NARM Emergency and Complication Management 5

Question 1

A client at 28 weeks gestation presents with headache, visual changes, epigastric pain, and a blood pressure of 162/110. Laboratory results show platelets 88,000 and ALT 3x normal. What syndrome is present?

Accepted Answer

HELLP syndrome

Answer

HELLP syndrome is characterized by Hemolysis, Elevated Liver enzymes, and Low Platelets; thrombocytopenia below 100,000 and elevated transaminases confirm this diagnosis.

Question 2

During neonatal resuscitation, after 60 seconds of effective chest compressions and ventilation with no improvement in heart rate, epinephrine is indicated. What is the preferred route of administration?

Accepted Answer

Umbilical vein catheter

Answer

Umbilical vein catheterization is the preferred vascular access route for epinephrine administration during neonatal resuscitation per NRP guidelines.

Question 3

A laboring client at 9 cm suddenly becomes unresponsive and seizing with no prior history of hypertension. After ensuring airway safety, what is the immediate pharmacologic treatment?

Accepted Answer

Magnesium sulfate 4-6g IV over 15-20 minutes

Answer

Any new-onset seizure in a pregnant or postpartum client must be treated as eclampsia; magnesium sulfate is the first-line treatment and prevents recurrent seizures.

Question 4

After delivery of a macrosomic infant, the midwife notes the placenta delivers but then the uterine fundus follows it through the vaginal introitus. This describes which obstetric emergency?

Accepted Answer

Uterine inversion

Answer

Uterine inversion occurs when the fundus turns inside out and descends into or through the vaginal canal, often associated with excessive cord traction or fundal pressure with an uncontracted uterus.

Question 5

What is the recommended initial management of uterine inversion before attempting replacement?

Accepted Answer

Administer a tocolytic agent to relax the uterus, then attempt replacement

Answer

Uterine relaxation with a tocolytic (e.g., terbutaline or nitroglycerin) is recommended before manual replacement to ease the uterus back through the cervical ring.

(NARM) North American Registry of Midwives Practice Test

(NARM) North American Registry of Midwives Practice Test

NARM Emergency and Complication Management 5