NMC Past Questions on Midwifery Set 4

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