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NMC Past Questions on Midwifery Set 4

142. In your health talk delivery on physiological changes in pregnancy during a community durbar, the target audience were concerned about the posture of the pregnant woman and the changes that occur in the skin. Which of the following would cause musculoskeletal discomfort during pregnancy?
A) Waddling gait of the pregnant woman
B) Increase in weight of the pregnant woman
C) Carpal tunnel syndrome

143. During your revision for licensing examinations in midwifery, a colleague asked of your opinion on Braxton Hick’s contraction as a sign of pregnancy. Which of the following would be your BEST response?
A) Probable
B) Presumptive
C) Positive

144. A woman aged 40 years and a primigravida was brought from Ehiamankyene village to your hospital with the history of labour pains. She was monitored with the partograph. After 4 hours, her cervix was found to be 5cm and descent was 4/5 above the pelvic brim without any advancement. The doctor was called and obstructed labour was diagnosed. Which of the under listed will be an early sign of obstructed labour?
A) Signs of dehydration including dry mouth
B) Formation of large elongated sac of fore waters
C) Bandl’s ring formation

145. Akosua Manu, G8P42D+3 was admitted to the labour ward with history of lower abdominal pains. On examination, the cervical os was 4cm, descent 4/5, FH 132bpm. After the vaginal examination, you noticed the presentation to be left mento anterior. In internal rotation of the shoulders, the shoulders enter the pelvis in the ………………….
A) Anterior oblique diameter
B) Right oblique diameter
C) Left oblique diameter

146. Madam Akweley Osei 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. As a Registered Midwife, which of the following would be your diagnosis for Madam Akweley Osei?
A) Postpartum psychosis
B) Postnatal blues
C) Puerperal sepsis

147. Madam Abi G4P3A was admitted to the Banso district hospital with the history of lower abdominal pains. On examination the presentation was breech, cervical dilation 6cm, membranes ruptured with meconium stained liquor and FH 126bpm. What will be your care for this woman?
A) Monitor her on partograph
B) Administer prescribe antibiotics
C) Monitor foetal heart rate

148. One hour after birth, the fundus is soft at the midline and 1cm below the umbilicus. Lochia flow is profuse with clots. What would be your initial action?
A) Administer a repeat oxytocin
B) Place a bedpan to empty the bladder
C) Massage the fundus

149. At the maternity unit, failure to communicate to health team members can have an adverse effect on both mother and baby. Which of the following would you do to save lives?
I. Alert your team members as birth approaches
II. Assign each member a role to play
III. Develop an emergency plan
IV. Involve mother and family in all your care / procedures
A) II, III and IV
B) I, II, III and IV
C) I, II and III

150. Augmentation of labour is an intervention to correct slow progress in labour. One of the under listed is an indication for augmentation.
A) In coordinate contraction
B) Hypertonic contraction
C) Hypotonic contraction

151. Mrs. Kakraba Johnson , an elderly primigravida aged 37 years reported to your ANC unit for the first time. On assessment, her gestational age was 24 weeks. LMP was 6/01/2018 and she was having a mixed feeling about her pregnancy and chronic hypertension. What would be the EDD of Mrs. Johnson?
A) 6/09/2018
B) 13/10/2018
C) 6/10/2018

152. As a Registered Midwife, if presumptive signs of pregnancy are changes that are felt by the pregnant woman, which of the following are RIGHT?
I. Amenorrhoea
II. Fatigue
III. Ballotement
IV. Fetal heart sounds
A) I and III
B) I and IV
C) I and II

153. Adwoa Mansah aged 30 years G3P2A was admitted at Kuntuasi District Hospital. On examination, there was a depression across the abdomen in the 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 labour
B) Prolonged labour
C) Cephalo pelvic disproportion

154. A 40-year-old woman, G8P7AA was admitted to the labour ward with the history of labour pains. She complained of having expulsive uterine action. On vaginal examination, a foetal blood vessel was found lying over the cervical os, in front of the presenting part. What condition do you suspect the woman to have?
A) Cord presentation
B) Vasa praevia
C) Placenta praevia

155. Madam Adwoba Lartey, aged 40 years, G5P4AA, 38 weeks of gestation was referred from the Polyclinic to the obstetric emergency ward on account of ruptured uterus. The Midwife performs a quick assessment for signs of ruptured uterus. The findings of the assessment should include:
I. Maternal bradycardia
II. Tenderness and pain in the caesarian scar
III. Abnormality of the foetal heart rate and pattern
IV. Vaginal bleeding
A) II, III and IV
B) I, II and III
C) I, II and IV

156. At what stage in the fetal development does the morula form?
A) Fetal stage
B) Embryonic
C) Pre-embryonic

157. Madam Joyce Ndabra aged 52 years G8P6 A plus 2 abortions with 3 months amenorrhoea reported at Kalaali CHPS zone with the history of swollen abdomen, nausea and vomiting. On assessment, her haemoglobin was 7.5g/dl. Which of the following are causes of amenorrhoea?
I. Anaemia
II. Diabetes mellitus
III. Menopause
IV. Malnutrition
A) I, II, III and IV
B) I, II and III
C) II, III and IV

158. During induction of labour, it is essential to rupture the membranes before. The reason for the rupturing is to visualize the ……………………….
A) Presenting part
B) Cervical os
C) Colour of the liquor

159. Madam Victoria Arhin 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. If increased flexion occurs and the posterior fontanelle is felt to the right and anteriorly, sagittal suture in the left oblique diameter of the pelvis, how would you diagnose the position?
A) Right occipito anterior
B) Left occipito posterior
C) Left occipito anterior

160. Fati Muammar, a 2-day postnatal mother reported for postnatal assessment. On inspection you noted the drainage and amount of lochia. What type of lochia is expected? Lochia …………….
A) Alba
B) Serosa
C) Rubra

161. Mrs. Juliana Antwi, an elderly primigravida aged 37 years reported to your ANC unit for the first time. On assessment, her gestational age was 24 weeks. LMP was 6/01/2018 and she was having a mixed feeling about her pregnancy and chronic hypertension. A feeling expressed by most women during the first trimester upon learning that they are pregnant is ………………………………
A) Depression
B) Ambivalence
C) Acceptance

162. Theresa Coffie, a puerperal mother at your lying-in ward with a normal healthy baby delivered 4 hours ago. During lochia assessment, the clots were larger than 1cm. What action would you take as a Registered Midwife to save Theresa Coffie’s life?
A) Notify the Obstetrician
B) Document the findings
C) Encourage intake of more fluids

163. Mercy Woods, a first year student Midwife in your ward told you that some third year students call her Woods manoeuvre. She therefore wants to know more about Woods manoeuvre. In which condition is Woods manoeuvre used?
A) Breech delivery
B) Face presentation
C) Shoulder dystocia

164. Madam Hizafa was admitted at the labour ward and started bleeding after delivery. The uterus on palpation was hard and the blood flow was steady. What is the cause of her bleeding?
A) Retained product
B) Blood coagulation defect
C) Trauma of the genital tract

165. Eno Agyeiwaa, 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. In your initial management of Eno Agyeiwaa, the under listed will be done EXCEPT:
A) Replace cord into the vagina
B) Set up IV normal saline
C) Set up oxytocin infusion

166. Hajia Zakia Mohammed, 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) Burns Marshall
B) McRoberts
C) Loveset

167. Maame Yaa Fofie was admitted to your facility with the history of severe abdominal pain, increased maternal pulse, no foetal heart sound and almost in a collapsed state with no contractions felt. What will be the possible diagnosis of her condition?
A) Maternal shock
B) Ruptured uterus
C) Placenta praevia

168. The Registered Midwife teaches the pregnant client at prenatal school on how to do Kegel’s exercise to accomplish …………
A) Stimulate labour contractions
B) Prevent perineal lacerations
C) Improve pelvic muscle tone

169. Madam Afua Asor was admitted at the Obotumpan Health Center with the history of labour. On admission, she complained of severe backache, the membranes had ruptured with strong uterine contractions with slow descent. What is the possible diagnosis?
A) Occipito posterior position
B) Cephalo pelvic disproportion
C) Breech presentation

170. 42-year-old Mary Oswol was brought into your ward after a home delivery which resulted in a fresh stillborn baby girl. Mary 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. In the case of Madam Oswol , you anticipate that the treatment would be:
I. Kegel’s exercise
II. Oestrogen therapy
III. Pessary use
IV. Life style modification
A) II, III and IV
B) I, II and III
C) I, II and IV

171. Aisha Ibrahim, G8P42D+3 was admitted to the labour ward with history of lower abdominal pains. On examination, the cervical os was 4cm, descent 4/5, FH 132bpm. After the vaginal examination, you noticed the presentation to be left mento anterior. On vagina examination, the presenting part would be;
A) High, hard and regular
B) High, soft and regular
C) High, soft and irregular

172. Mrs. Beatrice Alhassan, an elderly primigravida aged 37 years reported to your ANC unit for the first time. On assessment, her gestational age was 24 weeks. LMP was 6/01/2018 and she was having a mixed feeling about her pregnancy and chronic hypertension. Which of the following is the main psychological task that Mrs. Alhassan must accomplish during her third trimester?
A) Resolving grief over the loss of old roles.
B) Coping with common discomforts and changes
C) Overcoming fear of the unknown

173. Madam Yaaba Nyameke 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. How often would the foetal heart rate be monitored?
A) One hour
B) Thirty minutes
C) Fifteen minutes

174. During pregnancy, the cervix undergoes various changes. Which of the following indicate Goodell’s sign?
A) Bluish violet colour of the cervix
B) Softening of the cervix
C) Appearance of an erosion of the cervix

175. A 42-year-old Lucy Seidu was brought into your ward by after a home delivery which resulted in a fresh stillborn baby girl. Lucy 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. As a qualified midwife, what would be your diagnosis?
A) Uterine prolapse
B) Vaginal prolapse
C) Cystocele

176. At Gyankrom 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. Which of the under listed favours breech presentation?
A) Post term
B) Placenta praevia
C) Placenta abruptio

177. Madam Ashetu Abu was referred to your facility on account of retained placenta. On arrival, the Midwife in charge asked you to prepare syntocinon injection for the patient. How will you prepare this treatment?
A) 20 units of oxytocin with 30mls of N/S
B) 10 units of oxytocin with 20mls of N/S
C) 30 units of oxytocin with 20mls of N/S

178. You were monitoring a client who was augmented in the labour ward. Which of the under listed could be a side effect of oxytocin?
A) Bladder atony
B) Hyper stimulation
C) Hypo stimulation

179. A 25-year-old woman came to you with a complaint of bleeding. After history taking, you established that she has 2 months’ amenorrhea and has seen bright red blood. Which of the following would you use to manage the woman’s problem?
I. Administer RhoGAM immediately on admission
II. Assess the pain using appropriate pain scale and manage
III. Monitor vaginal bleeding by counting the soiled sanitary pads
IV. Observe passage of products of conception
A) I, II and III
B) I and II
C) II, III and IV

180. When the sagittal suture is found in the transverse diameter of the pelvis and both fontanelles are palpable, it is termed ………………………
A) Deep transverse arrest
B) Face to pubis
C) Persistent occipito posterior

NMC Past Questions on Midwifery Set 2

51. 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

52. Mrs. Amoah G3P2AA with 40 weeks’ gestation came to the clinic with labour pains. On examination, cervical os was 10cm with foetal heart rate of 90bpm. What would be your immediate response?
A) Position her and deliver
B) Administer oxygen intranasal
C) Let her lie on her side

53. Memuna Bukari 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. As a registered midwife, which of the following routine investigations would you do at the CHPS zone?
I. Haemoglobin level
II. Blood for malaria parasites
III. Urine for protein and sugar
IV. Blood for G6PD
A) I, II and III
B) II, III and IV
C) I, II and IV

54. All women under maternity care should be treated equally. As a Registered Midwife, which of the following would you teach first year students to show respect to clients?
I. Introduce self by name with a smile
II. Speak calmly with simple clear language
III. Explain procedure to client always to gain consent first
IV. Listen and look at the face of the client when speaking
A) I, II, III and IV
B) I, III and IV
C) I, II and III

55. You were monitoring a client at the 4th stage room, who told you that she has changed the pad more than 5 times within an hour and feels dizzy. On examination, the uterus was bulky, she looked pale and weak. What could be the cause of her condition?
A) Anaemia
B) Atony uterus
C) Abruptio placenta

56. The following are causes of shoulder presentation EXCEPT:
A) Placenta abruptio
B) Multiple gestation
C) Placenta praevia

57. Prolonged labour is most common in primigravidae and may be caused by the following EXCEPT:
A) An antero posterior position
B) An occipito position
C) Ineffective uterine contraction

58. Madam Kwakyewa was admitted to the labour ward with the history of 2 previous C/S. On admission, immediate caesarean section was requested. What is the second anatomical layer that would be incised by the obstetrician during the surgery?
A) Uterine muscle
B) Pelvic peritoneum
C) Abdominal peritoneum

59. Luruwie Adiza aged 16 years who delivered 3 days ago at home was brought to your health center with her baby. On assessment, Luruwie expressed some form of guilt feelings, loss of appetite and crying with no apparent reason. Her vital signs were within normal limits. Which risk factors will attribute to Luruwie Adiza’s problem
I. A young mother
II. Unwanted pregnancy
III. History of depressive moods
IV. Financial problems
A) II, III and IV
B) I, III and IV
C) I, II and III

60. Diagnosis of pregnancy is very important for one to prepare for birth. Which of the following is a presumptive sign or symptom of pregnancy?
A) Restlessness
B) Low backache
C) Frequency of micturition

61. Madam Maku G2P1A, 1 previous caesarean section 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 Maku want to have trial of labour. When would you end trial of labour and prepare her for emergency caesarean section? When there is ………………………………………………….
A) Adequate contraction
B) Foetal hypoxia
C) Hypotonic contraction

62. Midwives have good knowledge in management of their clients due to the professional training received. If a client who delivered an hour ago is receiving care, which of the following complications must she be observant for?
A) Post-partum haemorrhage
B) Post-partum depression
C) Deep vein thrombosis

63. 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 in the perineum and membranes were ruptured. Moulding of foetal head was ++ and liquor was clear. Which of the under listed measures can you employ to prevent pressure on the cord?
I. Apply pad on vulva
II. Instill normal saline into bladder
III. Put client in knee chest position
IV. Raise client’s buttocks on pillows
A) I, II and III
B) II, III and IV
C) II and III

64. Madam Cecelia Azuga, 36 years old, delivered a live male infant 7 days ago at your facility. She was rushed to the maternity ward on account of pyrexia 39.4°C, general malaise and severe abdominal pains. She was diagnosed as having puerperal sepsis. The Midwife also performed examination of the breast. Her documentation would include ………………
I. Tenderness in the breast
II. Engorged
III. Breast feels very cold to touch
IV. Discoloured of flaky skin of breast
A) I, II, and III
B) I, II and IV
C) II, III and IV

65. At Akwatia Hospital, there was an unsuccessful external cephalic version and the Midwife told the staff to prepare the patient for emergency caesarean section because…………………………………………
A) Membranes had ruptured
B) There is cord prolapse
C) Foetal heart rate not heard

66. Madam Yawa Akakpo, 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. With reference to the above history and findings, which of the following complications can occur?
A) Septicaemia
B) Ruptured uterus
C) Cervical dystocia

67. Anastasia Mutala, a 2-day postnatal mother reported for postnatal assessment. On inspection you noted the drainage and amount of lochia. If the fundus is palpated, and the uterus is buggy and feels soft, what would be your action?
A) Push the uterus to assist in expressing the clotting
B) Encourage mother to urinate
C) Massage fundus until it is firm

68. Postpartum depression has effect on the family involved. Which of the following effects would be manifested in the child if mother’s postpartum depression is left untreated?
I. Sleeping problems
II. Eating disorders
III. Excessive crying
IV. Delays in language development
A) I, II, III and IV
B) II, III and IV
C) I, II and III

69. Fulera Lomotey 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. As a Registered Midwife, which of the following are the main causes of bleeding after birth?
I. Uterine atony
II. Tears
III. Retained placenta products
IV. Full bladder
A) I, II and III
B) I, II and IV
C) I, III and IV

70. Which of the following are strategies to ensure respectful maternity care?
I. Ambulance transport for laboring women
II. Delivery room privacy must be ensured
III. Training of midwifery staff on ethics of the profession
IV. Welcoming and respectful atmosphere must be ensured
A) II, III and IV
B) I, II, III and IV
C) I, II and III

71. Ama Putin aged 16 years who delivered 3 days ago at home was brought to your health center with her baby. On assessment, Ama expressed some form of guilt feelings, loss of appetite and crying with no apparent reason. Her vital signs were within normal limits. Which of the following would be your BEST diagnosis for Ama Putin?
A) Puerperal sepsis
B) Postpartum depression
C) Postpartum psychosis

72. A complete assessment on clients in Maternity Nursing is very useful. Which of the following information would you gather on a client to diagnose postpartum depression?
I. Family history of mental illness
II. Current postpartum experience
III. Traumatic obstetric delivery
IV. Financial status
A) I, II and III
B) I, III and IV
C) I, II, III and IV

73. Madam Adwoa Lamisi was admitted to the labour ward with history of labour pains. On examination, cervical dilatation was 6cm, membranes intact, contraction 3 in 10minutes lasting between 25-32 seconds. FH was 110bpm and has been diagnosed as mal-presentation. What could be the possible cause of the mal-presentation?
A) Hydramnios
B) Macrosomia
C) Polyhydramnios

74. Madam Ama Boakyewaa, a puerperal mother at your lying-in ward with a normal healthy baby delivered 4 hours ago. During lochia assessment, the clots were larger than 1cm, she also exhibited cool clammy skin, restlessness and complained of thirst. What would you do immediately?
A) Count the number of pads used and reassure her
B) Assess for hypovolemia and notify the Obstetrician
C) Do fundal massage and give her oxygen

75. Ms. Afi Agodo, aged 24 years G3P2 was rushed to your facility after home delivery. On examination, the corpus of the uterus was inverted to the internal os. What classification of inversion is her condition?
A) Third degree
B) Second degree
C) First degree

76. Madam Barbara Gaisey 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. What is the function of MgSO4 in this situation?
A) Control blood pressure
B) Increase urine output
C) Prevent fits

77. When the attitude of the head is complete extension, the occiput of the foetus will be in contact with its spine and the face will present. What can cause face presentation?
A) Multiple pregnancy
B) Polyhydramnios
C) Oligohydramnios

78. Madam Georgina Acka aged 35 years, G2P1A reported at the District hospital where you work. Her urine tested sugar+++ and wanted to know more about her condition. Which of the following are maternal effects of uncontrolled diabetes mellitus in pregnancy?
I. Hydraminios
II. Infections (moniliasis)
III. Hyperglycemia
IV. Macrosomia
A) II, III and IV
B) I, III and IV
C) I, II and III

79. Maame Awusi aged 28 with 42 weeks’ gestation has been admitted to your ward for induction of labour due to postdate gestation. What is the rationale for the induction?
A) To avoid risk of caesarian section
B) To prevent degeneration of the placenta
C) To prevent foetal distress

80. As a newly placed midwife in the maternity ward of Kohia 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. You anticipated the outcome of their action could have resulted in…………………………………
A) Retained second twin
B) Delayed expulsion of placenta and membranes
C) Closure of the cervix

81. Mrs. Asante was admitted to the labour ward and was diagnosed with shoulder dystocia. What is the best explanation for this condition? The …………………….
A) Anterior shoulder becomes trapped in front of the symphysis pubis
B) Anterior shoulder is trapped behind or on the symphysis pubis
C) Posterior shoulder is trapped in the brim

82. As a Registered Midwife, which of the following would you consider in determining the gestational age of a woman’s pregnancy?
I. Current fundal height
II. Foetal heart tone/beat first heard
III. Menstrual history
IV. Pregnancy test
A) II, III and IV
B) I, II and III
C) I, II, III and IV

83. Maame Efua Kubi had just entered the 4th stage of labour. Her general condition is without any deviations however she was anxious about the way she was sweating and passing copious urine. She wants to know if she has developed a complication. Your BEST response will be:
A) Medications given during labour causes excessive sweat and urination
B) Sweating happens when the woman has fever during labour therefore they produce copious urine
C) The woman’s body is working to reduce the amount of water accumulated because of the pregnancy

84. Madam Pokua was admitted in your facility in labour. On examination, the presentation was cephalic, membranes ruptured with meconium stained liquor and the FH rate was 100bpm. She was diagnosed as foetal compromise (foetal distress). What condition can predispose to foetal distress?
A) Ruptured membrane
B) Hypertonic uterine action
C) Hypotonic uterine action

85. You are a newly posted Midwife to Nkumim 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 you use to monitor the case?
A) Partograph
B) Labour chart
C) Nurses notes

86. Trial of labour is done for women with minor degree of cephalo-pelvic disproportion and a concern to the outcome of labour. Therefore, the outcome of labour depends on the ………………
A) Nature of the cervix
B) Degree of moulding of the foetal head
C) State of membranes

87. Pregnancy may be detected by a woman herself even before she has missed her period because she experiences some body changes. These changes could be probable signs of pregnancy which include ………………………………
A) Foetal heart sound
B) Osiander’s sign
C) Amenorrhoea

88. Mental health problems can complicate pregnancy. The following are emotional disturbances that complicate gestation EXCEPT:
A) Maternal blues
B) Mood disorders
C) Toxic delirium

89. The most important thing a Midwife should do after delivering a baby is to ………………….
A) Clean the baby
B) Clamp and cut cord
C) Give uterotonic drugs

90. A client was in the labour ward with induction. Contraction was adequate and client is progressing well. What would be your main concern?
A) The contraction
B) Urine output
C) Foetal heart rate

91. As a Charge Nurse, you assigned a student Midwife to observe a labouring woman. She later came to inform you that her cervical dilatation was 10cm. What would be your immediate action?
A) Confirm the dilatation
B) Set your delivery trolley
C) Position the woman

92. Araba Mensah was admitted with the history of lower abdominal pains, cervical dilation of 6cm, descent 3/5 above pelvic brim. On examination, the pulse rate was 98bpm, respiration 26cpm. There was presence of acetone in her breath and urine and distension of the bowels with gas. What is the possible diagnosis?
A) Obstructed labour
B) Obstetric shock
C) Maternal distress

93. Efiba Osei 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. With your knowledge in respectful maternity care, which of the following activities would you provide privacy and confidentiality when caring for Efiba?
I. Counselling on health issues
II. Physical examination
III. Handling of records
IV. Taking health history
A) II, III and IV
B) I, II and III
C) I, II, III and IV

94. Mrs. Nancy Arhin, a post-partum client reported to your facility with complains of general weakness in the lower limbs, pain in the lower abdomen which is aggravated when the baby sucks. Management of the after pain will include all the following actions EXCEPT:
A) Ensuring an empty bladder
B) Regulating the frequency of breast feeding
C) Administration of analgesics

95. Mrs. Akwele Adama G2P1+ aged 24 years was admitted at the Pitiku Health Center with the history of labour. On examination, the uterine contractions were 3 in 10 minutes lasting between 20–40 seconds, the descent 3/5 but there was no cervical dilation. What will be the possible cause of her condition?
A) Primary cervical dystocia
B) Obstructed labour
C) Secondary cervical dystocia

96. Madam Esi Atta G4P3AA aged 32 years reported of having seizures on and off, loss of appetite for one week and have been using some local alcoholic beverages to boost her appetite. On examination, there was some paleness on the face, BP of 150/100mmHg and tachycardia. Which of the following psychoactive substances may exhibit the above withdrawal signs in Madam Esi?
A) Alcohol
B) Heroin
C) Cocaine

97. At the 2nd stage room, you realized that your client would need vacuum extraction. What would you look for before continuing with the vacuum extraction?
A) Descent of the head
B) Cervical dilatation
C) Foetal heart rate

98. Mrs. Amissah 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, and frequency in micturition. What accounts for the urinary frequency during pregnancy?
A) Growing uterus compresses the bladder
B) It is due to urinary tract infection
C) It is evidence of gestational diabetes

99. Agnes Konadu 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 hormones serves as a basis for pregnancy test?
A) Human Placental Lactogen (HPL)
B) Human Chorionic Gonadotropin (HCG)
C) Human Chorionic Corticotrophin (HCC)

100. You are at Nkrakan Health Center and managing a labouring woman who delivered and had post-partum haemorrhage. You need to refer her for a better care but was alone. What would you do?
A) Ask a relative to accompany her
B) Ask an orderly to accompany her
C) Go with her to the referral point

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

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

NMC Past Questions on Medicine and Medical Nursing Set 10

401. Which of the following drug is derived from animal products?
A. Opium
B. Insulin
C. Halothane
D. Atropine

402. Intravenous pyelogram is an investigation used to:
A. Isolate bacteria in the urine
B. Identify tumours in the lumbar region
C. Exclude underlying abnormality of the renal tract
D. Identify the colour of pus from an abscess

403. A typical measle rash that appear inside the mouth and cheeks of a patient is called:
A. Koplik’s spots
B. Leyman’s spots
C. Rose spot
D. Ryle’s spot

404. The main symptoms of measles do not include:
A. Haematuria
B. Coryza
C. Fever
D. Conjunctivitis

405. The germs of bacillary dysentery are called:
A. Salmonella
B. Taeniae
C. Shigella
D. Candida

406. Salmonella typhi is carried by the bloodstream to special cells in the:
A. Lungs
B. Kidney
C. Liver
D. Pancreas

407. A typical rash that appear on the skin of a typhoid patient is called:
A. Koplik’s spot
B. Leyman’s spot
C. Rose spot
D. Ryle’s spot

408. Salmonella typhi is usually spread to man by:
A. Air only
B. Air and water
C. Water only
D. Water and food

409. The typhoid symptom of food poisoning is:
A. A long fever
B. Severe malaria
C. Abdominal pain
D. Pleuritic pain

410. In amoebic dysentery, a later complication is:
A. Severe diarrhea
B. Intestinal haemorrhage
C. Severe prostration
D. Liver abscess

411. Cholera is cured by:
A. Replacement of body fluids
B. Ingestion of spicy foods
C. Diet restriction
D. The use of antibiotics only

412. In botulism infection, the toxins paralyses:
A. Epithelial tissues
B. Nerve endings
C. All glands
D. Mucous lining

413. Tetanus is contracted by:
A. Contact with the skin
B. Consumption of contaminated food
C. Inhalation of droplets containing the bacillus
D. Exchange of body fluids during sexual intercourse

414. A patient with tetanus infection often dies from:
A. Destruction of nerve fibres
B. Spasms of mouth muscles
C. Destruction of blood
D. Spasms of respiratory muscles

415. Plague is transmitted to man by the bite of:
A. Rats
B. Dogs
C. Fleas
D. Pigs

416. Diphtheria is caused by:
A. Mycobacterium diphtheriae
B. Diphtheriae virus
C. Haemophilus diphtheriae
D. Corynebacterium diphtheriae

417. Diabetes mellitus is:
A. Not treatable
B. Curable
C. Not controllable
D. Treatable but not curable

418. Which of the following measures will involve a non-pharmacological treatment of acute myocardial infarction?
A. To ensure bed rest
B. To relieve pain
C. To treat complications
D. To prevent re-infarction

419. Acute myocardial infarction is typically characterized by a(n):
A. Reduced oxygen supply to the heart muscles
B. Damage of the heart muscle
C. Increase supply of nutrients containing prolactin
D. Decrease of blood supply to the heart muscles

420. The normal adult dosage of aspirin is:
A. 300mg
B. 0.2G
C. 600mg
D. 2G

421. Which of the following drugs is an anti-platelet?
A. Propranolol
B. Lisinopril
C. Aspirin
D. Nifedipine

422. Which of the following is a good example of a vasodilator?
A. Atenol
B. Lisinopril
C. Hydralazine
D. Nifedipine

423. Cells susceptible to HIV include one of the following:
A. Giant cells + CD4
B. Macrophages only
C. T lymphocytes + CD4
D. Buccal epithelium and astrocytes alone

424. The first case of AIDS appeared in:
A. 1978
B. 1878
C. 1981
D. 1991

425. The human immunodeficiency virus was isolated in:
A. 1978
B. 1983
C. 1986
D. 1948

426. In HIV infected patient, a complete blood count reveals:
A. Neutropenia, anaemia and thrombocytopenia
B. Leucopenia, prothrombin and cholestraemia
C. Normal blood count with low basophils
D. Abnormal blood count but increased neutrophils

427. Every patient suffering from HIV infection should also undergo for:
A. Syphilis serology
B. Serum prolactin
C. Liver biopsy
D. Culture and sensitivity test

428. Which of the following is a common sign of syphilis in its primary stage?
A. Condylomata lata
B. Condylomata acuminate
C. Chancre
D. Small eroded papules

429. Late syphilis is characterized by:
A. Chancre
B. Condylomata lata
C. Soft papules
D. Gummatous lesions

430. Late syphilis occurs:
A. Six weeks after appearance of secondary stage
B. Eight weeks after appearance of secondary stage
C. Two or more years after secondary stage
D. One year exactly after secondary stage

431. In syphilis vaginal chancres are:
A. Rare
B. Very common
C. Common
D. Absent

432. Lymphogranuloma Venereum is a disease caused by infective agent that belongs to the:
A. Lymphogranuloma-pallidum
B. Lymphogranuloma-psittacosis
C. Lymphadenoma pyogenes
D. Lymphadenoma ulcerans

433. The incubation period of lymphogranuloma venereum is:
A. 6 to 7 weeks
B. 4 to 5 weeks
C. 1 to 3 weeks
D. 2 to 4 weeks

434. Ringing in the ear is described as:
A. Buzzing sound
B. Vertigo
C. Otosclerosis
D. Tinnitus

435. In lymphogranuloma venereum, the common glands affected are found in the:
A. Axilla region
B. Cervical region
C. Inguinal region
D. Popliteal region

436. Diabetic ketoacidosis is common in:
A. Type I
B. Type II
C. Both Type I and II
D. None of them

437. In initial management of a diabetic mellitus, the patient should be given:
A. Glucose 5%
B. Glucose 50%
C. Sodium chloride (0.9%)
D. Dextrose saline

438. A simple non-toxic goiter is called:
A. Hyperthyroidism
B. Benign thyroid
C. Hypothyroidism
D. Endemic goiter

439. A common cause of cretinism is:
A. Hypoadrenalism
B. Hypothyroidism
C. Hyperadrenalism
D. Hyperadrenalism

440. Which of the following is a notifiable disease?
A. Leprosy
B. Coryza
C. HIV infection
D. Bird flu

441. Which of the following is a non-notifiable disease?
A. Influenza
B. Acute flaccid paralysis
C. Yellow fever
D. Meningitis