer

Walnut

Question 7

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

Accepted Answer

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

Answer

Apply lateral pressure bilaterally to locate the fetal back

Answer

Press downward just above the pubic symphysis to assess engagement

Answer

Use one hand to ballott the presenting part