NMC Past Questions on Midwifery

NMC Past Questions on Midwifery

1. After fertilization the sequence of events occur in the developing structure. Choose the correct sequence of events that occur.
A) Zygote, Blastocyst, Morula, Blastocele
B) Zygote, Morula, Blastocele, Blastocyst
C) Zygote, Blastocele, Morula, Blastocyst

2. A suture is an area of membrane between the skull bones where ossification has not been completed. Which of the following is an appropriate description for coronal suture? It is ……
A) Located between the occipital bone and the two parietal bones extending transversely on either side of the posterior fontanelle.
B) Located between the frontal bone and the parietal bones and extended transversely on both side of the anterior fontanelle.
C) Located between the parietal bones and divides the skull into left and right halves

3. A final year midwifery student was asked to lecture the junior colleagues in the second year on bony pelvis. She made mention of obstetrical outlet which gives the foetus enough room to be able to pass through. Which of the following will she include as landmarks on the obstetrical outlet?
A) Posterior of the symphysis pubis
B) Lower border of the symphysis pubis
C) Lower border of the sacrum
D) Ischial spine

4. The midwife aspirates the airway of the new born baby immediately at birth before the baby takes his first breath. This action is taken to prevent which of the following complications in the newborn?
A) Compression of the thorax
B) Obstructed right bronchus
C) Obstructed left bronchus

5. Mrs. Ekua Bronya came to your facility after 1 week of delivery and complains of abdominal tenderness in association with urination. What other signs and symptoms would you look out for to confirm urinary tract infection?
A) Dysuria and vomiting
B) Dysuria and pyrexia
C) Nausea and vomiting

6. A baby was delivered in the labour ward with compressed facial appearance, renal agenesis and limb contractures. The midwife on duty informed you that the characteristic features occurred because of oligohydrominios. What condition could the baby suffering from?
A) Potter’s syndrome
B) Cystic kidneys
C) Cryptorchidism

7. As a staff midwife at Gbogame Health center, a 3-day old baby was brought to your facility with physiological jaundice and was put under phototherapy. What is the essence of the phototherapy?
A) Convert fat soluble unconjugated bilirubin into water soluble bilirubin to be excreted through bile and urine
B) Convert fat soluble unconjugated bilirubin into water soluble bilirubin that be excreted through bile and urine
C) To clear the toxins from the system

8. Madam Akoma Banka, para 1 was seen at the post-natal clinic for the second post-natal visit. She complained of severe backache and discomfort. The midwife employs which of the following measures in her care?
A) Reassure client
B) Encourage client to wear supporting corset
C) Teach client squatting exercises

9. A midwife was asked to select from among a list of genetic disorders which may present with cardiac malformation. Which of these best explains that?
A) Turner syndrome
B) Potter syndrome
C) Edwards syndrome
D) Patau syndrome

10. Mrs. Okpotti-Mensah brought her baby to your ward with the diagnosis of necrotizing enterocolitis. What is the possible risk factors during pregnancy?
A) Respiratory distress syndrome
B) Uterine hypoxia
C) Congenital heart disease

11. As a midwife at Zolubabu community, you were called to give health talk on menstrual disorder to students of Zolubabu SHS. A student asked of the best treatment for primary dysmenorrhea. Which of the following under listed will be your best response?
A) Give antispasmodic drug
B) Give hormonal drugs
C) Indulge in physical exercises

12. A new born baby was delivered through C/S and sustained a little cut on the scalp. The midwife managed by applying a sterile dressing on the cut. As part of management to control pain from the cut, a decision was made to administer a sucrose to the baby. Precautionary measures the midwife would employ before administering oral sucrose include which of the following?
I. Check for contraindications
II. Prepare the amount of sucrose with the correct dosing
III. Give a small amount at the start and increase when necessary
IV. Administer the required dose onto the anterior of the tongue
A) II, III, IV
B) I, IV
C) I, II, III, IV

13. The normal amount of amniotic fluid is ……………………
A) 500-700mls
B) 100-300mls
C) 800-1200mls

14. A baby with hypothyroidism will present the following under listed except?
A) Macrosomia
B) Low birth weight
C) Post term

15. Maame Esi Benewah aged 17 years delivered in your facility three days ago. Upon examination, her breasts were found to be engorged, hard, tense and painful. What will be the immediate management of Benewaah?
A) Limit fluid intake
B) Encourage her to continue breastfeeding
C) Apply shea butter on breast

16. The midwife at the ANC unit performed vaginal examination on a 20 year old multiparous woman at 16 weeks of gestation to assess the adequacy of the pelvic cavity. Which of the following landmarks will she include in her examination?
I. Curve of the sacrum
II. Sacrospinous ligament
III. Greater sciatic notch
IV. Promontory of the sacrum
A) III, IV
B) II, III
C) I, II, III

17. Mrs. Addo, who delivered 4 days ago came and complained of small degree of leakage of urine since 2 days ago which is making her uncomfortable. This should be resolved with the practice of all these except?
A) Bladder draining
B) Antibiotics treatment

18. Adowa Mansah aged 30 years G3P2A was admitted to Kuntuasi District hospital. On examination there was a depression across the abdominal region of the umbilicus. The presenting part was found to be impacted in the pelvic. A large caput succedaneum was felt and there was excessive moulding. What is the possible diagnosis?
A) Obstructed labor
B) Prolong labor
C) Cephalo pelvic disproportion

19. As a staff midwife at the intensive care unit, a rotation nurse reported to you that the temperature of one of the babies in the incubator read 35.5°C. What will be your immediate response?
A) Check the temperature of the incubator and regulate it to normal body temperature
B) Remove the baby and put her under radiant warmer
C) Remove the baby and provide warmth

20. When the uterus fails to respond to ovarian stimulation, it is termed as …………………….. amenorhea?
A) Uterine
B) Ovarian
C) Pituitary

21. Baby Peter has been delivered in the labor ward where you work has omphalocele. The midwife who assisted the delivery immediately covered the herniated abdominal content with a warm sterile saline swab. What is the rationale behind the midwife’s action?
A) Prevent the swelling of the organs
B) Reduce fluid and heat loss
C) Encourage granulation over the organs

22. Madam Mercy Andore, an elderly primigravida aged 40 years reported to your hospital in labor. On assessment the presenting fetal diameter was vertex. Which of the following diameter of the fetal head makes the head assume a well flexed position?
A) Bi-temporal
B) Sub occipito-bregmatic
C) Sub occipito-frontal

23. At the Bonsa health center, some of the babies delivered are having sunken eyes, bulging fontanelle and big heads. Their mothers are concerned about the shape of their newborn baby’s head after birth. As registered midwife, how would you explain a serous fluid collected in the scalp?
A) Caput succedaneum
B) Cephalohematoma
C) Cerebral haemorrahage

24. After a preterm birth, a student midwife observed the placenta to be bigger than the normal size and reported to you. Your best response would be;
A) The placenta size is commensurate with the mother’s weight
B) The placenta in a preterm is bigger than the term ones
C) The baby is undernourished

25. The foreign bodies in the vagina and trichomonas vaginitis can cause ……………………………………
A) Epimenorrhoea
B) Metrorrhagia
C) Polymenorrhoea

26. A 3-day baby was referred to your hospital with persistent vomiting since the first day after birth. The doctor order for an abdominal radiological investigation which revealed a double bubble of gas. What will be the likely diagnosis?
A) Duodenal atresia
B) Oesophageal atresia
C) Volvulus

27. During your clinical practical, you were asked to carry out an assessment on the diameters of the foetal head. Which of the under listed is the largest transverse diameter of the foetal head?
A) Bi-parietal
B) Anteroposterior
C) Bi-temporal

28. Baby Akuvi who was delivered at 39 weeks of gestation had an Apgar score of 6. He was diagnosed of having birth Asphyxia neonatorium. Which of the following complications is the baby likely to exhibit if the asphyxia is prolonged?
I. Cerebral hypoxia
II. Seizures
III. Polycaethemia
IV. Intraventricular haemorrhage
A) II, III, IV
B) I, II, IV
C) I, II, III, IV

29. The commonest cause of apnoea in preterm babies is ………………………………………….
A) Pulmonary surfactant deficiency
B) Hypocalcaemia
C) Hyaline membrane deficiency

30. The most important example of point mutation is found in a disease called ……………………………
A) Night blindness
B) Sickle cell anaemia
C) Thalassemia

31. Madam Aku brought her one-week old baby to the ward and complained that she has observed yellow papules (pinhead spots) on baby’s forehead. She looked worried. What will be your immediate action as a student midwife?
A) Administer baby into intensive care unit
B) Reassure her that it will disappear in few days
C) Apply calamine lotion

32. During an obstetric anatomy class, a first year student midwife asked you about the regions of the foetal skull. Which of the following are parts of the regions of the foetal skull? The………
I. Base
II. Face
III. Mentum
IV. Vault
A) I, II
B) II, III, IV
C) I, II, IV

33. A rotation midwife is describing the varieties of the pelvis. She includes the following when describing the android pelvis Except
A) The brim is heart sharped
B) The inferior pubic rami are shape
C) The cavity is deep

34. Baby Kofi has been admitted to the neonatal intensive care unit with pemphaigus neonatorium. He is placed on systemic antibiotics and he is to be monitored closely to prevent spread of the infection. The under listed are complications of premphigus neonatorium except
A) Infection of the blood stream
B) Brain infection
C) Skin infection

35. You are a newly posted Midwife to Bentum Health Center. Madam Abena Kokobi was brought to the clinic with history of labour pains. On examination, the cervical dilatation was 7cm with breech presentation with no foetal heart rate. What would be the mode of delivery?
A) Forceps delivery
B) Spontaneous vagina delivery
C) Vacuum extraction

36. If control cord traction is used during the delivery of the placenta, there are checks to be made, of which the first is to:
A) The uterus is well contracted
B) Ensure that uterotonic drug has been administered
C) There are signs of placenta separation

37. Madam Akuaba was admitted to your facility with the history of lower abdominal pains, cephalic presentation, descent 3/5, 5cm dilatation. On examination, there was no engagement, the head had slightly overlapped the anterior edge of the symphysis pubis. What will be the best line of action?
A) Deliver by vacuum when fully dilated
B) Monitor her on the partograph
C) Prepare her for caesarian section

38. At Otuwakrom where you work as a midwife, a woman was brought in with labour pains. On examination, the cervical os was 6cm, membranes ruptured with meconium stained liquor, FH was 136bpm and the presentation was breech. These are complications of breech delivery EXCEPT:
A) Foetal abnormality
B) Cord prolapse
C) Maternal trauma

39. Mrs. Anokye aged 24 years reported at the ANC unit for the first time. On assessment her obstetrical history was G3P2A, fundal height 12cm, LMP 12/8/18 and complained of having nausea and vomiting. What would be her EDD?
A) 19/5/2019
B) 20/4/2019
C) 12/5/2019

40. Occipito posterior position occurs as a result of failure of internal rotation prior to delivery. The common cause of this condition is ………………………
A) Platypethiod pelvis
B) Android pelvis
C) Anthropoid pelvis

41. Mrs Constance Essel, G4P3AA, 34 years has been brought to the labour ward with the history of labour pains. Her maternal health records showed that the foetal presentation is breech. On examination, she was in the second stage of labour with the breech presenting. During your delivery, what will you do to deliver the baby’s legs if they are extended?
A) Pull knees forward from under the symphysis pubis
B) Apply gentle pressure to the popliteal fossa
C) Apply downward traction to the baby’s knees

42. All the following factors influence the onset of labour by the action of oestrogen EXCEPT:
A) Release oxytocin and prostaglandins effect
B) Increased irritability of the myometrium
C) Stimulate development of oxytocin receptors

43. Madam Jemima Tonsu aged 28 years who delivered 6 days ago at your health center, was brought in a rush one early morning by her spouse. On assessment, client presented with the following: feelings of suspiciousness, confusion, restlessness and strange behaviour towards her own baby. Which of the following treatments would you plan in your care for Madam Jemima Tonsu?
I. Antidepressants
II. Anti psychotics
III. Psychotherapy
IV. Electro convulsive therapy
A) II, III and IV
B) I, III and IV
C) I, II, III and IV

44. Madam Catherine Ontoo, G6P5, a non-attendant was brought to your hospital after being in labour for two days. She looked frail and could barely answer questions posed to her. Abdominal examination revealed a line of depression at the umbilical area of the abdomen and supra pubic swelling. On vaginal examination, there was slight offensive odour, vagina was hot and dry with oedematous cervix about 8cm dilated, with the bregma to the symphysis pubis. The Midwife interpreted her findings to be………………………
A) Severe urinary tract infection
B) Ante partum chorioamnionitis
C) Obstructed labour

45. Madam Asana Duku reported to your facility with the history of 37 weeks’ gestation, multiple pregnancy, breech presentation, FH 110bpm and ruptured membranes. Her scan revealed polyhydramnios. The Obstetrician decided to perform cephalic version for her. The procedure could be done because of the ……………………….
A) Ruptured membranes
B) Multiple pregnancy
C) Polyhydramnios

46. Madam Wahab, 28 years, 38 weeks pregnant with history of labour and a scan report of polyhydramnios. She started bleeding 1 hour after delivery. All efforts were made but the uterus failed to contract. What could be the possible cause of the atony?
A) Polyhydramnios
B) Blood coagulation defect
C) Trauma to the genital tract

47. Madam Abena Asantewaa reported to your facility with the history of severe lower abdominal pains. On examination, the presentation was breech, FH 134bpm, cervix fully dilated, membranes ruptured. What type of delivery will be used for this woman?
A) Burns Marshall
B) Spontaneous
C) Lovset manoeuvre

48. Your pale looking client complained she has changed her sanitary pad about 4 times in the last one hour. The best action would be:
A) Assess the fundus and enquire about urinary output
B) Set up an intravenous line and administer magnesium sulphate
C) Explain to the client it is physiological and would stop soon

49. When a diagnosis of occipito posterior position is confirmed, the best place to check the foetal heart rate is at the …………………………….
A) Midline
B) Lateral
C) Fundus

50. Based on your knowledge in regenerative health and nutrition in midwifery, which of the following would be some alternative treatment for postpartum depression?
I. Guided imagery
II. Deep breathing
III. Medications
IV. Massage
A) I, II and III
B) I, II and IV
C) I and II