Midwifery Related Tests Quiz - July 2011

1. Anne is a Primigravida who is 8 weeks pregnant. She has been vomiting and is becoming dehydrated as cannot keep any food down. She calls out the local GP who performs Urinalysis on her urine using a dipstick. What in particular is the GP looking for to show signs of dehydration and why?

A. Ketones

Ketones show up on Urinalysis when the body starts using its own body fat reserves for energy because it cannot get enough glucose from consumed or readily available energy stores.

2. Anne is now 24 weeks and is at home following her routine antenatal check up with her midwife. In her notes she reads ‘ Urinalysis NAD’ which stands for No anomalies detected and is unsure of what NAD stands for. What could the midwife have done to better explain to Anne her Urinalysis test results?

A. Followed the NMC record keeping guidelines 2009
Ensure all entries into notes are legible to the reader they are intended for.
Discuss the results of any tests in full with Anne at the time they are performed and recorded.

3. Anne is now 37 weeks gestation and has attended the assessment unit following spontaneous rupture of membranes a few hours earlier. The Liquor is slightly offensive smelling and the midwife takes a blood sample to take a CRP level. What does this stand for and what would a rising CRP level indicate?

A. C-Reactive Protein
A rising CRP level indicates an inflammatory respose, often in response to infection.

4. Whilst in the unit, Anne’s full blood count is also tested and her Haemoglobin comes back at 11.8g/dl. What action would a midwife take on a haemoglobin result such as this?

A. None, NICE antenatal care guidelines state that iron supplementation is only indicated if Hb levels are below 10.5g/dl after 28 weeks. The midwife can fulfil her role in promoting public health however and take the time to reassure Anne of her excellent haemoglobin levels!

There are other guidelines such as WHO that state slightly different variations, and these might be quoted.

5. Anne has just had an emergency caesarean section for fetal distress. The paediatrician in attendance at the delivery gives the baby an APGAR score of 3 at one minute. What does this test result indicate?

An APGAR score is given at one minute following birth and a score of 3 or less indicates that full resuscitation is necessary which may include cardiac massage, intubation and ventilation.

6. Anne’s baby’s cord gases are analysed and the midwife is trying to interpret the results. Which aspects of a cord gas analysis are important for the midwife to look at if she is wanting to know if the newborn baby may be acidotic?

pH – important to diagnose fetal acidaemia

7. Anne is rhesus negative. Following delivery a kleihauer test is performed – what does this look for?

A. To detect if any fetal cells have crossed over into the maternal circulation. If the baby is found to be rhesus positive an injection of Anti D will be offered to the mother.


8. Anne is now at home and is 6 days postnatal. She complains of feeling clammy and the midwife takes her temperature. Anne is pyrexial with a temperature of 38.2 degrees Celsius. What might this indicate?


A. Infection, this may be from a number of sources including:

- genital tract – perineum, vegina, cervix, uterus.
- Breasts – such a mastitis
- urinary system
- Thrombophlebitis
- Respiratory infection – following a general anaesthesia or a cold.

9. In a woman with preeclampsia the obstetric team reviewing the woman will require many blood test results to gain an overview of the woman’s wellbeing. What test may the midwife be required to perform on a woman with suspected pre eclampsia?

A. Full blood count
Electrolytes
Renal function tests
Liver function tests
Clotting studies

This is because pre eclampsia is a multi organ syndrome!

10. If a woman is found to have pre eclampsia her liver will most likely be being put under stress. This is indicated by her liver enzymes tests changing in which way?

They will rise


11. Bonus Question:

Is an ultrasound scan a diagnostic or screening test?

A. Both!