NARM Midwifery Practice and Professionalism 3

Question 1

A midwife's client at 39 weeks is GBS-positive and declines IV antibiotics in labor. The midwife should:

Accepted Answer

Provide thorough counseling on risks to the newborn, document the informed refusal, and attend the birth with enhanced newborn monitoring

Answer

Refuse to attend the birth until the client agrees to antibiotics

Answer

Transfer care immediately to a hospital-based provider

Answer

Administer antibiotics without the client's knowledge for the newborn's safety

Question 2

Which of the following is a core tenet of the midwifery model of care as recognized by MANA and reflected in NARM competencies?

Accepted Answer

Watchful waiting and non-intervention in normal processes unless warranted

Answer

Routine use of electronic fetal monitoring for all low-risk labors

Answer

Mandatory physician co-management for all clients

Answer

Standardized intervention protocols regardless of individual client circumstances

Question 3

A postpartum client at day 3 calls reporting a temperature of 100.6°F (38.1°C), tender uterus, and foul-smelling lochia. What is the midwife's priority action?

Accepted Answer

Assess urgently, as these findings suggest endometritis requiring prompt evaluation and likely antibiotic treatment

Answer

Advise increased fluid intake and call back in 24 hours

Answer

Reassure the client that mild fever is normal in the first week postpartum

Answer

Recommend a sitz bath and over-the-counter pain relievers

Question 4

During a prenatal visit, a client discloses recreational marijuana use. The midwife's most appropriate response is to:

Accepted Answer

Provide non-judgmental education on risks, document the disclosure, and continue supportive care

Answer

Report the client to child protective services immediately

Answer

Discharge the client from midwifery care

Answer

Ignore the disclosure to preserve the therapeutic relationship

Question 5

The NARM Skills Assessment requires demonstration of competency in which of the following?

Accepted Answer

Newborn resuscitation, including bag-mask ventilation

Answer

Surgical first-assist techniques

Answer

Placement of epidural catheters

Answer

Interpretation of fetal MRI imaging

Question 6

A midwife learns that a colleague is practicing outside her approved scope by routinely performing vacuum-assisted deliveries at home births. The midwife should:

Accepted Answer

Report the concern through appropriate professional or regulatory channels to protect client safety

Answer

Confront the colleague publicly at the next professional meeting

Answer

Assume the colleague has special training and take no action

Answer

Share the information only with mutual clients who ask

Question 7

Which documentation element is most critical after every prenatal visit according to professional midwifery standards?

Accepted Answer

A legible, contemporaneous record including findings, discussions, client questions, and the plan of care

Answer

A signed waiver from the client for each visit

Answer

A billing invoice with procedure codes

Answer

A standardized hospital-style progress note regardless of birth setting