Community Midwifery Quiz Q&A (July 2010)

Q1. How many times throughout pregnancy will a primigravida woman, with no complications, be offered an appointment for antenatal care?
A1. 12 - up to 10 midwifery and 2 scans.
booking (appx 8-10weeks?), early scan (12 weeks), 16 weeks, anomaly scan (20 weeks), 25 weeks, 28 weeks, 31 weeks, 34 weeks, 36 weeks, 38weeks, 40 weeks, 41 weeks if needed.

Q2. Name the screening tests offered throughout antenatal care
A1. Blood tests to test/screen for - Sickle Cell and Thallasemia, Hep B, HIV, Syphillis, Rubella Immunity, Triple Test/Combined Nuchal for over 35's at EDD, Haemoglobin, Group and Antibodies, Resus Factor

Q3. How much folic acid should a pregnant woman take?
A3. Advise all women to take 400 micrograms of folic acid daily before pregnancy and throughout the first 12 weeks of pregnancy. Advise them about a suitable supplement like the Healthy Start vitamin supplement for women. Advise them to eat foods rich in folic acid and folate. If there is a family history of neural tube defects, the woman has had a baby with a neural tube defect or she has diabetes, prescribe 5 milligrams of folic acid a day for women who are planning a pregnancy, or are in the early stages of pregnancy,.


Q4. Which exercise/s are considered safe or dangerous during pregnancy?
A4. Examples of safe exercise are: cycling, swimming , walking, yoga, pilates, aquaerobics, low impact aerobics, pelvic floors. nothing that raises the heart rate over 140bpm.
There are potential dangers with certain activities during pregnancy, E.G. - contact sports, high-impact sports and vigorous racquet sports that may involve the risk of abdominal trauma, falls or excessive joint stress, and scuba diving, which may result in fetal birth defects and fetal decompression disease.
Advice women not to take up any new forms of exercise, as this is a potential risk in itself.


Q5. A single woman has booked with her second pregnancy. She is currently a stay-at-home mum caring for her 2 year old son. At her 28 week appointment she asks you what benefits or money she is entitled too. What do you advice?
A5. Give her a copy of the Money Guide from the FSA. Tell her she is entitled to apply for a Sure Start Maternity Grant, Health Start Coupons, and the Health in Pregnancy Grant. Advice her to complete the Child Benefit forms for her second child once she has been given the documentation after birth, and to inform Child Tax Credits of a change in circumstance.
Advice her to speak to the job centre to ensure she is claiming the correct maternity benefit/s.

Q6. Annie is a primigravida woman. At booking, she had a Hb of 11.5g/dl and is A Negative. All other screening tests were negative/normal. What plan of care should Annie be offered at her 34 week appointment.
A6. Offer a second dose of Anti-D due to resus negative status. Measure blood pressure and test urine for protenuria, measure and plot SFH and activity of the fetus. Discuss preparation for labour and birth, including pain relief and how to recognise active labour. Ensure antenatal classes have been offered and book, if required. Discuss tests taken at 28weeks and reassess care plan if needed. Offer Annie the opportunity to discuss any other problems or issues. Confirm next appointment.

Q7. Name 5 things, either maternal or neonatal, that should be checked at each postnatal visit?
A7. Any from:
Maternal - update postnatal care plan, ask about physical and emotional health and well-being; coping strategies and support; discuss PV loss, healing of perineum, headache symptoms, check uterus contracting down/involuting. Give advice and support on breastfeeding where required. Check for signs of mastitus.
Baby - health check - clear eyes, good colour, stable temperature, passing urine, regular stools, regular feeding, not excessively tense/irritatble/sleepy/floppy. Check for signs of jaundice and give appropriate advice.

Q8. What should the lochia be like on day 5?
A8. Lochia is 'Serosa'. Pink and watery, turns to brown like end of period. Contains erythocytes, leucocytes, decidua.

Q9. What colour should the stools of a breastfed baby be like on days 0-1, 5 and 10.
A9: day 0-1 (first stools) - meconium. blackish-green, contains bile, fatty acids, mucus and epithelial cells. day 5 - changing - brownish-yellow in colour. day 10 - breastfeeding established, stools are yellow and loose. may be seen to contain 'tomato pips'.

Q10. Name 2 characteristics of physiological jaundice which distinguish it from pathological jaundice?
A10. 1 - it never appears in the first 24 hours of life. 2 - it usually fades by 2 weeks of age. 3 - bilirubin levels never rise above 12-13mg/l. Physiological jaundice is often found at the 'top' of the baby, around the face and torso.

same here lol, but im basically happy with answers i gave. was on the right track with each question.

No - if a questions asks you to 'name 5 things' then you don't get extra marks for naming 6 things - bonus marks could be awarded for extra details on one of the 5 things that you do name though.