NMC Past Questions on Midwifery Set 5

NMC Past Questions on Midwifery Set 5

181. Mrs. Adom was admitted to the labour ward of the Nsubeto district hospital in labour. Her contractions were strong, painful and irregular with slow dilation of the cervix. The client complained of severe back pain which she said was referred to her rectum. Which type of abnormal uterine action is the client experiencing?
A) Incoordinate uterine action
B) Hypotonic uterine action
C) Cervical dystocia

182. During vagina examination with occipito posterior position, the anterior fontanelle can be located at …………………………. part of the pelvis.
A) Lateral
B) Anterior
C) Posterior

183. Madam Yaa Moro has inversion of the uterus. On your assessment, the body of the uterus is inverted to the internal os. How will you diagnose Madam Moro according to the severity in degrees?
A) Third
B) First
C) Second

184. During breech delivery, the internal rotation of the head enters the pelvis with the ……………………………
A) Lambdoidal suture
B) Sagittal suture
C) Frontal suture

185. Hyperemesis gravidarum refers to excessive nausea and vomiting during pregnancy. Which of the following weeks of pregnancy does it persist?
A) 10 to 16 weeks
B) 16 to 20 weeks
C) 4 to 10 weeks

186. Mrs. Sowah, G4P3 with good obstetric history was admitted to the labour ward. On examination, the cervical os was tip of finger. The obstetrician was called to review patient who suggested induction as the gestational age was 41 weeks. Which of the following can be induced?
A) Intrauterine death
B) Oligohydramnios
C) Cord presentation

187. An increase in uterine blood flow and lymph during pregnancy causes pelvic congestion and oedema contributing to the softening of the uterus, cervix and isthmus. This gives the cervix a bluish colour. This is termed ……………………………
A) Chadwick’s sign
B) Goodell’s sign
C) Hegar’s sign

188. Maame Afiba Tandoh in her last trimester complained of oedema of the lower limbs which subsides after taking rest. In explaining the cause, the Midwife explains that this is physiological oedema which occurs as a result of……………
A) Reduced osmotic pressure
B) Increased osmotic pressure
C) Haemodilution

189. Madam Alimatu Seidu aged 35 years, G2P1A reported at Bankyease Health Center. Her urine tested sugar+++ an indication of Gestational diabetes, which refers to:
A) First time during pregnancy and resolve after delivery
B) First time during pregnancy and reduces during pregnancy
C) First time during pregnancy and persists during pregnancy

190. The amount and drainage of lochia varies with the individual. Which of the following indicate the abnormalities of lochia?
I. Offensive vaginal diacharge
II. Lochia rubra throughout 10 days after birth
III. Abnormally heavy bleeding making a sanitary pad soaked within 1 hour
IV. Passage of blood clots larger than golf ball
A) II, III and IV
B) I, II and III
C) I, II, III and IV

191. Hajia Limatu Husein, 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. In using the Burns Marshall manoeuvre during delivery, which of the under listed will you perform?
A) Put slight pressure on the occipital bone
B) Apply gentle pressure on malar bones
C) Grasp baby’s ankles with forefinger between the two

192. Maame Ayensua delivered at your facility and started bleeding profusely in the course of managing her. She collapsed and was diagnosed as having obstetric shock. What clinical observation will you make on this patient?
I. Low blood pressure
II. Cyanosis of the finger
III. Cold clammy skin
IV. Response to stimuli
A) II, III and IV
B) I, II and IV
C) I, II and III

193. Akweley Oddom aged 16 years was brought to your facility by her mother with complains of swollen abdomen, nausea and vomiting, abdominal pain and not knowing her last menstrual cycle. She is to undergo urine or blood test to confirm pregnancy. Which of the following would you use to determine Akweley Oddom’s gestational age?
I. McDonald’s rule
II. Niagele’s rule
III. Quickening
IV. Ultrasound scan
A) I, II and III
B) I, III and IV
C) II, III and IV

194. During breech delivery, the descent takes place with increasing…………………..
A) Compaction
B) Flexion
C) Contraction

195. Eno Sarpomaa, G4P3AA has been brought to the labour ward where you work. On examination, the cervix was fully dilated, presentation was cephalic and descent was 0/5 above the pelvic brim. The cord was found on the perineum and membranes were ruptured. Moulding of foetal head was ++ and liquor was clear. As a midwife, which of the under listed will you do for Eno Sarpomaa in the second stage of labour?
A) Give client oxytocic drug and observe
B) Deliver baby by vacuum extraction
C) Perform episiotomy and deliver baby

196. You just finished delivering the placenta and the woman started bleeding profusely. The immediate action you need to take is……………
A) Give uterotonic drugs
B) Call for help
C) Massage the uterus

197. As a Registered Midwife in a district, which of the following would you consider in helping mothers to survive bleeding after birth?
I. Clients losing 500mls or less blood is life threatening
II. All women regardless of their background are at risk of bleeding
III. Clients with anaemia and malnutrition may become ill after little blood loss
IV. Mother and baby should be kept together
A) I, III and IV
B) II, III and IV
C) I, II and III

198. As a newly posted Midwife in the maternity ward of Feehi District Hospital, you observed the delivery process of a non-attendant in labour. After your colleague had taken the baby out, she asked her assistant to administer injection oxytocin. However, you observed the uterus was above the umbilicus. You therefore cautioned the assistant not to give the injection. The Midwife asked you what to expect when the placenta is still in situ. Your BEST action in this situation would be:
A) Palpate the abdomen to confirm your suspicion
B) Allow the midwife and her assistant to finish the delivery
C) Report to the charge nurse and document

199. Which of the following structural abnormalities of the chromosome has a distinctive cry of a cat in the newborn?
A) Turner’s syndrome
B) Cri du chat syndrome
C) Fragile X syndrome

200. Madam Afua Ataayi G7P5+1 with gestational age of 36 weeks was brought to the labour ward. On examination, cervical os was 6cm, descent 2/5, FH was 152bpm with membranes intact. BP was 180/120mmHg, urine protein 2++ and looked very puffy. The Obstetrician reviewed her and ordered MgSO4 and hydralazine to be given and to monitor her for vaginal delivery. How often would the blood pressure be monitored? Every ………………………………. minutes
A) 45
B) 30
C) 15

201. As a professional Midwife working in the lying-in ward, which of the following complications is responsible for delayed post partum haemorrage?
A) Cervical lacerations
B) Clotting defeciency
C) Uterine subinvolution

202. The loss of pregnancy by 22 weeks of gestation is termed as ………………………
A) Induced abortion
B) Threatened abortion
C) Spontaneous abortion

203. Mercy Woods, a first year student midwife in your ward told you that some third year students call her Woods manoeuvre. Mercy asked you to describe how Woods manoeuvre is done. Which of the under listed will you include in your description? It involves:
I. Insertion of a whole hand into the vagina
II. Foetal chest is identified by the one doing the manoeuvre
III. Pressure is put on posterior foetal shoulder
IV. Use of suprapubic rocking to dislodge foetal anterior shoulder.
A) I, II and III
B) I, II and IV
C) I, III and IV

204. Madam Fatima Musah was referred to the Bosu District Hospital on account of eclampsia. Magnesium sulphate was prescribed for her. The loading dose was given. Before repeating the next regime, the Midwife ensures that the ……………………………………
A) Urinary output falls below 30mls per hour
B) Respiratory rate is at least 16cpm
C) Pulse rate is at least 60bpm

205. In breech delivery, one of the manoeuvre used is the Mauricean-Smellie-Veit. This procedure involves the use of the following:
A) Jaw flexion and shoulder traction
B) Forefinger between the ankles
C) Grasps the baby’s ankles

206. There are several positions a mother can adopt during second stage of labour. The under listed are advantages of squatting method EXCEPT:
A) Relieve backache
B) Requires strong bearing down
C) Widening pelvic outlet

207. At which week of pregnancy would foetal heart pulsation be detected by transabdominal ultrasound?
A) 5th week
B) 6th week
C) 7th week

208. Yaaba Kaku 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. To ensure the survival of both Madam Yaaba and her baby, which of the following health team members would you involve in your planning of care?
I. Partner, family and friends
II. Mental health professionals
III. Skilled midwife and obstetrician
IV. Community health nurse
A) I, III and IV
B) I, II, III and IV
C) II, III and IV

209. Mrs. Koomson 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 are the other presumptive signs and symptoms of first trimester pregnancy?
I. Amenorrhoea
II. Breast changes
III. Frequency of micturition
IV. Nausea and vomiting
A) I, II and III
B) I, II and IV
C) II, III and IV

210. Madam Owusua G2P1A, 1 previous C/S was admitted to the labour ward with 5cm, contraction 3 in 10mins lasting between 35 – 42 seconds. SFH was 36cm with FH of 136bpm. Madam Owusua want to have trial of labour. All the under listed can have trial of labour EXCEPT:
A) One previous C/S
B) Two previous C/S
C) Post term pregnancy

211. You were on duty on the ward when a case was brought from the theater after undergoing caesarean section. What would be your first action?
A) Empty the bladder
B) Administer prescribed drugs
C) Check vital signs

212. Madam Lordina Alhassan 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. In delivering the head of the baby, which of the under listed will you do if the head remains in persistent occipito posterior position?
I. Allow the sinciput to escape as far as the glabella under the symphysis pubis
II. Allow the occiput to escape from under the symphysis pubis
III. Let the occiput sweep the perineum
IV. Hold the sinciput back to maintain flexion
A) II, III and IV
B) I, II and III
C) I, III and IV

213. At Ayikuma 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) Maternal trauma
C) Cord prolapse

214. You are the labour ward in charge at Akrado Health Center. A relative brought a client who is G7P42D+2 with history of bleeding per vaginum. The first action you need to take is ……………………………….
A) Perform vagina examination
B) Set IV fluids
C) Refer to a hospital

215. Based on your knowledge in physiological changes in pregnancy, at what gestational age does lightening occur?
A) 30-36 weeks
B) 38-40 weeks
C) 26-28 weeks