NMC Past Questions on Midwifery Set 3

NMC Past Questions on Midwifery Set 3

101. A 42-year-old Musferia Arhin was brought into your ward after a home delivery which resulted in a fresh stillborn baby girl. Musferia was immediately wheeled into the examination room. On examination vaginally, a dark red tissue was observed protruding out of the vagina with evidence of urine leakage. Management of this client may be surgical or non-surgical. However, it will depend on all the flowing EXCEPT:
A) Severity of the symptoms
B) The health status
C) Past obstetric history

102. Madam Asabea Duker was admitted to the labour ward with history of labour abdominal pains. On examination, cervical dilatation was 6cm, membranes intact, contraction 3 in 10mins lasting between 25-32 secs. FH was 110bpm and has been diagnosed as mal-presentation. What would be the possible outcome of the labour?
A) Normal labour
B) Persistent
C) Prolonged labour

103. Madam Baaba Hagan G4P3A has been admitted in labour with the history of labour pains. On vaginal examination, the anterior fontanelle was felt in the anterior part of the pelvis to the left and sagittal suture in the transverse diameter of the pelvis. What is the position of the foetus?
A) Right occipito posterior
B) Left occipito anterior
C) Left occipito posterior

104. Mrs. Aba Addo who delivered in your facility an hour ago started bleeding profusely from the vagina. On examination, the blood pressure was 90/60mmHg, pulse 100bpm, temperature 35.6°C and respiration 24cpm. Her uterus was laxed. Which of the under listed will you do to resuscitate Mrs. Addo?
A) Give a uterotonic drug
B) Rub up a contraction
C) Set up iv fluid normal saline

105. In your anatomy class, you were taught that the study of all genes, interactions between and among genes and environment is termed as…………………………
A) Genetics
B) Genomics
C) Genotype

106. Mrs. Gina Cudjoe with 30 weeks of pregnancy came to the antenatal clinic and her BP was 140/80mmHg. Which of the following is most appropriate for her to do at home?
A) Diet should be rich in carbohydrate
B) Take more rest at left lateral position
C) Decrease regular fluid intake

107. Which of the under listed would need induction of labour at the Regional Hospital?
A) Prolonged labour
B) Previous caesarean section
C) Placenta praevia

108. Madam Frema Nyamekye G2P1A reported to your health facility with the history of dizziness and paleness of hands, lips and palm. Her gestational age was 12 weeks. In assessing the nutritional status of Madam Frema, which of the following anthropometric measurements would you use?
I. BMI
II. MUAC
III. Dietary methods
IV. Laboratory tests
A) II and III
B) I and II
C) I and III

109. Madam Grace Bills aged 28 years, was admitted in labour at your facility. The presentation was breech with cervical dilation of 6cm, membranes ruptured and both hips were extended with the knees flexed. What type of breech presentation could this be?
A) Frank
B) Complete
C) Knee

110. With your knowledge on fetal lie in midwifery, which of the following would be MOST conducive to a spontaneous vaginal birth?
A) Perpendicular
B) Oblique
C) Longitudinal

111. At a prenatal class, Manase Moro G3P2, aged 40 years asked about the characteristics of a baby with Down’s Syndrome. Which of the following are the common features you would describe to the class?
I. Small low set ears
II. Muscle hypotonia
III. Open mouth with protruding tongue
IV. Broad short finger
A) I, III and IV
B) I, II and III
C) I, II, III and IV

112. Madam Amidu, 37 weeks gestation was admitted in the labour ward with the history of lower abdominal pains, cephalic presentation, cervical dilation 6cm, membranes ruptured. In the cause of monitoring she started presenting with respiratory distress, severe dyspnoea, cyanosis, low BP and strong uterine contraction. What would you suspect?
A) Amniotic fluid embolism
B) Obstetric shock
C) Silent uterine rupture

113. After delivering baby and placenta, misoprostol is given in some cases to …………….
A) Prevent contraction
B) Control bleeding
C) Abort pregnancy

114. As a Registered Midwife making decisions for both mother and baby during your District Midwifery practice, which of the following would influence your decision to act quickly?
I. Changes in the signs of both mother and baby’s conditions
II. Signs of excessive bleeding
III. The tone of the fundus and breathing of the baby
IV. Increased pulse, low blood pressure and pale clammy skin.
A) I, II, III and IV
B) I, II and III
C) II, III and IV

115. Madam Sheila Bramson was admitted to the labour ward with history of labour pains. On examination, cervical dilatation was 6cm, membranes intact, contraction 3 in 10mins lasting between 25-32 secs. FH was 110bpm and has been diagnosed as mal-presentation. What would be the possible outcome of the labour?
A) Normal labour
B) Precipitate labour
C) Prolonged labour

116. One of the medical conditions associated with pregnancy is pregnancy induced hypertension. Which of the following diastolic blood pressure measurements indicates the presence of mild to moderate hypertension during pregnancy?
A) 90 to 110mmHg
B) 70 to 90mmHg
C) 110 to 120mmHg

117. Medical conditions associated with pregnancy have great effects on both maternal and foetal health. Which of the following groups of medications is the MOST appropriate treatment for severe pre-eclampsia?
A) Anti-convulsive
B) Antidiuretics
C) Antihypertensive

118. Preconception education is very important to all prospective couples to prevent abnormalities. Which of the following statements about folic acid and folate is correct?
I. An intake of 5mg daily can reduce the risk of neural tube defects
II. All women should increase their daily folate and folic acid intake by an additional 400mg before conception and during the 12 weeks of pregnancy
III. The main sources of folate are dark green leafy vegetables, fruits and fruit juices
IV. The term folate refers to the synthetic used in vitamin supplementation
A) II, III and IV
B) I, II and III
C) I, II and IV

119. During a class on changes in the breast during pregnancy, the following problems were stated by some mothers. Which of the statements indicate that further clarification is needed?
A) Breasts are tender and swollen
B) Areola get smaller and lighter in colour
C) Nipples get darker and more erect

120. Maame Akosua Mensah aged 40 years G8P7A reported at Ashiem Health Center in labour. On assessment, she was found to be in second stage of labour. Due to maternal exhaustion, she could not push. The Midwife on duty scolded and shouted at her. What other range of disrespectful and abusive behaviours of health providers dehumanizes clients?
I. Conducting procedures without consent
II. Discrimination and threats
III. Requesting for bribes for care
IV. Shouting and scolding at clients
A) I, II and III
B) I, II and IV
C) I, III and IV

121. At the completion of the third stage of labour, the immediate action of the midwife is to ……………………
A) Examine the genital tract
B) Expel blood clots
C) Check for uterine contractions

122. Maame Akosua Hasia delivered at your facility and started bleeding profusely in the course of managing her. She collapsed and was diagnosed as having obstetric shock. What will be your first line of action?
A) Call for help
B) Provide warmth
C) Replace fluid

123. Madam Akosua Badu aged 52 years G8P6 A plus 2 abortions with 3 months amenorrhoea reported at Ahwea CHPS zone with the history of swollen abdomen, nausea and vomiting. On assessment, her haemoglobin was 7.5g/dl. What education would you give to Madam Akosua Badu on other causes of enlarged/swollen abdomen?
I. Abdominal tumours
II. Cirrhosis of the liver
III. Pseudocyesis
IV. Uterine fibroids
A) I, II and III
B) I, II, III and IV
C) II, III and IV

124. Madam Sadia Ackon aged 26 years, 31 weeks of gestation has just been admitted to the maternity ward with the history of amniotic fluid embolism. She complained of anxiety, shivering and sweating. What other clinical manifestations is she likely to exhibit?
I. Uterine hypertonus
II. Maternal respiratory distress
III. Convulsions
IV. Maternal hypertension
A) II, III and IV
B) I, II and IV
C) I, II and III

125. Asibi Yahaya, a non-attendant came to your facility with labour pain. On examination, she looked pale with cervical dilation of 4cm. BP was 100/80mmHg, presentation was breech and FH was 120bpm. Contraction was 2-10 lasting between 30-40 secs. You finally diagnosed her as Anaemia in labour. What could be the possible outcome of the delivery?
A) Stillbirth
B) Post-partum haemorrhage
C) Abruption

126. Mawusi Agbave aged 17 years G2P1A reported to the ANC at your CHPS zone for the first time. On assessment, gestational age was 24 weeks, vital signs were within normal range. What other information would you gather on Mawusi Agbave’s past obstetrical history?
I. Number of pregnancies
II. Mode of delivery
III. Outcome of delivery
IV. Sex and birth weight of baby
A) I and II
B) I, III and III
C) II and IV

127. Madam Frema Nyamekye G2P1A reported to your health facility with the history of dizziness and paleness of hands, lips and palm. Her gestational age was 12 weeks. At what periods in pregnancy would you check Frema’s haemoglobin level?
I. First visit
II. 28 weeks
III. 36 weeks
IV. When necessary
A) I, II and III
B) II, III and IV
C) I, III and IV

128. Which of the following are the importance of respectful maternity care?
I. Dignity and respect are given when necessary
II. Freedom from harm and maltreatment
III. There is equity, freedom from discrimination and equitable care
IV. There is companionship that reduces stress and anxiety
A) II, III and IV
B) I, III and IV
C) II, III and IV

129. Madam Kukua Mantey aged 35 years, G2P1A reported at Bilumbu Health Center. Her urine tested sugar+++ and she wanted to know more. Which one of the following would be the nursing diagnosis of Madam Kukua Mantey?
A) Anxiety related to effects of diabetes mellitus
B) Knowledge deficit related to woman’s responsibility in managing her diabetes during pregnancy
C) Altered nutrition more than body requirements related to diabetes in pregnancy

130. Madam Mazah Boafo, a primigravida showed her laboratory results on haemoglobin of 9g/dl to you during your district midwifery practice. What interpretation would you give to this result?
A) Moderate anaemia
B) Severe anaemia
C) Mild anaemia

131. The following are risk factors for gestational diabetes EXCEPT:
A) Previous poor obstetrical history
B) Family history of diabetes
C) Eating habits

132. Maame Gyasiwaa aged 16 years was brought to your facility by her mother with complains of lower abdominal distension with pain, nausea and vomiting, and not knowing her last menstrual cycle. Which of the following are the possible causes of lower abdominal distension?
I. Ascites
II. Full bladder
III. Ovarian tumour
IV. Uterine tumour
A) II, III and IV
B) I, III and IV
C) I, II, III and IV

133. A 42-year-old Seyram Duuluo was brought into your ward by after a home delivery which resulted in a fresh stillborn baby girl. Seyram was immediately wheeled into the examination room. On examination vaginally, a dark red tissue was observed protruding out of the vagina with evidence of urine leakage.The most possible contributory factors would be the following EXCEPT:
A) Delivery of macrosomic babies
B) Weakened pelvic support
C) Congenital problem

134. Based on your knowledge of foetal circulation, which of the shunts are present during foetal life?
I. Ductus venosus
II. Corpora cavenosus
III. Ductus arteriosus
IV. Foramen ovale
A) I, II and III
B) I, III and IV
C) I, II and IV

135. Adokarley Tetteh G5P4A reported in the first stage of labour with the previous history of PPH in all her deliveries. On assessment, client has poor skin turgor and is anxious about outcome of labour. Which of the following would be your standard of care for Madam Tetteh?
I. Explain procedures to client and family and health care team in a simple and clear language
II. Assess maternal and fetal status as well as progress of labour
III. Do bedside clotting time test
IV. Set IV line to secure vein and take blood sample for grouping and cross matching.
A) I, III and IV
B) I, II, III and IV
C) I, II and IV

136. Madam Adjoa Taashi, aged 40 years, G5P4AA, 38 weeks of gestation was referred from the Polyclinic to the obstetric emergency ward on account of ruptured uterus. A second year student asked the Midwife to explain the precipitating factors of ruptured uterus. The appropriate response should include all the following EXCEPT:
A) Extension of severe cervical lacerations upwards into the lower uterine segment
B) Trauma as a result of accident
C) Judicious use of oxytocin in mother with high parity

137. Respectful maternity care is a universal human right due every childbearing woman in every health system around the world. Which of the following are the components of respected maternity care?
I. Free from fear or mistreatment during obstetric care
II. Have a birth companion
III. Choose a birthing position of her choice
IV. The woman should have privacy throughout care
A) II, III and IV
B) I, II, III and IV
C) I, II and III

138. Mrs. Dora Atta a Primip who delivered 4hours ago asked the Midwife why her abdomen is still big after delivery of her baby. The Midwife will respond by saying ………………………….
A) She would have to examine Mrs. Atta for an undiagnosed twin
B) The uterus though empty, is still big and will become smaller after some weeks
C) The muscles of the abdomen that stretched would take some time to go back to how it was before pregnancy

139. You delivered Primip at your facility. Which of the following signs on the baby would indicate post maturity?
A) Absence of lanugo
B) Presence of lanugo hair
C) Presence of vernix

140. Which of the following statements about the umbilical cord after birth is right?
I. Cut the cord between one and three minutes after birth
II. If mother is bleeding or baby not breathing well, cut the cord early
III. Delayed clamping of the cord support the baby’s circulatory system
IV. Use a sterile sharp scalpel blade or cord scissors
A) II, III and IV
B) I, II, III and IV
C) I, II and III

141. Mrs Osei Tunde G3P2A with 16 weeks cyesis is concerned about physiological changes in the skin during pregnancy. Which of the following falls under the intergumentary system?
I. Linnea nigra
II. Struae gravidarum
III. Telangiectasi
IV. Milia
A) I, II and III
B) I, II and IV
C) II, III and IV