Answer All questions

MCQ’s Select the most correct answer.

1. The skills of the midwife include all these except;

a. Being a team member.
b. Research awareness.
c. Dependent action.
d. Evidence based practice.

2. The following are the responsibilities of the midwife except

a. Competence.
b. Record keeping.
c. Responsibility to the fetus only.
d. Responsibility to society.

3. The rewards of the midwife are the following except;

a. The salary.
b. The birth of an individual baby.
c. Continuity of care to the family.
d. The gratitude of the parents.

4. Ethically
a. The client is always right.
b. The doctor is always right.
c. The midwife is always right.
d. Who is right depends on the situation.

5. The term given to the care a couple planning a pregnancy gets is

a. Preconception care.
b. Pre-conceptual care.
c. Pre-pregnancy care
d. All of the above.

6. During pregnancy the following BMI is desirable

a. Less than 20.
b. 20 – 24.9
c. 25 – 29.9
d. Over 30.

7. The following are all issues to consider during pregnancy except

a. Exercise and relaxation.
b. Smoking.
c. Family planning.
d. Diet and nutrition.

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8. On antenatal examination, the following pre-existing medical conditions are of
extremely significant fetal importance except
a. Rheumatic fever.
b. TB.
c. DVT.
d. Malaria.

9. Under influence of progesterone the thickened mucus forms a cervical plug called
a. Colostrum.
b. Operculum.
c. Meconium.
d. Linoleum.

10. The following changes occur in the cardiovascular system during pregnancy
except
a. The heart muscle hypotrophies.
b. Cardiac output is increased.
c. Blood flow increas4es to the uterus, kidneys, breasts and skin.
d. Plasma protein concentration is reduced from 35 to 250/C.

11. In the urinary system

a. Under the influence of progesterone the ureters become relaxed.
b. UTI’s are uncommon in pregnancy.
c. The muscles of the bladder constrict due to progesterone.
d. Plasma levels of urea, creatinine and uric acid fall.

12. One of the skin changes is a patch on the face which is similar to a butterfly and is
known as ‘the mask of pregnancy’. The term a midwife would use is
a. Vernix caseosa.
b. Lanugo.
c. Chloasma.
d. Erythema rubra.

13. The female pelvis has the following functions

a. Permits the person to jump.
b. Transmits the weight of the trunk to the heel.
c. Gives protection to abdominal organs mainly.
d. Permits one to sit and kneel.

14. The normal female pelvis is

a. Platypelloid.
b. Gynecoid.
c. Android.
d. Anthropoid.

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15. The pelvis is comprised of …………… bones.
a. Three.
b. Four.
c. Five.
d. Eight.

16. The following is the correct order of the first 4 parts of the pelvic brim,
commencing posteriorly.
a. Sacral ala, sacral promontory, iliopectineal line, iliopectineal eminence.
b. Sacral promontory, sacral ala, sacroiliac joint, iliopectineal line.
c. Upper border of symphysis pubis, upper border of public bone, superior
ramus of pubic bone, iliopectineal eminence.
d. Upper border of symphysis pubis, upper border of pubic bone, superior
ramus of pubic bone, iliopectineal line.

17. Which shows the correct measurements of the pelvic outlet?

a. AP – 10, oblique – 11, Transverse – 12.
b. AP – 11, oblique – 12, Transverse – 13.
c. AP – 13, oblique – 12, Transverse – 11.
d. AP – 12, oblique – 12, Transverse – 12.

18. The false pelvis

a. Is the part below the outlet.
b. Is the part above the cavity.
c. Is the part where the fetus passes but cannot be measured.
d. Is the part above the brim.

19. The superficial layer of the pelvic floor is composed of …………….. muscles.
a. Three
b. Four
c. Five
d. Six

20. The vulva consists of the following structures except;

a. Labia majora.
b. Clitoris.
c. Vagina.
d. Bartholin’s glands.

21. The clitoris

a. Is a large rudimentary organ.
b. Is a small non-rudimentary organ.
c. Is highly a vascular.
d. Is extremely sensitive.

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22. The following are the lateral relations of the vagina except
a. Pelvic fascia.
b. Uterus.
c. Ureters.
d. Pelvic floor muscles.

23. The posterior wall of the vagina is ……….. cm long.

a. 7.5
b. 8
c. 9
d. 10

24. The blood supply to the uterus is from all these except
a. Internal iliac artery.
b. Ovarian artery.
c. Uterine artery.
d. Cervical artery.

25. The following are the structures of the fallopian tubes. Which is the odd one?
a. Isthmus
b. Ampulla
c. Anvil
d. Infundibulum.

26. The ovary is composed of

a. Medulla and cortex.
b. Germ and cortex.
c. Medulla and pith.
d. Medulla and core.

27. The ovum is situated at one end of the graffian follicle and is encircled by the
narrow
a. Perivitelline space.
b. Corona radiate.
c. Zona pellucida
d. Theca interna

28. Estrogen
a. Comprises a number of compounds like oestriol, oestrol and oestrone.
b. Is produced under the influence of FSH.
c. Has localized effects.
d. Is responsible for the primary sex characteristics.

29. The effects of progesterone are mainly evident

a. During the middle of the cycle.
b. During the first half of the cycle.
c. During the second half of the cycle.
d. During the middle of the cycle.
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30. Under the influence of the hypothalamus, the anterior pituitary gland produces the
following hormones
a. FSH
b. LH
c. FSH & LH and relaxin.
d. FSH, LH and prolactin

31. The proliferative phase of the menstrual cycle is also called the ……………
phase.
a. Secretory
b. Menstrual
c. Regenerative.
d. Reactive.

32. After fertilization and cell division have taken place a cluster of cells is formed
called the
a. Trophoblast.
b. Blastocyst.
c. Blastocele.
d. Morula.

33. The ectoderm mainly forms the

a. Skin.
b. Bones.
c. Mucous membranes.
d. Blood vessels.

34. The endoderm mainly forms the

a. Skin.
b. Bones.
c. Mucous membranes.
d. Blood vessels.

35. Mrs. Obayo is LNMP is 10th January 2005, her EDD is

a. 13th September 2005
b. 17th September 2005.
c. 17th October 2005.
d. 13th October 2005.

36. Mrs. Baruku had her LNMP on 18th April 2005. The date today is 9th August
2005. What are her weeks of amenorrhea? ……………………………….

37. The following are structures present in fetal circulation that are absent in adult
circulation except;
a. Umbilical artery.
b. Ductus venosus.
c. Foramen ovale.
d. Hypogastric arteries.
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38. This is the only vessel in the fetus which carries unmixed blood
a. Vena cava.
b. Umbilical vein.
c. Aorta.
d. Pulmonary artery.

39. On the fetal skull, which of the sutures listed below is wrong
a. Lambdoidal
b. Sagittal
c. Bregmatic
d. Frontal.

40. The desired diameter to cause engagement by the midwife is

a. Bitemporal.
b. Biparietal.
c. Submentovertical.
d. Submentobregmatic.

41. Which of these is not an advantage of using the condom

a. It prevents unwanted pregnancy.
b. It prevents against HIV/AIDS and STI’s.
c. It is nice to use because it interrupts sexual intercourse.
d. It does not interfere with ones hormonal levels.

42. The following are the functions of bladder care during labor.
1. A full bladder may initially prevent the fetal head from entering the pelvic
brim
2. later impede the descent of the fetal head
3. It will also inhibit effective uterine action
4. This may give rise to bruising which can slough during puerperium leaving a
vesicle vaginal fistula

Which of the statements is most correct?

a. 1, 2 and 4
b. 3 and 4
c. All the above
d. 1,2 and 3
e. 1 and 2

43. With the increasing use of assisted reproductive technology (ART) for
treatment of infertility, there is increased risk of ectopics. The following are the
common risk factors of ectopic pregnancy except:-
a. Previous genital infections
b. Salpingitis isthmica nodosa
c. Multiple sexual partners
d. First intercourse >18 years
e. Cigarette smoking
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44. Endometriosis is a common gynecologic problem in reproductive-age women who
may have all of the following symptoms except:-
a. pelvic pain
b. excessive weight gain
c. endometrial glands and stroma outside the endometrial cavity
d. infertility
e. dyspareunia

45. Miscarriage is the most common complication of pregnancy, occurring in at least

15% of clinically recognized pregnancies. Which of the following is the most likely
cause of miscarriages in early pregnancy?
a. such as abnormal germ cells
b. chromosomal abnormalities in the conceptus
c. defective implantation
d. accidental injuries to the fetus
e. All the above

46. Breast milk secretion is stimulated by:-

a. Oxcytocin
b Oestrogen
c. Prolactin
d. Human chorinic Gonadotrophin
e. Pancreatic hormones

47. Mrs Kwagala asked the midwife what to do if her baby developed a nappy rash. The
midwife should suggest which of the following as the best method to TREAT
nappy rash?
a. Use disposable diapers
b. Apply water solution ointment
c. Expose the buttocks to air and sun light
d. Feed the baby a low residue diet until the rash clears
e. Apply a salt solution

48. In advising Mrs Kwagala concerning the care of the umbilical cord stump, the
midwife should teach her to:-
a. Expose the cord stump to air to to promote drying
b. cover the cord stump with a soft sterile gauze dressing until it heals
c. Begin tab bathing as soon as the cord appears dry and is ready to fall off
d. Apply alcohol to the cord stump daily until healing has occurred
e. Apply a herbal concoction to the cord stump until it dries

49. The client asks the midwife. “where is the cancer usually found in the breast?” On a
diagram of the breast, the midwife would indicate that most malignant tumors
occur in which quadrant of the breast?
a. Upper outer quadrant
b. Upper inner quadrant
c. Lower outer quadrant
d. Lower inner quadrant
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50. Mrs Kabale had decided to breastfeed anna. Milk is produced in which of the
following structures of the breast?
a. Acini cells
b. Breast alveoli
c. Lactiferous sinuses
d. Montgomery tubercles

SECTION B
Answer all questions
1. Mrs X 28years came in labor like pains that started since yesterday
LNMP13/10/2009 .Reg.No.2010.D.O.A 21.7.2010 She is a Gravida 3para 2+0,
TRR .B/P110/70mm/hg Pulse 76bts/minute Past Obstetrical Hx 1st pregnancy 2006
SVD pregnancy was normal delivered male infant 3.7kgs, fully immunised alive and
well .Her previous delivery was by a ceasarian section due to fetal distress caused by
native medicine. She has been given a chance to deliver vaginally.O/E she had
moderate dehydration. P/abdomen ROP .At 9.00a.m she was 5cm dilated presenting
part 3/5 membranes intact. She was getting one 1-2contractions in 10 minutes lasting
20 secs. At 9.30a.m she had 2-3 lasting 30 secs. Moulding 0 liquor clear drained. At
9.30a.m she took 250mls of dry tea +sugar. At 9.50 a.m she took 300mls of dry tea
+sugar. At 10.30a.m she vomited 50mls (clear vomitus) At 11.00a.m presenting
part 2/5 dilatation was 7cm, 3-4 contractions lasting 30 seconds in 10 minutes
Urine tested Albumin 1+ Sugar Nil Acetone Nil
Questions:
(a) What is the best fluid for hydrating her? (2marks)
(b) What is her EDD? (2marks)
(c) Plot the above information on the partograph (5marks)
(d) How many weeks was she? (1mark)
(e) She has been given a chance to deliver vaginally? Write down the diagnosis
(2marks).
d) What are the outcomes of the above position? (Prolonged labor leading to a normal
delivery, Persistant Occipito-Posterior ending up face to pubis delivery or deep
transverse arrest) (4marks)
What are your nursing concerns to this mother? (4 marks)

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2. UTI is common in pregnancy. The main predisposing cause is stasis of urine,
and an increased susceptibility to ascending infection.
Question. Write short notes of how stasis comes about (10marks)

3. The mother in her second trimester presents with edema of pre-tibial, hands,
fingers, face, eyelids and abdominal wall. She also has blurred vision
a) What is the condition? (1mark)
b) What is the effect this condition on the mother? (3mark)
c) What is the management of this mother? (6marks)