NMC Past Questions on Midwifery Set 2

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