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M 104 - CLINICAL MANAGEMENT.

-OB EMERGENCIES,
HIGH RISK PREGNANCY MANAGEMENT
(Test 1)

Name: ________________________________________________________________
I.

Select the letter of the best answer. (8 pts.)

1. Which of the following is the most critical in lowering maternal mortalities?


Increasing
a) The proportion of pregnant women who knows the danger signals of pregnancy
b) The number and proportion of deliveries attended by a skilled health professional
c) The contraceptive prevalence rate among married couples in the country
d) The number and proportion of mothers visited 24 to 48 hours after delivery
2. All of the following are root causes of why the Philippines has a high maternal
mortality ratio. Which one is the most important of root causes to be solved so that
maternal deaths will be prevented?
a) Low national budget for health
b) Rights of women not upheld
c) Lack of support and political commitment from local government officials
d) Poor socio economic situation of pregnant women
3. The quality of antenatal care is best determined by the presence of the following
services:
a) Breastfeeding advisory, family planning advisory and nutrition counseling
b) Tetanus toxoid immunization, iron-folate supplementation, complete blood count
c) Advisory on danger signals of pregnancy and labor, birth plan and money savings for
delivery
d) Blood pressure taking, urinalysis, weight and height measurement
4. The most common reasons cited by health providers and community members why
there is delay among pregnant women in deciding to seek care are:
a) Failure of midwife and mother to recognize danger signals, lack of money to pay for
transport and medical expenses and lack of encouragement from family and
neighbors to seek care
b) High cost of antenatal care and birth delivery services, fear of being ill treated in the
health facility, lack of companion in going to the referral facility
c) Poor quality of antenatal care, the pregnancy is unplanned and unwanted, reluctance
on the part of the mother or her family due to cultural constraints
d) The woman or family member is not capable of making a decision whether to seek
care or not, no available person to take care of the children, the home and the
livestock

5. The second delay is the delay and identifying and reaching the appropriate health
facility. This second delay is mostly due to:
a) Lack of awareness by the mother and the skilled birth attendant of where the referral
health facilities are
b) Lack of an effective referral system in the district and province where the mothers
barangay is located
c) Lack of support from family, neighbors and barangay officials to provide transport to
the referral health facility
d) Lack of roads and transportation network from the mothers home to the referral
health facility
6. Delay in receiving appropriate and adequate care at the referral health facility is
the third delay why women die due to pregnancy and childbirth. Which of the
following reasons should be resolved first to prevent the third delay?
a) Lack of skilled health professionals in providing emergency obstetrical care
b) Lack of LGU support to ensure referral facility has complete facilities and trained
health personnel
c) Unprofessional attitudes of health professionals in the referral facility
d) Shortages of supplies and equipment not maintained or upgraded in the referral
facility
7. Which of the following elements and factors are most crucial in making a successful
maternal and newborn care?
a) Mayor and Sanggunian Bayan supportive of safe motherhood, at least one district
hospital with CEmONC facilities, community based midwives covering 2 to
barangays
b) a community based mothers organization, barangay councils resolution on support
for transportation and blood donors for pregnant women, community plans for safe
motherhood
c) rural health team committed to lowering maternal mortalities, regular maternal death
reviews with the Barangay Captain and Council and provincial hospital with
CEmONC for referral
d) Sentrong Sigla certified RHU and BHS, more than 70% of couples in barangay using
modern family planning, all poor families covered by PhilHealth sponsored program
8. The best support system to ensure a sustainable maternal and newborn care in a
municipality is:
a) a 100% increase in the national health budget only for safe motherhood and newborn
health
b) Mayor and Sanggunian Bayan create budget line items for resident midwives in all
barangays of the municipality and universal coverage of PhilHealth of all families in
the municipality
c) Province and all municipalities in the province declared priority area for decreasing
maternal mortalities as part of governments commitment to Millennium Development

Goals #4 and #5
d) Presidential Proclamation supportive of community managed maternal and newborn
care in all barangays of the Philippines

II.

On the spaces provided for, write T if the statement is true and F if false.
(10 pts.)

_________1. At 8-9 months of pregnancy, a woman should eat less food than what she
regularly takes to prevent the baby from getting too big, which may result
to difficult labor
_________2. Malaria causes low birth weight.
_________3. Tetanus toxoid immunization protects the mother from getting tetanus.
_________4. Avoiding strenuous activities and taking a nap in the middle of the day
during pregnancy will help the baby in the mothers womb to grow.
_________5. Sexual intercourse during pregnancy is harmful.
_________6. A pregnant woman, who is obese, has a family history of diabetes, and an
apparently large baby should be referred immediately to a BEmONC
facility for glucose screening.
_________7. A blood pressure of 140/90 mm Hg is normal.
_________8. Health facility delivery is safer than home delivery.
_________9. A hemoglobin of 10 mg/dl is normal for a pregnant woman.
_________10. A pregnant woman should have at least four prenatal care visits.

III. Choose the best answer/s. Write the letter before the statement of your choice
on the spaces provided for. (10 pts.)
_________1.When NOT to do an internal vaginal exam of a pregnant woman in labor.
a. As part of the initial examination upon arrival of the woman in the health facility
and every four hours thereafter.
b. If the woman is bleeding, to determine the cause.
c. To determine the stage of labor.
d. To determine progress of labor.
_________2. The following statements about the first stage of labor (not yet in active
labor) are true except:

a.
b.
c.
d.

Cervix is 0-3 cm dilated.


Contractions are less than 2 in 10 minutes.
Emergency signs are checked every hour.
Temperature, blood pressure and cervical dilatation are checked hourly.

_________3. Which of the following statement/s about labor is/are correct?


a. Pushing/bearing down by the woman during the first stage speeds up delivery.
b. A woman in labor may eat and/or drink as she wishes.
c. It is alright to give medications to speed up labor to prevent the woman from
becoming exhausted.
d. Massaging the perineum will help it to thin out and thereby prevent lacerations.
_________4. The following statements about delivery of the placenta are true except:
a. Never apply cord traction without applying counter traction above the pubic bone
with the other hand.
b. Always use gentle traction to pull the placenta.
c. Do not squeeze or massage the abdomen to deliver the placenta.
d. Do a manual exploration of the uterus after the delivery of the placenta as a
routine procedure.
_________5. Which statement/s regarding oxytocin is/are correct?
a. It prevents postpartum hemorrhage.
b. It is administered right after the delivery of the baby and before the delivery of the
placenta.
c. It is administered right after the delivery of the placenta.
d. It is administered to speed up a normal labor.
_________6. The best way to keep a newborn warm is by:
a. Wrapping the baby in a blanket (mummy style)
b. Long sleeved clothing, mittens and cap over the head
c. Skin to skin contact with the mother, baby on her chest and covered with a
blanket
d. Closing the door and all windows of the room to keep cold away
_________7. If partograph passes alert line, do the following except:
a. Reassess woman and consider criteria for referral.
b. Empty urinary bladder.
c. Encourage upright position and walking if woman wishes.
d. Monitor woman and wait until partograph passes action line to alert transport
services.
_________8. The following are the requirements for internal vaginal examination
except:
a. Womans consent
b. Washing examiners hands thoroughly with soap and water before examination
c. Sterile gloves

d. Washing of vulva and perineum before each examination


_________9. The normal fetal heartbeat is
a. 80-160 per minute
b. 100-180 per minute
c. 120-180 per minute
d. 140-180 per minute
_________10. What will you do in case of emergency delivery and you do not have
available gloves?
a. Wash hands thoroughly with soap and water and proceed with the internal
vaginal examination.
b. Do away with internal vaginal examination and use all other indicators for
monitoring labor.
c. Ask the womans partner to buy gloves from the town pharmacy four kilometers
away.
d. Use plastic bag instead of gloves for internal vaginal examination.

IV. Enumeration (22 pts)


1. Define quick check and state its purpose. (5 pts.)

2. Enumerate at least 5 emergency signs in the mother. (5 pts.)


1.
2.
3.
4.

5.

3. Enumerate at least 7 danger signs in the newborn.((7 pts)


1.
2.
3.
4.
5.
6.
7.

4. Enumerate the at least 5 capabilities of a Basic Emergency Obstetric& Newborn


Care (BEmONC) Facility. (5 pts.)
1.
2.
3.
4.
5.
.
V. Fill the tables below: (50 pts)
Prenatal Care (10 pts.)
Minimum number of visits

Schedule

Postpartum Care (10 pts)


Minimum number of visits
Schedule

Micronutrient Supplementation and Medication during Prenatal Care (30 pts)


Supplement/Medication
Dosage/Schedule
Purpose
1.

2.

3.

4.

5.