Republic of the Philippines

PROFESSIONAL REGULATION COMMISSION

Board of Midwifery
OBSTETRICS
Set B
November 2022 Midwifery Licensure Examination
General Instructions:
1. The test questionnaire contains 100 test questions.
2. Read the INSTRUCTIONS printed on your answer sheet.
3. The type of examination is MULTIPLE CHOICE. Choose the letter of the
best answer.
4. Shade only 1 box for each question on your answer sheets. Two or more
boxes shaded will invalidate your answer. AVOID ERASURE
______________________________________________________________________
1. Marian, 6 months pregnant is seen by Midwife Nona at the RHU for her prenatal
check-up. She said she is having trouble with constipation. She is taking iron daily.
To minimize this condition, she should be instructed to:
a. Increase roughage and fluid intake to three liters per day.
b. Minimize her intake of iron supplement
c. Take mineral oil daily
d. Have strenuous exercise daily

2. A 30-year-old, G1P0 woman came to the clinic because she thinks she might be
pregnant. She tells the RM that she has irregular menstruation. Her last menses
was 8 weeks ago but she noticed some changes and discomforts in her body. Which
finding should the midwife observe when assessing for a probable sign of
pregnancy?
a. Morning sickness c. Positive pregnancy test
b. Urinary frequency d. (+) FHT

3. The Midwife is caring for Joana at the labor unit. She is irritable, does not want that
her stomach be touched, nauseated, her show is heavier and her membranes
already ruptured. The RM understands that this indicates:
a. Her labor has to be augmented by Oxytocin drip
b. Joana is having a complication so needs to be referred
c. That Joana has psycho-emotional-spiritual problem
d. A normal occurrence when a parturient is in transition stage of labor

4. An involution that progress normally can have the following findings of the fundus.
This will be located immediately after delivery at:
a. The level of the umbilicus c. 2 cm below the umbilicus
b. Three cm above the umbilicus d. 2 cm above the symphysis pubis

5. A primigravida is at high risk for abortion. She heard the midwife says she might
have inevitable abortion. The woman further asks what this means. Her response
is:
a. Inevitable abortion is spontaneous abortion in 3 or more successive
pregnancies.
b. Inevitable abortion is a threatened loss that cannot be prevented.
 c. Inevitable abortion is retention of products of conception in utero after fetal
death.
d. Inevitable abortion happens when there are uterine contractions without
cervical dilatation.

6. Health education on minor discomforts and danger signs of pregnancy was

conducted by the RM. A week after, a multigravida came with the following
complains. Which of these needs immediate attention by the midwife?
a. Presence of chloasma c. Swelling of the legs and face
b. Darkening of the areola d. Frequent micturition

7. Oxytocin is administered to augment the labor of a multigravida. Which finding is

indicative of adverse effect of this drug?
a. A blood pressure of 109/ 78 mmHg
b. Urinary output of 100 ml/ hour
c. Increasing intensity of uterine contractions
d. A duration of contraction lasting 120 seconds

8. Mrs. Doraca, G2P2 was discharged after NSVD. She is breastfeeding for the first
time and is now returning to the clinic complaining about unsuccessful
breastfeeding. Which of the following actions is the best to be done by the midwife?
a. Ask her the reasons why she said she is unsuccessful
b. Advise her to just continue and keep on trying
c. Tell her to demonstrate how she is breastfeeding and assist her on this at the
clinic
d. Just give her a pamphlet about breastfeeding so she can read it repeatedly

9. It is the dream of a 40-year-old married woman to become pregnant. As she was at

the prenatal check-up, she was told she is not, rather she has an H-mole. Which of
the following is NOT an assessment of H-mole?
a. Big for dates uterus c. Bleeding from vagina with vesicles
b. Negative HCG test d. No fetus seen on ultrasound

10. Mrs. Tiniano is on her third trimester. She suddenly experienced vaginal bleeding
that prompted her to report for prenatal check-up at the hospital. On the way to the
hospital, she felt a sharp abdominal pain then uterine tenderness followed. What is
the possible cause of the bleeding?
a. Abortion c. Ectopic pregnancy
b. Placenta previa d. Abruptio placenta

11. A G3P2 woman came to the clinic for prenatal visit. Her complains are: right lower
quadrant unilateral sharp pain that is radiating to the shoulders. She was diagnosed
of ectopic pregnancy and has to be admitted ASAP. She asked what ectopic
pregnancy is. As a RM, your response is:
a. Sudden cervical dilatation that results in abortion.
b. Low implantation of placenta.
c. Implantation of the zygote at the site other than in the uterus
d. Pregnancy with no fetus inside but there is high HCG titer

12. The following are signs of impending delivery EXCEPT:

a. Increasing bloody show
b. Rectal pressure
c. Contractions more frequent and of shorter duration
d. Rupture of membrane
13. initial action of the Midwife upon knowing that a client has watery vaginal discharge
is:
a. Instruct her to lie on bed
b. Monitor her fetal heart tone
c. Advise her to take nothing by mouth
d. Observe the characteristic of the discharge

14. Which of the following statements best describes an internal rotation?

a. Allows the passage of the presenting part through the irregular pelvis.
b. The smallest antero-posterior diameter of the fetal head is presented to the
pelvis.
c. The greatest biparietal diameter of the fetal head is presented to the pelvis.
d. The head descends as the chin is flexed more on the chest.

15. When bulging of the perineum is observed, the Midwife has to prepare to:
a. Clamp the cord
b. Clear the mouth and nose of secretions
c. Apply abdominal (fundal) pressure
d. Apply Ritgen’s maneuver

16. You are called to attend to Rodora, G2P1, 39 weeks AOG at home. Upon
assessment, you observe her to be having placenta previa with bouts of bleeding.
Your management would consist of:
i. Place woman in T-position, monitor vital signs
ii. Start IV – 1 liter of D5W, fast drip with 18-gauge intra-catheter
iii. Call for help or prepare for transfer to the hospital
iv. Prepare delivery of the baby by ascertaining your asepsis and
preparing equipment needed.
a. 1 only
b. 1,2 &3
c. all of these
d. 4 only

17. Which among these signs would not indicate post maturity syndrome?
a. Long fingernails
b. wrinkled peeling skin
c. abundant vernix caseosa
d. with subcutaneous fat

18. Pregnancy induced hypertension (PIH) is a medical condition during pregnancy

which can cause harm to the mother and baby. Which among the following are
symptoms that signal the development of PIH?
1. Rapid weight gain (over 2 lb per week in second trimester)
2. Increased urine output
3. Mild intermittent headache
4. Dots before the eyes
5. Blurring of vision
6. Persistent vomiting
a. 2,3,6 b. 1,4,5 c. 1,3,4,5 d. 4,5,6
19. A woman who is trying to get pregnant asked a midwife related to the causes of
bleeding during pregnancy. She asked about the signs of low lying placenta during the
third trimester. What should be the midwife’s response?
a. “A painful vaginal bleeding will occur that may result to maternal shock.”
b. “You will fee a painless bleeding at the beginning of cervical dilatation.”
c. “Some contractions will only be felt after bleeding.”
d. “You will feel cramping and perhaps vaginal spotting.”

20. Oday is in her 16th week of pregnancy. You conducted a home visit to her because
her house is 4 hours hike to the health center. She complained of severe nausea
and vomiting and claimed to have lost weight since her first week of pregnancy. You
are aware that she is having hyperemesis gravidarum. What best advise can you
give her now?
a. Make sure that you replace the lost fluid by drinking oral rehydration solution.
b. Come to the clinic for a follow-up check-up at the MHO
c. It is only normal during the time that you are pregnant because of HCG
d. You have to be admitted for at least 24 hours so you can have IVF, then your
input and output will be monitored

21. Vicky Cheng age 32 years old visited the lying-in clinic to confirm her suspected
pregnancy. During the assessment, she stated that her LMP began on April 11.
She however experienced vaginal spotting on May 8. Using the Naegele’s rule, the
Midwife calculated the due date which is:
a. January 18 b. February 18 c. February 12, d. February
15

22. A parturient being monitored during labor is now on the second stage of labor.
Which of the following would not signal the midwife that the patient is in her second
stage of labor?
a. Woman experience momentary nausea and vomiting.
b. Full dilatation and completer cervical effacement.
c. Contractions stronger and lasting 40 to 60 seconds every 5 minutes.
d. Fundus midway between symphysis pubis and umbilicus

23. All of the following are physiologic effects of progesterone, EXCEPT:

a. Movement of zygote through the oviduct
b. Slightly elevated basal body temperature
c. Formation of corpus luteum
d. Inhibition of uterine contractility during pregnancy

24. Which of the following problems is likely to be associated with iron intake?
a. Nausea c. Constipation
b. Diarrhea d. Gas pain

25. Which of the following food will you advise to relieve leg cramps?
a. Mongo, cheese, dilis
b. Pechay, squash, malunggay
c. Nuts, legumes, eggs
d. Rice, bread, root crops
26. During the third stage of labor, the Midwife knows that the placenta is about to be
delivered if the following signs will be observed BUT ONE:
a. Umbilical cord becomes longer c. Uterus becomes globular
b. Sudden gush of vaginal fluid d. Release of amniotic fluid

27. Mona asked for a nutrition supplement to ease her leg cramps. Which of the
following is NOT to be advised?
a. Calci Aid c. Cal de Ce
b. Calcebone d. Calpol

28. which of the following is a diagnostic test for fertility?

a. PAPSMEAR
b. Coomb’s test
c. Culdocentesis
d. Hysterosalphingogram

29. Which of the following development of events occurs last?

a. blastocyst formation c. trophoblast formation
b. fertilization d. ovulation

30. A pregnant woman complains of back pain. Which of the following is NOT to be
advised?
a. Pelvic rocking at the end of the day
b. Use low heeled shoes
c. Walk observing good posture and sit with your back straight
d. Try to rest with back flat and legs straightened

31. A first-time pregnant woman wants to know further what Goodell’s sign is. She
already knows that it is the softening of the cervix, and so she will look for the
following characteristic:
a. Its consistency is like that of an earlobe
b. Its consistency is like that of a nose
c. Its consistency is like that of a tongue
d. Its consistency is like that of the lips

32. Mary age 11, was surprised and asked her mother who is a nurse-midwife when she
saw blood on her under wear. Her mother explained that she is having her first
menstrual period and this is called menarche. Which of the following is NOT true
about this?
a. It occurs prior to the development of the breast.
b. It is a sign of end of puberty
c. It indicates sexual development
d. It can occur anytime between 9 and 17 years old

33. As part of health teaching, the Midwife provides Julia with information about food
items high in folic acid. Which of the following can be a good snack in the morning?
a. 1 medium banana c. 1 cup of green vegetable salad with
mayonnaise
b. 1 piece of apple d. 1 cup of fruit salad

34. What is the rationale behind that ideal time for implantation of the fertilized egg is
during the secretory phase of the menstrual cycle?
a. The endometrium is thick during this time and there is increased vascularization
to the uterus.
 b. The endometrium during this period is richly supplied with hormones that will
support the growing fetus.
c. The endometrium is thin and blood vessels of the uterus are easily attached to
the chorionic villi.
d. The endometrium is thin, so the chorionic villi can attach well to the decidua
basalis.

35. In administering medroxyprogesterone (Depo-Provera), the midwife remembers to:

a. Remind the patient to return for another injection in 6 weeks to ensure adequate
hormone levels.
b. Wash the site with povidone-iodine to prevent infection.
c. Not massage the site because this action hastens drug absorption and may
shorten the effectiveness of the drug.
d. Give the injection subcutaneously to ensure slow release for maximum
effectiveness.

36. During the discharge of a 2 days postpartum mother, which of the following will the
midwife NOT include in the regular postpartum care?
a. Inspection of the breasts and perineum
b. Giving information regarding options in family planning
c. Giving instruction on nutrition to increase lactation
d. Giving instruction that she can start coitus anytime with her husband

37. A midwifery student asked her instructor what hormones cause the changes in the
breasts of a pregnant woman?
a. Estrogen and follicle stimulating hormone
b. Estrogen and progesterone
c. Progesterone and luteinizing hormone
d. Follicle stimulating hormone and luteinizing hormone

38. A G1P0 woman is inside the labor room and is in the transition stage of labor. You
are about to do an IE when the patient pushed your hand away from her and asked
why you are doing an IE every now and then. What is your reply?
a. Internal examination is done to check the placental separation.
b. Internal examination is done to check for the cervical dilatation every four hours.
c. Internal examination is done to check the fetal position.
d. Internal examination is done to check for the presentation of the fetus.

39. As a woman was being examined by the gynecologist, and as you assist the
physician, you observed the following on the perineum: profuse, whitish, bubbly
discharges; vaginal walls have petechiae. You know that these findings are
indicative of:
a. Moniliasis c. Gonorrhea
b. Trichomonas vaginalis d. Chlamydia trachomatis

40. A mother with cervicitis was given the following advice during the RHU team’s home
visit. Which of the following is appropriate?
a. Douche the perineal area with a betadine antiseptic to clean the exudate.
b. Douche the perineal area with a feminine wash to decrease the bacteria.
c. Douche the perineal area with a vinegar solution to aid healing.
d. Douche the perineal area with warm water-soap solution to promote vasodilation
& cleansing.
41. You are advising primigravidas at the RHU regarding the importance and benefit of
iron supplementation during pregnancy. One woman explained correctly when she
said:
a. I should only eat meat like liver and drink milk throughout my 9 months
pregnancy.
b. Iron cause diarrhea and bloody stool.
c. Iron is needed for red blood cell formation and this will prevent anemia.
d. I have enough iron before I became pregnant so there is no need for
supplementation.

42. Lovelyn, 35 years old decided to take oral contraceptives after providing her
information on pills (POP & COC). She made some research on pills. Which of the
following is NOT true when using it?
a. The side effects are nausea, spotting, weight gain and breast tenderness.
b. During the first 14 days of pill use, this is not yet effective.
c. If prescribed a 21-day cycle pill, this will be taken same time every day for 21
days
d. Contraindications in the use of the pills are breastfeeding, epilepsy, seizure,
obesity & hypertension

43. During the menstrual phase of the menstrual cycle, the characteristic of the cervical
mucus is:
a. Clear, thin, watery, and elastic.
b. Scanty, viscous, opaque
c. Combination of a & b
d. Scanty, viscous, elastic and with blood

44. DMPA is being used by Koralyn, 27-year-old with 3 children already. Which of the
following statements indicate her understanding of its use?
a. If I discontinue using this, I will be fertile at once.
b. I can use this even if I am breastfeeding my baby who is 6 weeks old.
c. Depomedroxyprogesterone acetate is given every 6 hours.
d. This method has no side-effects.

45. Which is a primary power of labor?

a. Uterine contractions c. Intrathoracic pressure
b. Pushing of the mother d. Abdominal contraction

46. Which of the following may happen if the uterus becomes over stimulated by
oxytocin during induction of labor?
a. Weak irregular contractions prolonged to more than 70 sec.
b. Increased restlessness
c. Tetanic contractions prolonged for more than 90 sec
d. Increased pain with bright red vaginal bleeding

47. The husband of a postpartum woman 20 minutes ago complained to the midwife the
vaginal bleeding of his wife. Upon assessment, you only saw spotting in her pads.
The following are all related to postpartum hemorrhage, EXCEPT:
a. Postpartum hemorrhage is more than 500 ml of blood loss.
b. Postpartum hemorrhage manifests a boggy uterus, hypotension and large
amounts of blood.
c. Postpartum hemorrhage may be due to uterine atony or retained placental
fragments.
d. Postpartum hemorrhage usually occurs during the first 48 hours after delivery.
48. While assisting a gynecologist inside the labor room, you were informed that the
client was assessed for an implantation of uterine-endometrium or nodules that have
spread from the interior of the uterus to locations outside of the uterus. What is this
condition called?
a. Endometriosis c. Endometritis
b. Infertility d. Ectopic pregnancy

49. Midwife Nemia was assigned inside the labor room by the nurse. As part of the
labor room health care team, what is the primary responsibility of Midwife Nemia?
a. Administration of IV fluids and medications throughout labor process.
b. Force the delivery of the infant when 5 cm dilatation is achieved
c. Assist the woman during the labor process until the safe delivery of the baby.
d. Maintain cleanliness and sterility inside the labor room

50. Fatima, a lactating mother complains of intermittent, afterbirth pains. The midwife
can best help her if she does all of the following, except:
a. Explain to the client that this is normal.
b. Give analgesics as ordered PRN
c. Applies a hot water bag.
d. Applies an ice cap.
51. A neonate born any time after 37 completed weeks of gestation through 42
completed weeks of gestation or born from 260-294 days is termed:
a. Preterm neonate c. Premature neonate
b. Post term neonate d. Term neonate

52. A G1P1 mother delivered by NSVD at the RHU birthing facility of a municipality was
attended by a RHM. Three minutes has passed and the cord has been cut, and she
waited for 15 minutes for the complete expulsion of the placenta. This complete
expulsion of the fetus is called:
a. Death b. Neonate c. Birth d. Fetus

53. A child bearing age woman is worried about the PAPSMEAR procedure she will
undergo. She asked the midwife as to where and how the specimen is collected.
Your answer would NOT be one of the following:
a. A sterile cotton applicator with saline is inserted through the speculum in the os
of the cervix.
b. Once in the cervical os, a gentle rotation in a clock wise then counter clockwise
movement is done.
c. Specimen from vaginal orifice is also taken same procedure as letter b, making
sure the cotton applicator will not touch the external genitalia.
d. The specimen is painted on a glass slide then sprayed with fixative to preserve
the cells.

54. Among the following description, which one best describes the Gynecoid pelvis?
a. Inlet is well rounded forward and backward, pubic arch is wide.
b. Inlet is an oval, smoothly curved, but anteroposterior diameter is shallow.
c. Transverse diameter is narrow, ape-like pelvis.
d. Pubic arch type forms an acute angle making lower dimensions extremely
narrow.
55. As labor contractions progress and become regular and strong, the uterus gradually
differentiates itself into two distinct functioning areas. The boundary between these
two is called:
a. Physiologic Bandl’s ring c. Pathologic Bandl’s ring
b. Cervical ring d. Pathologic retraction ring

56. In a community health station, a breastfeeding mother asked the midwife if she can
use the Lactational Amenorrhea Method (LAM) as a form of family planning. As the
Midwife, what is your best response?
a. Yes, you can if your menses have not yet returned, if you are bottle feeding
early, exclusively, and extendedly and your infant is less than 6 months old.
b. Yes, you can if your menses have not yet returned, if you are breast feeding
early, exclusively, and extendedly and your infant is less than 6 months old.
c. Yes, you can if your menses have not yet returned, if you are breast feeding
early, exclusively, and extendedly and your infant is less than 9 months old.
d. Yes, you can if your menses have returned, if you are breast feeding early,
exclusively, and extendedly and your infant is less than 6 months old.

57. Which among the following data is not included in the partograph?
a. Progress of labor c. Delivery process
b. Fetal and maternal condition d. Abnormal progress of labor

58. Cretinism is a condition of severely stunted physical and mental growth due to
untreated deficiency of iodine. What teaching can you give best to pregnant
mothers to avoid this kind of condition from being acquired by their babies?
a. Enough iodine during pregnancy is important to supply the needs of her
increased thyroid function.
b. If iodine deficiency occurs, it may cause the fetus hyperthyroidism which may
cause early respiratory distress
c. Seafoods are least source of iodine, thus supplementation is needed.
d. Hyperthyroidism may cause the infant to be cognitively challenged.

59. When the fetal surface of the placenta presents a central depression surrounded by
a thickened grayish white ring, this condition is known as:
a. Placenta succenturiate c. Placenta marginata
b. Fenestrated placenta d. Placenta circumvallata

60. During the initial assessment, the midwife notes that the neonate’s hands and feet
appear blue while the neonate’s torso appears pale pink. Which of the following
would the midwife do the next?
a. Wrap the neonate.
b. Ask the mother to massage the neonate’s hands and feet.
c. Keep the neonate in an isolation incubator for at least 2 hours.
d. Report the neonate’s cyanosis to the physician promptly.
61. When assessing a neonate, you note that one side of his body has a deep pink color
and the other side appears pale. This condition is known as:
a. Jaundice c. Stork bites
b. Harlequin sign d. Erythema toxicum

62. A method of breech delivery through the vagina wherein the infant is expelled
entirely spontaneously without any traction other than support of the infant.
a. Spontaneous breech delivery c. Partial breech delivery
b. Total breech delivery d. Prague technique
63. During the time of effacement, as the cervical canal shortens to ¾ of its original
thickness/ length, it means:
a. The cervix is 25% effaced c. The cervix is 50% effaced
b. The cervix is 75% effaced d. The cervix is 100% effaced

64. When a midwife practices Ritgen’s Maneuver during NSVD, she therefore
understands that she maintains flexion and gradual extension of the:
a. Buttocks b. Shoulders c. Placenta d. Head

65. The act of giving birth or parturition has three phases. Which of the following is not
part of these?
a. Time of uterine preparation for implantation of the blastocyst
b. Time of uterine preparedness for labor
c. Time of forceful contraction during labor and delivery
d. Time of puerperal contraction and delivery

66. The normal physiologic hemostatic mechanism to combat postpartum hemorrhage

is:
a. Increased blood clotting factors in pregnancy.
b. Contraction of interlacing muscle bundles in the myometrium
c. Markedly decrease BP in the uterine vessels
d. Vasoconstriction of the uterine blood vessels

67. Moderate ankle edema during late pregnancy is best treated by:
a. Administration of diuretics c. Marked restriction of fluids
b. Resting in lateral recumbent position d. Restriction of sodium intake

68. Smoking during pregnancy is associated with an increase incidence of:

a. Small for gestational age neonate c. Post mature neonate
b. Structurally deformed neonate d. Premature delivery

69. A lack of sufficient pulmonary surfactant at the time of delivery may predispose the
neonate to respiratory distress syndrome. This is commonly present in:
a. Term neonate
b. Pre-term neonate
c. Post term neonate
d. Still birth babies

70. A labor and delivery room Midwife admits a woman G2P1, 38 weeks AOG and in
early labor. Admission assessment is completed and documented. The midwife
learned that the mother’s temperature is 38.8 C. What is the midwife’s most
appropriate action?
a. Document the finding and recheck the client’s temperature after 4 hours.
b. Administer paracetamol as ordered and recheck the temperature in 30 minutes
c. Notify the physician immediately.
d. Put on the hypothermia blanket.

71. A midwife conducted a home visit to a mother who had a normal vaginal delivery 5
days ago. On assessment, the midwife determines that the client is experiencing
breast engorgement. The midwife teaches the mother on how to care for this
condition. Which of the following conditions if made by the mother indicates to the
midwife that teaching was successful?
a. “I will let my baby breastfeed on only one breast each time.”
b. “I will avoid wearing a bra during the daytime.”
 c. “I will apply cold compress to my breasts before each feeding.”
d. “I will massage my breasts before I feed my baby to stimulate let-down reflex.”

72. The midwife administered the first dose of hepatitis B vaccine to a newborn infant.
The mother asks the midwife if her baby needs further hepatitis B immunizations.
Which response by the midwife is most informative for the mother regarding hepatitis
B immunization scheduling?
a. “Your baby only need this Hepatitis B injection.”
b. “Your baby can receive one more hepatitis B immunization any time after his first
birthday.”
c. “Your baby should have a second injection between the ages 1 and 2 months
and final immunization 4 months after this initial dose.”
d. “Your baby needs a second hepatitis B injection when he is 6 months of age and
a third immunization at 1 year of age.”

73. A positive early diagnosis of pregnancy is based on the presence of:

a. Quickening
b. Fetal Heart Rate
c. X-ray visualization
d. All of these

74. A multipara with previous CS operation underwent trial labor but eventually had
uterine rupture. What is the probable cause of the uterine rupture?
a. CPD c. Forceful breech extraction
b. Injudicious use of oxytocin d. Past weak CS scar

75. The best time to counsel a diabetic patient about drug usage and glucose
content in pregnancy would be:
a. Before she get pregnant c. The early second trimester
b. The third trimester d. The first trimester

76. Placental condition wherein the chorion and amnion are raised in the margin by
interspersed decidua and fibrin is known as:
a. Placenta succenturiata c. Fenestrated placenta
b. Placenta marginata d. Placenta circumvallate

77. A client asks why menstruation ceases once pregnancy occurs. Your best response
would be:
a. “Because of the reduction in the secretion of hormone by the ovaries.”
b. “Because of production of estrogen and progesterone by the ovaries.”
c. “Because of secretion of LH by the pituitary gland.”
d. “Because of secretion of FSH by the pituitary gland.”

78. A client on her 8th week of pregnancy complains of having to go to the bathroom
often to urinate. You explain to the client that urinary frequency often occurs
because the capacity of the bladder during pregnancy is diminished by:
a. Atony of the detrusor muscle of the bladder
b. Compromised by the autonomic reflexes
c. Compression of the ascending uterus
d. Constriction of the ureteral entrance at the trigone

79. A newly pregnant client having her first child expresses concern about her “dark
nipples” and “dark line” from her navel to the symphysis pubis. You explain that
 these normal adaptations are due to the hyperactivity of the ____________ during
pregnancy.
a. Ovaries
b. Thyroid gland
c. Adrenal gland
d. Pituitary gland

80. A common method to determine the precise position of a fetus and placenta prior to
an amniocentesis is:
a. Fetoscopy
b. Fluoroscopy
c. Sonography
d. X-ray examination

81. You understand that an ultrasound examination ordered for a pregnant client is used
primarily to:
a. Estimate fetal age c. Rule out congenital defects
b. Detect mental retardation d. Approximate fetal linear
growth

82. Which of the following during labor is unlikely to happen when the membranes
rupture?
a. Imminent onset of labor c. Risk of infection
b. Risk of cord prolapse d. Maternal hypovolemia

83. Which of the following may happen if the uterus become over stimulated by the
oxytocin during induction of labor?
a. Weak uterine contractions is prolonged to more than 70 seconds
b. Tetanic uterine contractions prolonged to more than 90 seconds
c. Increased pain with bright red vaginal bleeding
d. Increased restlessness and anxiety

84. Pregnancy is least likely to occur if coitus occurs at what time?

a. At ovulation c. 2 days after ovulation
b. 2 days before ovulation d. 1 day before ovulation

85. Prophylactic to newborn soon after birth because they have no normal flora yet in
their intestine.
a. Vitamin K b. Vitamin A c. Vitamin D d. Vitamin C

86. Which of the following maternal organs physically enlarges during pregnancy?
a. Appendix b. Kidneys c. Liver d. Lungs

87. Mrs. Gan comes to the Emergency Room with labor pains. Upon IE, cervix reveals
5 cm dilatation. She is on her 36 th week AOG. Which would possibly be given to her
at this time?
a. Terbutaline
b. Aspirin
c. Dexamethasone
d. Prostaglandin

88. Which change in the cardiovascular system is NOT expected during pregnancy?
a. Increase in the beats/ minute c. Increase in cardiac volume
 b. Increase in blood pressure d. Displacement to the left

89. At midpoint during pregnancy, you review to a client during a prenatal visit the
beginning signs of labor. One of the beginning signs of labor you would review is:
a. A sudden gush of clear fluid from the vagina
b. An increased pulse rate and upper abdominal pain
c. Excessive fatigue and headache
d. Sharp right-sided abdominal pain

90. The two most important predisposing causes of puerperal or postpartum infection
are:
a. Organisms present in the birth canal and trauma during labor
b. Hemorrhage and trauma during labor
c. Malnutrition and anemia during pregnancy
d. Preeclampsia and retention of placental fragments

91. To promote comfort during labor, the midwife teaches the client to avoid the:
a. Sitting position c. Side-lying position
b. Supine position d. Lateral recumbent position

92. As a pregnant woman lies supine on the examining table during her prenatal visit,
she experienced shortness of breath and dizziness. This phenomenon probably
happens because:
a. Her cerebral arteries are congested with blood
b. Blood is trapped in the vena cava in a supine position
c. The uterus requires more blood in a supine position
d. Sympathetic nerve responses cause dyspnea when a woman lies supine

93. Which two tests are generally performed on urine at a prenatal visit?
a. Protein and sodium c. pH and glucose
b. Occult blood and protein d. Protein and glucose

94. Within the first 30 seconds after delivery of the neonate, the following needs to be
done by the midwife attending the delivery, EXCEPT:
a. Dry the newborn
b. Place on mother’s abdomen for skin-to-skin contact
c. Check the newborn’s breathing
d. Feel for cord pulsation, clamp and cut the cord

95. Within 1-3 minutes after delivery of the newborn, Oxytocin IM is administered after
_______ .
a. Delivery of the placenta c. Excluding a second baby
b. Cutting the cord d. After drying the newborn

96. The first full breastfeeding is done as the EINC guidelines says:
a. While the mother is inside the delivery room
b. Once the mother is transported to the ward together with the newborn
c. After the bathing of the baby and administration of eye prophylaxis
d. A day after delivery but before discharge of the mother

97. A woman G1P0, 10 weeks AOG is admitted with a diagnosis of ectopic pregnancy.
For which of the following would you anticipate beginning preparation?
a. Bed rest for the next 4 weeks
 b. Intravenous administration of a tocolytic
c. Immediate surgery
d. Internal uterine monitoring

98. A woman at 32 weeks gestation is admitted in preterm labor. On your admission

assessment, which of the following findings would cause you to question the doctor’s
order for a tocolytic agent?
a. Cervical dilatation of 5 cm
b. Strong, regular contractions
c. Fetus in breech presentation
d. History of spontaneous abortion in a previous pregnancy

99. A woman G3P2 is being admitted to the Obstetric department of your hospital for
severe preeclampsia. When deciding on where to place her, which of the following
room would be most appropriate?
a. Room by the nursery so she can maintain hope she will have a child
b. Room near the elevator so she can be transported quickly to the delivery room.
c. Room near the nurse’s station so she can be observed quickly
d. Room in the back hallway where there’s a quiet, private room.

100. Which of the following activities as EINC guidelines mandates is optional 6 hours
after the birth of the baby?
a. Breastfeeding c. Bathing
b. Administering Vitamin K d. Immunizing with Hepatitis B vaccine