1

1. Total body water increases by an average of 8.5 liters & is made up of the following:
 Fetal water
 Amniotic fluid
 Placental tissue
 Maternal tissue
 All of the options are correct

2. Average Weight Gain during Pregnancy is 25-35 lb (11-16 kg) & consists of:
15-25 lb
25-35 lb
35-45 lb
45-55 lb

3. Which of the following is NOT an emotional reaction experienced by a newly pregnant woman?
Calm and non-ambivalent reactions
Fear & Anxiety
Introversion or Narcissism or Extroversion
Uncertainty
Grief
Stress Reaction
7. Emotional Lability
8. Couvade Syndrome

4. Which of the following is NOT a Characteristics of the Pregnant Woman at 1 st trimester?

Displays a sense of ambivalence to the pregnancy
Fantasize about the pregnancy
Role playing
Increased concern for financial & social problems
Decreased interest in sex due to bodily changes
Quickening is experienced

5. Which of the following is NOT a characteristic of the pregnant woman at 2 nd trimester?

The woman develops a sense of well-being as her body becomes adjusted to the changes associated
w/ pregnancy
“Quickening” is experienced
The fetus heartbeat is heard
Both parents develop interest in fetal growth & development
The woman may have wide mood swings
Altered self-image

CHANGES IN REPRODUCTIVE SYSTEM(Uterus):

Changes in the Uterine Measurement

6. The fundic height is at the level of the umbilicus.

12 weeks
16 weeks
20 weeks
24 weeks

7. The fundic height is at the level of the xiphoid process.

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28-30 weeks
32-34 weeks
36 weeks
40 weeks

8. This refers to the softening of the lower uterine segment that begins as early as 5 weeks gestation.
Hegar’s sign
Goodel’s sign
Chadwick’s sign
Gestational sign

9. This refers to the purplish discoloration of the vagina.

Hegar’s sign
Goodel’s sign
Chadwick’s sign
Gestational sign

10. During pregnancy the ovaries rise from being pelvic organs to become abdominal structures.
True
False

Part 2

11. Which of the following is NOT a normal cardiovascular finding during pregnancy?

Splitting third sound due to lowered blood viscosity.

Systolic murmurs in about 90% and diastolic murmurs in about 20% of pregnant women.
Palpitations and benign arrhythmias especially on sudden positional changes.
Decrease pulse rate by 5-15 beats per minute

12. During pregnancy there is an increased total blood volume of:

25 to 35%
35% to 45%
45% to 50%
50% to 65%

13. Due to increase in plasma volume, blood loss of up to 500 ml is well-tolerated during labor, and maternal
vital signs may not show changes for blood loss of 1500 cc or less.
True
False

14. Plasma volume increases earlier during pregnancy and more plasma is added to the blood than RBC.
The higher proportion of the liquid component of the blood results in lowered hematocrit and hemodilution,
known as physiologic anemia of pregnancy.
True
False

15. During labor, cardiac output increases more by 15% in the first stage and 50% in the second stage because
of:
1. Pain
2. Uterine contractions
3. Expulsive efforts of the mother
4. All options are correct
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16. Which of the following is CORRECT about Supine Hypotension Syndrome:

When the woman lies on her back, the gravid uterus lies on the inferior vena cava and interferes with blood flow
from the lower extremities, resulting in blood returning to the heart to be greatly reduced.

When the woman lies on her back, the gravid uterus lies on the inferior vena cava and interferes with blood flow
from the lower extremities, resulting in blood not returning to the heart to be greatly increased.

17. There will be an increase oxygen requirement as the mother must supply not only for herself but for the
baby, too. Total body consumption of oxygen increased by:
10-15%
15-20%
20-25%
25-30%

18. Which of the following is NOT a normal urinary change during pregnancy?
Increased Bladder capacity
Increased Ureter diameter
Increased Frequency of urination
Increased Size of kidney
Increased Renal threshold for sugar

19. There is an expected nausea and vomiting on the first trimester of pregnancy which is attributed to:
1. Increased HCG levels
2. Increased estrogen levels
3. Decreases maternal glucose levels as glucose is being utilized for fetal brain development
4. All options are correct

20. This is a term used for craving for nonfood stuff or unusual food stuffs during pregnancy which is common
in some cultures.
Pika/Pica
Couvade
Asphyxia
Aneurysm

21. Which of the following statement is NOT correct about pica?

1. Aversions to various types of food including sour, savory or sweet taste.
2. An unusual craving for substances such as clay, chalk, starch, cold soup, toothpaste or even disinfectants.
3. Pika for soil and ash is quite common amongst the black ethnic minority groups.
4. Increased sensitivity of the taste buds during pregnancy creates the no desire for markedly sweet, sour or
salty foods.

22. Hemorrhoids is a common gastrointestinal system discomforts during pregnancy due to:
1. Mechanical pressure of the uterus
2. Slowed intestinal movement due to relaxant effect of progesterone
3. Constipation
4. All options are correct

23. Hormone progesterone causes constipation during pregnancy.

True
False
24. Hormone progesterone causes pyrosis/ heartburn during pregnancy
True
False
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24. Hormone estrogen causes ptyalism or the increased salivation during pregnancy.
True
False

25. The adrenal gland hyperthropy during pregnancy, particularly the cortex, resulting in increased hormone
production.
TRUE

Increased mineral corticoids production is stimulated in part by adrenocorticotrophic hormone (ACTH)

secretion and corticotropin releasing hormone (CRH) from the placenta. This result in:
1. Increased secretion of aldosterone which promotes sodium and water retention, contributing to edema of
pregnancy. Urinary aldosterone increases 10 fold by the third trimester.

ENDOCRINE SYSTEM
ADRENAL GLAND
This result in:

26. During pregnancy there is decreased demand for iron, calcium, phosphate and magnesium.
TRUE
FALSE

27.The major serum electrolytes sodium, potassium and chloride have almost unchanged concentration
during pregnancy.
TRUE
FALSE

Increased glucocorticoids cortisol stimulates increased insulin production.

The dexamethasone suppression test response in blunted in pregnancy, although the ACTH challenge test is
unchanged in pregnancy.
Angiotensin II increases 2-4 times the non-pregnant level.
Rennin activity increases 2-3 times the non-pregnant level.

ENDOCRINE SYSTEM
PITUITARY GLAND
The pituitary gland enlarges but this is not essential to pregnancy.
The pituitary gland produces the following hormones:
1. Anterior Pituitary
Prolaction (PRL):
The amniotic fluid prolactin level is 2-10 times.
Despite increase prolactin secretion, lactation itself or milk production will not be initiated until after delivery
of the placenta because of the inhibitory effect of estrogen.
In labor there is an acute fall, followed by a surge 2 hours postpartum. These changes are not observed in
women undergoing elective caesarian sections.
ENDOCRINE SYSTEM
PITUITARY GLAND
1. Anterior Pituitary
Prolactin may act synergistically with estrogen, progesterone and hPL to provide prolactational changes
during pregnancy including breast development.
Prolactin levels approach the normal range in non-lactating women 2-3 weeks after delivery, but remain high
in women who breastfeed.
Gonadotropins: high estrogen and progesterone levels inhibit LH and FSH production.
Growth Hormone (GH): hyperglycemia decreases secretion. Unchanged to slight increase during pregnancy.
Adrenocorticotropin Hormone (ACTH): remains unchanged during pregnancy.
Melanocyte Stimulating Hormone: Increased during pregnancy.
ENDOCRINE SYSTEM
PITUITARY GLAND
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2. Posterior Pituitary

28. This causes contraction of the breast “let-down reflex” and the uterus.
Pitocin
Oxytocin
Hyosin
Estrogen

SKELETAL SYSTEM
29. Softening of joints and ligament, especially of symphysis and sacroiliac joints is caused by relaxin and
progesterone which results in increased mobility of the pelvic joints resulting in the waddling gait seen among
pregnant women.
TRUE
FALSE

Low back ache: the relaxation of the sacroiliac joints throws greater strain on the surrounding muscles causing
low backaches during pregnancy.

SKELETAL SYSTEM
30. This happens when the pregnant woman stands, the major part of the gravid uterus rests on the anterior
abdominal wall altering her center of gravity.
Lordosis
Scoliosis
Asperdosis
Maleosis

In order to maintain balance, the woman walks with head and shoulders thrown backwards with the chest
and abdomen thrusts forward. This posture results in exaggerated inward curve of the spine called lordosis.
Leg cramps: Caused by pressure of gravid uterus on nerves and imbalance of serum calcium level in the body.

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