NARM study Test Questions and
Complete Solutions Graded A+
What is the most prevalent sexually transmitted disease in the United States? - Answer: Chlamydia. 50%
of women are asymptomatic. Increased incidence in women using OC, because pills cause cervical
ectopia and makes a woman more vulnerable. Symptoms are mucopurulent discharge from the cervix,
wet mount will revel a high WBC. Diagnosis is by cervical culture, treatment is with antibiotics. High
incidence of coexisting gonorrhea infection.
How long should you leave a diaphragm in after intercourse to maximize effectiveness? - Answer: 6
hours
Approximately what percentage of women with untreated syphilis infection experience fetal or neonatal
loss? - Answer: 40%
What test is diagnostic for syphilis? - Answer: Positive darkfield microscopic examination of exudate
(fluid) from a chancre - the painless ulceration (sore) formed during the primary stage of syphilis.
What is the treatment for syphilis in pregnancy? - Answer: Parenteral penicillin G is the only drug
effective and safe in pregnancy. Tetracycline and doxycyclin are contraindicated in pregnancy, and
erthromycin will not cure an infected fetus.
How is syphilis transmitted? - Answer: Direct contact with body fluids or blood transfusion. Perinatal
transfer may occur hematogenously through the placenta or during delivery.
What are the possible results of a syphilis infection in pregnancy? - Answer: SAB, stillbirth, premature
delivery, nonimmune hydrops, generalized congenital disease, or neonatal death. An infant is presumed
infected if the mother had untreated syphilis at the time of delivery.
Women presenting with gonorrheal infection should also be treated for... - Answer: Chlamydia
,A pattern of petechiae (bleeding under the skin can occur from broken blood vessels that form tiny
pinpoint red dots) on the vaginal walls and cervix, a condition referred to as "strawberry cervix" is
associated with.... - Answer: Trichomoniasis
Name two vulvovaginal/cervical infections that are NOT usually transmitted sexually. - Answer:
Candidiasis and Bacterial Vaginosis. Pregnancy almost doubles the incidence of candida, most often in
3rd trimester.
Which one necessitates a C-Section if they are present when a woman goes into labor: Active HSV
(Herpes Simplex Virus) lesions or Condylomata Acuminata (genital warts, veneral warts) caused by
human papillomavirus (HPV)? - Answer: Active HSV
Which forms of birth control DECREASE the risk of PID (pelvic inflammatory disease)? - Answer:
Diaphragms and cervical caps used with vaginal spermicides, and condoms.
Lower abdominal tenderness, bilateral adnexal tenderness, cervical motion tenderness and
vaginal/cervical mucopurulent discharge and increased leukocytes on wet mount are symptoms of ... -
Answer: PID- Pelvic Inflammatory Disease
What makes a tampon more likely to be indicated in TSS (Toxic Shock syndrome)? - Answer: The higher
the absorbency of the tampon, the greater the risk.
What bacteria causes TSS (Toxic Shock Syndrome)? - Answer: A strain of Staphylococcus Aureus
What are the symptoms of TSS? - Answer: Sudden and severe fever of 102 degree of higher, vomiting,
copious watery diarrhea, dizziness and fainting or near fainting when standing. There may also be sore
throat, headache, severe myalgia (muscle pain), and bloodshot eyes. Uncared for, the disease can lead
to cardiac dysfunction, respiratory distress, and death within a week of onset.
If you do a bimanual exam and note that a woman's uterus bends backwards at the isthmus you would
classify it as... - Answer: Retro-flexed
Which Natural Family Planning Methods are the most effective? - Answer: The ovulation method (the
Billings method) and the sympto-thermal method
,When using the Billings method (cervical mucus method, ovulation method) how many days after
ovulation (peak day) are counted as fertile days? - Answer: Three
Describe the sympto-thermal method of birth control. - Answer: The sympto-thermal method of birth
control utilizes all the signs and symptoms that ovulation is impending or has occurred- mucus
observation, basal body temp, mittelschmerz, libido, cervical mucus ferning (spinnbarkeit) and cervial
changes.
What are the three important guidelines for using the LAM (Lactation Amenorrhea Method) of birth
control in order to achieve its purported 98% effectiveness? - Answer: 1. Baby must be less than 6
months old
2. The woman has no vaginal bleeding after 56 days PP
3. Breastfeeding must be the exclusive source of nourishment for the baby
What is the active ingredient in spermicide? What sexually transmitted diseases does it help protect
women from? Why? - Answer: The active agent in most spermicidal preparations is nonoxynol-9, which
is lethal to the organisms that cause chlamydia, gonorrhea, syphilis and genital herpes.
How long before intercourse is vaginal contraceptive film (VCF) inserted, and how long does it remain
effective? - Answer: 5 minutes, and 1 hour. A new film should be inserted with each act of intercourse.
How long is a contraceptive sponge effective after insertion? - Answer: 6 hours. It should also not be
removed until at least 6 hours after intercourse. For a repeat act of intercourse during this time, another
smaller sponge is inserted in addition to the first one.
How many hours before intercourse can the female condom be inserted? - Answer: 8 hours. It is
removed after intercourse before standing up.
Diagnose this position:
The lie is longitudinal, the head is at or in the pelvis,
the back is on the left & toward the mother's flank,
, the small parts of on the right and sometimes can felt clearly, the breech is in the fundus, the cephalic
prominence (forehead) is on the right, FHT loudest in L lower quadrant - Answer: LOT- Left Occiput
Transverse. This is the most common position at the onset of labor.
When palpating, if the attitude of the fetal head is flexed, what will be the cephalic prominence? -
Answer: The forehead- sinciput, on the opposite side as the back.
When palpating, if the attitude of the fetal head is extended, what will be the cephalic prominence? -
Answer: The occiput, on the same side as the back.
What do you determine in the first Leopold's maneuver? - Answer: The presenting part
What do you determine in the second Leopold's maneuver? - Answer: The location of the back
What do you determine in the third Leopold's maneuver? - Answer: What is in the fundus?
What do you determine in the fourth Leopold's maneuver? - Answer: Where is the cephalic
prominence?
Diagnose this presentation:
Longitudinal lie, head at or in the pelvis, back is on the left, anterior, and easily palpated, small parts on
the right, not felt clearly, breech is in the fundus, cephalic prominence is on the right. - Answer: LOA
When the widest diameter of the presenting part has passed through the inlet, we call this- - Answer:
Engagement
Diagnose this position:
The lie is vertical, the head is at or in the pelvis, the fetal back is in the right maternal flank and cannot
be outlined clearly,the small parts are easily felt anteriorly on the left side, the breach is in the fundus,
the cephalic prominence is on the left and not easily felt. - Answer: ROP. The cephalic prominence is not
felt as easily as in anterior positions, because flexion is less marked.
Complete Solutions Graded A+
What is the most prevalent sexually transmitted disease in the United States? - Answer: Chlamydia. 50%
of women are asymptomatic. Increased incidence in women using OC, because pills cause cervical
ectopia and makes a woman more vulnerable. Symptoms are mucopurulent discharge from the cervix,
wet mount will revel a high WBC. Diagnosis is by cervical culture, treatment is with antibiotics. High
incidence of coexisting gonorrhea infection.
How long should you leave a diaphragm in after intercourse to maximize effectiveness? - Answer: 6
hours
Approximately what percentage of women with untreated syphilis infection experience fetal or neonatal
loss? - Answer: 40%
What test is diagnostic for syphilis? - Answer: Positive darkfield microscopic examination of exudate
(fluid) from a chancre - the painless ulceration (sore) formed during the primary stage of syphilis.
What is the treatment for syphilis in pregnancy? - Answer: Parenteral penicillin G is the only drug
effective and safe in pregnancy. Tetracycline and doxycyclin are contraindicated in pregnancy, and
erthromycin will not cure an infected fetus.
How is syphilis transmitted? - Answer: Direct contact with body fluids or blood transfusion. Perinatal
transfer may occur hematogenously through the placenta or during delivery.
What are the possible results of a syphilis infection in pregnancy? - Answer: SAB, stillbirth, premature
delivery, nonimmune hydrops, generalized congenital disease, or neonatal death. An infant is presumed
infected if the mother had untreated syphilis at the time of delivery.
Women presenting with gonorrheal infection should also be treated for... - Answer: Chlamydia
,A pattern of petechiae (bleeding under the skin can occur from broken blood vessels that form tiny
pinpoint red dots) on the vaginal walls and cervix, a condition referred to as "strawberry cervix" is
associated with.... - Answer: Trichomoniasis
Name two vulvovaginal/cervical infections that are NOT usually transmitted sexually. - Answer:
Candidiasis and Bacterial Vaginosis. Pregnancy almost doubles the incidence of candida, most often in
3rd trimester.
Which one necessitates a C-Section if they are present when a woman goes into labor: Active HSV
(Herpes Simplex Virus) lesions or Condylomata Acuminata (genital warts, veneral warts) caused by
human papillomavirus (HPV)? - Answer: Active HSV
Which forms of birth control DECREASE the risk of PID (pelvic inflammatory disease)? - Answer:
Diaphragms and cervical caps used with vaginal spermicides, and condoms.
Lower abdominal tenderness, bilateral adnexal tenderness, cervical motion tenderness and
vaginal/cervical mucopurulent discharge and increased leukocytes on wet mount are symptoms of ... -
Answer: PID- Pelvic Inflammatory Disease
What makes a tampon more likely to be indicated in TSS (Toxic Shock syndrome)? - Answer: The higher
the absorbency of the tampon, the greater the risk.
What bacteria causes TSS (Toxic Shock Syndrome)? - Answer: A strain of Staphylococcus Aureus
What are the symptoms of TSS? - Answer: Sudden and severe fever of 102 degree of higher, vomiting,
copious watery diarrhea, dizziness and fainting or near fainting when standing. There may also be sore
throat, headache, severe myalgia (muscle pain), and bloodshot eyes. Uncared for, the disease can lead
to cardiac dysfunction, respiratory distress, and death within a week of onset.
If you do a bimanual exam and note that a woman's uterus bends backwards at the isthmus you would
classify it as... - Answer: Retro-flexed
Which Natural Family Planning Methods are the most effective? - Answer: The ovulation method (the
Billings method) and the sympto-thermal method
,When using the Billings method (cervical mucus method, ovulation method) how many days after
ovulation (peak day) are counted as fertile days? - Answer: Three
Describe the sympto-thermal method of birth control. - Answer: The sympto-thermal method of birth
control utilizes all the signs and symptoms that ovulation is impending or has occurred- mucus
observation, basal body temp, mittelschmerz, libido, cervical mucus ferning (spinnbarkeit) and cervial
changes.
What are the three important guidelines for using the LAM (Lactation Amenorrhea Method) of birth
control in order to achieve its purported 98% effectiveness? - Answer: 1. Baby must be less than 6
months old
2. The woman has no vaginal bleeding after 56 days PP
3. Breastfeeding must be the exclusive source of nourishment for the baby
What is the active ingredient in spermicide? What sexually transmitted diseases does it help protect
women from? Why? - Answer: The active agent in most spermicidal preparations is nonoxynol-9, which
is lethal to the organisms that cause chlamydia, gonorrhea, syphilis and genital herpes.
How long before intercourse is vaginal contraceptive film (VCF) inserted, and how long does it remain
effective? - Answer: 5 minutes, and 1 hour. A new film should be inserted with each act of intercourse.
How long is a contraceptive sponge effective after insertion? - Answer: 6 hours. It should also not be
removed until at least 6 hours after intercourse. For a repeat act of intercourse during this time, another
smaller sponge is inserted in addition to the first one.
How many hours before intercourse can the female condom be inserted? - Answer: 8 hours. It is
removed after intercourse before standing up.
Diagnose this position:
The lie is longitudinal, the head is at or in the pelvis,
the back is on the left & toward the mother's flank,
, the small parts of on the right and sometimes can felt clearly, the breech is in the fundus, the cephalic
prominence (forehead) is on the right, FHT loudest in L lower quadrant - Answer: LOT- Left Occiput
Transverse. This is the most common position at the onset of labor.
When palpating, if the attitude of the fetal head is flexed, what will be the cephalic prominence? -
Answer: The forehead- sinciput, on the opposite side as the back.
When palpating, if the attitude of the fetal head is extended, what will be the cephalic prominence? -
Answer: The occiput, on the same side as the back.
What do you determine in the first Leopold's maneuver? - Answer: The presenting part
What do you determine in the second Leopold's maneuver? - Answer: The location of the back
What do you determine in the third Leopold's maneuver? - Answer: What is in the fundus?
What do you determine in the fourth Leopold's maneuver? - Answer: Where is the cephalic
prominence?
Diagnose this presentation:
Longitudinal lie, head at or in the pelvis, back is on the left, anterior, and easily palpated, small parts on
the right, not felt clearly, breech is in the fundus, cephalic prominence is on the right. - Answer: LOA
When the widest diameter of the presenting part has passed through the inlet, we call this- - Answer:
Engagement
Diagnose this position:
The lie is vertical, the head is at or in the pelvis, the fetal back is in the right maternal flank and cannot
be outlined clearly,the small parts are easily felt anteriorly on the left side, the breach is in the fundus,
the cephalic prominence is on the left and not easily felt. - Answer: ROP. The cephalic prominence is not
felt as easily as in anterior positions, because flexion is less marked.
