OBSTETRICS AND GYNAECOLOGY

INDEX
S.NO. TOPIC NAME

OBSTETRICS AND GYNAECOLOGY

1. FEMALE REPRODUCTIVE SYSTEM
2. FUNDAMENTAL OF REPRODUCTION
3. MENSTRUAL CYCLE
4. PLACENTA & UMBLICAL CORD
5. AMNIOTIC FLUID
6. ANTE NATAL CARE
7. DIAGNOSIS OF PREGNANCY
8. FEMALE PELVIS AND FETAL SKULL
9. LABOUR
10. PUERPERIUM
11. POSTPARTUM HEMORRHAGE
12. ABORTION
13. ECTOPIC PREGNANCY
14. MOLAR PREGNANCY
15. ANTEPARTUM HEMORRHAGE
16. HYPERTENSIVE DISORDER
17. POST MATURITY
18. PROM, PRETERM LABOR& PRECIPITATED LABOR AND IUD
19. MULTIPLE PREGNANCY
OPERATIVE OBSTETRICS, CEASARIAN SECTION &
20. EPISIOTOMY
21. HYPEREMESIS GRAVIDARUM
22. PHARMACOLOGY
23. GYNAECOLOGY

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OBSTETRICS AND GYNAECOLOGY
12. True support of uterus
FEMALE REPRODUCTIVE SYSTEM (a) Broad ligament (b) Round ligament
(c) Cardinal ligament (d) Uterosacral ligament
13. Blood supply of the uterus is by
1. Vulva consists of:
(a) Ovarian artery (b) Uterine artery
(a) Uterus and fallopian tube
(c) Both (d) None of the above
(b) Uterus, cervix and fallopian tube
14. Uterine artery is a branch of:
(c) Ovary, uterus, vagina and cervix
(a) Abdominal aorta (b) External iliac artery
(d) Labia majora, labia minora and clitoris
(c) Femoral artery (d) Internal iliac artery
2. Inflammation of the fallopian tube is:
15. The layer of uterus that is sloughed off during
(a) Endometritis (b) Salpingitis
menstruation is
(c) Cervicitis (d) Vaginitis
(a) Endometrium (b) Myometrium
3. Nerve supply to vulva is through:
(c) Perimetrium (d) Serous layer
(a) Ilioinguinal nerve (b) Pudendal nerve
16. The origin of the ovaries is from
(c) Genitofemoral nerve (d) All of the above
(a) Genital ridge (b) Genital tubercle
4. The structure that provides a pad of fatty
(c) Wolffian duct (d) Mullerian duct
tissue for the external female genitalia is:
17. Ovarian artery is a branch of
(a) Perineum
(a) Renal artery
(b) Labia minora and majora
(b) Internal iliac artery
(c) Mons pubis
(c) Part of the abdominal aorta
(d) Vulva
(d) External iliac artery
5. Identify the part of uterus among the
18. Arrange the part of fallopian tube from medial
following?
to lateral order
(a) Body (b) Isthmus
(A) Interstitial
(c) Cervix (d) All of the above
(B) Isthmus
6. The most common anatomical position of
(C) Ampulla
uterus is.
(D) Infundibulum
(a) Anteverted and antiflexed
(a) A, B, C, D
(b) Retroverted and retroflexed
(b) D, C, B, A
(c) Retroverted and antiflexed
(c) A, C, B, D
(d) Antiverted and retroflexed
(d) B, D, A, C
7. The lower uterine segment is formed from
19. Go through the following statements
the.......
regarding fallopian tube and identify the
(a) Cervix (b) Isthmus and cervix
incorrect statement
(c) Body of the uterus (d) Isthmus
(a) Serosa, muscular and mucosa are the layers of
8. Structures that support the uterus
tube
include..............
(b) Columnar ciliated epithelium is predominant
(a) Round ligament
in fallopian tube
(b) Broad ligament
(c) Uterine and ovarian artery supply blood to it
(c) Cervicovaginal junction
(d) The main function is to produce ova
(d) All of the above
20. Pacemaker of uterine contraction is
9. The strongest ligament in the female pelvis is:
(a) Tubal Ostia
(a) Reverse cervical (b) Oblique cervical
(b) SA node
(c) Transverse cervical (d) None
(c) AV node
10. At term uterus weight is
(d) Purkinje fibers
(a) 200-300 gm (b) 400-500 gm
ANSWER KEY
(c) 600-700 gm (d) 900-1000 gm
11. The shape non-pregnant uterus is 1. [d] 2. [b] 3. [d] 4. [c] 5. [d]
(a) Globular 6. [a] 7. [b] 8. [d] 9. [c] 10. [d]
(b) Pear shaped (pyriform) 11. [b] 12. [c] 13. [c] 14. [d] 15. [a]
(c) Oval 16. [a] 17. [c] 18. [a] 19. [d] 20 [a]
(d) Cylindrical ❑❑❑

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OBSTETRICS AND GYNAECOLOGY
9. Spermiation is the process of the release of
FUNDAMENTAL OF REPRODUCTION sperms from
(a) Seminiferous tubule
1. How many autosomes does a human primary (b) Vas deferens
spermatocyte have? (c) Epididymis
(a) 34 (b) 44 (d) Prostate gland
(c) 54 (d) 46 10. Which among the following has 23
2. The hormone that is released from the testes chromosomes?
is ______ (a) Spermatogonia
(a) Progesterone (b) Vasopressin (b) Zygote
(c) Testosterone (d) None of the above (c) Secondary oocyte
3. Wolffian duct is also known as ____________ (d) Oogonia
(a) Mesonephric duct 11. Which of the following hormones is not
(b) Ejaculatory duct secreted by human placenta?
(c) Major sublingual duct (a) HCG
(d) Cystic duct (b) Estrogens
4. Acrosome is filled with _________ (c) Progesterone
(a) Lipids (d) LH
(b) Hormones 12. Which of the following is correct about
(c) Digestive enzymes mammalian testes?
(d) None of the above (a) Graafian follicles, Sertoli cells, Leydig’s cells
5. After ovulation Graafian follicle regresses into (b) Graafian follicles, Sertoli cells, seminiferous
(a) Corpus atresia tubules
(b) Corpus callosum (c) Sertoli cells, seminiferous tubules, Leyding’s
(c) Corpus luteum cells
(d) Corpus albicans (d) Graafian follicle, leyding’s cells, seminiferous
6. Which one of the following events is correctly tubule
matched with the time period in a normal 13. In humans, at the end of the first meiotic
menstrual cycle? division, the male germ cells differentiate into
th
(a) Release of egg : 5 day the
(b) Endometrium regenerates: 5 – 10 days (a) Spermatids
(c) Endometrium secretes nutrients for (b) Spermatogonia
implantation: 11 – 18 days (c) Primary spermatocytes
(d) Rise in progesterone level: 1 – 15 days (d) Secondary spermatocytes
7. If mammalian ovum fails to get fertilized, 14. How many sperms are formed from a
which one of the following is unlikely? secondary spermatocyte?
(a) Corpus luteum will disintegrate (a) 4
(b) Progesterone secretion rapidly declines (b) 8
(c) Estrogen secretion increases (c) 2
(d) Primary follicle starts developing (d) 1
8. In oocyte secondary maturation occurs in 15. How many sperms are formed from 4 primary
(a) ovary spermatocytes?
(b) Abdominal cavity (a) 4
(c) Fallopian tube (b) 1
(d) Uterus (c) 16
(d) 32
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OBSTETRICS AND GYNAECOLOGY
16. In spermatogenesis, reduction division of
chromosome occurs during conversion of MENSTRUAL CYCLE
(a) Spermatogonia to primary spermatocytes
(b) Primary spermatocytes to secondary 1. Which gland is responsible for initiating the

spermatocytes menstrual cycle?

(c) Secondary spermatocytes to spermatids (a) Hypothalamus

(b) Anterior pituitary gland (APG)
(d) Spermatids to sperms
(c) Posterior pituitary gland (PPG)
17. Which of the following groups of cells in the
(d) Ovaries
male gonad, represent haploid cells?
2. The entire transitional phase between sexual
(a) Spermatogonia cells
maturity and menopause is called:
(b) Germinal epithelial cells
(a) Menarche
(c) Secondary spermatocytes (b) Puberty
(d) Primary spermatocytes (c) Thelarche
18. The process of release of spermatozoa from (d) Climacteric
Sertoli cells into cavity of the seminiferous 3. Menarche is:
tubules is called (a) The entire span of the menstrual cycle from
onset to menopause
(a) Spermiogenesis
(b) A girl's first menstruation
(b) Spermatogenesis
(c) The first year of menstruation which usually
(c) Spermatocytogenesis occurs without ovulation
(d) Spermiation (d) The onset of uterine maturation
19. 1st polar body is formed at which stage of 4. Average age of menarche is........
oogenesis? (a) 10 years
(a) 1st meiosis (b) 13 years
(b) 2nd mitosis (c) 16 years
(c) 1st mitosis (d) 19 years
(d) Differentiation 5. Delayed puberty is............
20. Which one is released from the ovary? (a) The absence of testicular development by the
(a) Primary oocyte age 14 years in male
(b) Secondary oocyte
(b) The absence of breast development by the age
(c) Graafian follicle
of 13 years in females
(d) Oogonium
21. During oogenesis, each diploid cell produces (c) Primary amenorrhea with normal breast
(a) Four functional eggs development by the age of 15 in females
(b) Two functional eggs and two polar bodies (d) All of the above
(c) One functional egg and three polar bodies 6. LMP of a woman who has 28 days regular cycle
(d) Four functional polar bodies is March 31, 2020. The next ovulation day is
22. In oogenesis haploid egg is fertilized by sperm
most likely to be
at which stage ?
(a) Primary oocyte (a) April 17, 2020
(b) Secondary oocyte (b) April 15, 2020
(c) Oogonium (c) April 13, 2020
(d) Ovum (d) April 11, 2020
ANSWER KEY 7. Mild premenstrual syndrome can be treated
1. [b] 2. [c] 3. [a] 4. [c] 5. [c] with
6. [b] 7. [c] 8. [c] 9. [a] 10. [c]
(a) Anxiolytics
11. [d] 12. [c] 13. [d] 14. [c] 15.[c]
(b) Dietary advice, exercise
16. [b] 17. [c] 18. [d] 19. [a] 20. [b]
(c) Vitamins and mineral supplements
21. [c] 22. [b]
❑❑❑ (d) Antidepressants

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OBSTETRICS AND GYNAECOLOGY
8. Hormonal influence of menstrual cycle 17. Menorrhagia is caused by........
includes............. (a) Fibroid uterus
(a) Ovarian hormones (b) Adenomyosis
(b) Uterine hypoplasia and contraction (c) Dysfunctional uterine bleeding
(c) Hypothalamic releasing hormones (d) All of the above
(d) All of the above 18. A condition in which prolonged or excessive
9. Primary dysmenorrhea is caused by uterine bleeding occurs irregularly and more
(a) Narrowing of the cervical canal frequently than normal is known as
(b) Uterine hypoplasia and contraction (a) Menorrhagia (b) Metrorrhagia
(c) Increased vasopressin release (c) Menometrorrhagia (d) Epimenorrhoea
(d) All of the above 19. Hypomenorrhoea is caused by..............
10. Abnormal bleeding between the menstrual (a) Endometrial tuberculosis
period is known as? (b) Excessive exercise
(a) Menorrhagia (c) Uterine synechiae
(b) Metrorrhagia (d) All of the above
(c) Polymenorrhea 20. Dysmenorrhea is due to
(d) Dysmenorrhea (a) Ovulation
11. Absence of a menstrual period in a woman of (b) Decreased progesterone
reproductive age is known as (c) Increased progesterone
(a) Hypomenorrhoea (d) Secretory epithelium
(b) Amenorrhea 21. A condition in which the menstruation occurs
(c) Dysmenorrhea but is not worse of an obstruction of the
(d) Eumenorrhoea outflow tract is known as
12. Short and scanty periods that lasts for less (a) Cryptomenorrhoea
than 2 days is known as (b) Dysmenorrhea
(a) Amenorrhea (c) Xerocolpos
(b) Hypomenorrhoea (d) Menorrhagia
(c) Menorrhagia 22. Commonest cause of cryptomenorrhoea is
(d) Metrorrhagia (a) Recto vaginal fistula
13. Too frequent menstruation, occurring at any (b) Imperforate hymen
time but particularly at the beginning and end (c) Adhesions
of menstrual life is known as (d) Cervical stenosis
(a) Metrorrhagia 23. Failure of menses to occur by age 16 years, in
(d) Epimenorrhoea the presence of normal growth and secondary
(c) Hypermenorrhoea sexual characteristics is known as
(d) Polymenorrhea (a) Primary amenorrhea
14. Increased uterine blood flow occurring at (b) Secondary amenorrhea
regular intervals or loss of more than 80 mL of (c) Dysmenorrhea
blood is called as (d) Menorrhagia
(a) Epimenorrhoea 24. Secondary amenorrhea is
(b) Menorrhagia (a) Cessation of regular menses for three months
(c) Cryptomenorrhea (b) Cessation of regular menses for six months
(d) Metrorrhagia (c) Both (a) & (b)
15. Epimenorrhoea is also known as............ (d) Absence of menses for more than one year
(a) Menorrhagia ANSWER KEY
(b) Polymenorrhea 1. [a] 2. [d] 3. [b] 4. [b] 5. [d]
(c) Metrorrhagia 6. [c] 7. [b] 8. [d] 9. [d] 10. [b]
(d) Dysmenorrhea 11. [b] 12. [b] 13. [d] 14. [b] 15. [b]
16. Abnormally heavy bleeding at menstruation is 16. [a] 17. [d] 18. [c] 19. [d] 20. [b]
known as 21. [a] 22. [b] 23. [a] 24. [c]
(a) Menorrhagia (b) Metrorrhagia ❑❑❑
(c) Polymenorrhea (d) Dysmenorrhea

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OBSTETRICS AND GYNAECOLOGY
8. One or more lobes of the placenta placed at
PLACENTA varying distance from the main placental
region is known as........
(a) Placenta succenturiata
1. The abnormal condition in which the umbilicus
(b) Placenta extrachorialis
is inserted through the membranes of
(c) Placenta membranecae
placenta is known as:
(d) Battledore placenta
(a) Succenturiate
9. What is velamentous placenta?
(b) Battledore
(a) Fibrous ring present at the margin of placenta
(C) Marginal
(b) Placenta is thin and large
(d) Velamentous
(c) Cord is attached to the membranes
2. The placental abnormalities in which, the
(d) Cord is attached to the margin of the placenta
accessory lobe is developed from the activated
10. Morbidly adherent placenta is called as:
villi on the chorionic laeve is:
(a) Battledore placenta
(a) Placenta Succenturiata
(b) Placenta accreta
(b) Placenta Spuria
(c) Placenta succenturiata
(c) Placenta extrachorialis
(d) Placenta circumvallate
(d) Placenta marginata
11. Omphalitis is:
3. The placental abnormalities in which, a thin
(a) Abdominal sepsis
fibrous ring is present at the margin of the
(b) Placental sepsis
chorionic plate where the fetal vessels appear
(c) Peritoneal sepsis
to terminate is:
(d) Umbilical sepsis
(a) Circumvallate placenta
12. At term approximate placental weight is…
(b) Placenta membranecae
(a) 300 gm
(c) Placenta marginata
(b) 500 gm
(d) Placenta Spuria
(c) 700 gm
4. Premature separation of a normally implanted
(d) 900 gm
placenta during the second half of pregnancy,
13. Fetal origin of placenta is.........
usually with severe hemorrhage is known as:
(a) 1/5th
(a) Placenta previa
(b) 2/5th
(b) Ectopic pregnancy
(c) 3/5th
(c) Incompetent cervix
(d) 4/5th
(d) Abruptio placenta
14. The umbilical cord is attached to the placental
5. In which condition, the umbilical cord is
margin in
attached to the margins of placenta?
(a) Placenta succenturiata
(a) Battledore placenta (b) Battledore placenta
(b) Circumvallate placenta (c) Circumvallate placenta
(c) Placenta membranacea (d) Placenta accreta
(d) Velamentous placenta 15. Placenta has more than one lobe and may be
6. What is the proportionate weight of the placed at varying distance from main
placental margin is...............
placenta to the baby at term?
(a) Placenta succenturiata
(a) 1:2
(b) Battledore placenta
(b) 1:4 (c) Circumvallate placentae
(c) 1:6 (d) Placenta accreta
(d) 1:8
7. Umbilical cord is attached to ANSWER KEY
(a) Fetal surface of placenta 1. [d] 2. [a] 3. [c] 4. [d] 5. [a]
(b) Maternal surface of placenta 6. [c] 7. [d] 8. [a] 9. [c] 10. [b]
(c) Near to the center of the surface 11. [d] 12. [b] 13. [d] 14. [b] 15. [a]
(d) Both A and C ❑❑❑

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OBSTETRICS AND GYNAECOLOGY

UMBLICAL CORD AMNIOTIC FLUID

1. Umbilical cord is attached to 1. At 12th weeks of gestation amniotic fluid

(a) Fetal surface of placenta measures about-
(b) Maternal surface of placenta (a) 40 ml
(c) Near to the center of the surface (b) 50 ml
(d) Both A and C (c) 60 ml
2. What is velamentous placenta? (d) 70 ml
(a) Fibrous ring present at the margin of placenta 2. Main carbohydrate in amniotic fluid is......
(b) Placenta is thin and large
(a) Glucose
(c) Cord is attached to the membranes
(d) Cord is attached to the margin of the placenta (b) Fructose
3. Acordia is.......... (c) Lactose
(a) Absence of cord (b) Lengthy cord (d) Maltose
(C) Short cord (d) Twisted cord
3. The functions of amniotic fluid are:
4. Gelatinous substance in the umbilical cord is
known as
A. Protects fetus from jarring and injury
(a) Wharton's jelly (b) True knot B. Maintains intrauterine temperature
(c) False knot (d) Vernix caseosa C. Provides nutrients to fetus
5. Reason behind false knot in umbilical cord D. Protects the placenta and umbilical cord
is...............
(a) A, B, C
(a) Accumulation of Wharton's jelly
(b) Accumulation of amniotic fluid (b) B, C, D
(c) Accumulation of blood (c) A, C, D
(d) Dilation of umbilical blood vessels (d) A, B, C, D
6. Omphalitis is: 4. What is the normal color of amniotic fluid
(a) Abdominal sepsis (b) Placental sepsis
when the water ruptures?
(c) Peritoneal sepsis (d) Umbilical sepsis
7. Short cord; if the length of the umbilical cord is (a) Clear
less than................ (b) Greenish
(a) 10 cm (b) 20 cm (c) Brownish
(c) 35 cm (d) 40 cm
(d) Golden
8. Complications of long umbilical cord include
5. Golden color of amniotic fluid seen in-
(a) Cord prolapse (b) Cord entanglement
(c) Fetal distress (d) All of the above (a) Rh- Incompatibility
9. Most commonly single umbilical artery is seen (b) Fetal death
in................... (c) IUGR
(a) Abruptio placenta (b) Placenta previa
(d) Fetal distress
(c) Multiple birth (d) Battledore placentae
10. The umbilical vein carries............. 6. Polyhydramnios pour in all of the following
(a) Oxygenated blood (b) Deoxygenated blood EXCEPT...............
(c) Mixed blood (d) All of the above (a) Diabetes mellitus
11. Cord prolapse is.................... (b) Anencephaly
(a) When umbilical cord comes out of the vagina
(c) Multiple pregnancies
after delivery
(b) Lengthy cord visible first in the USG (d) Renal agenesis of fetus
(c) Cord lying behind the fetus 7. Identify correct statement regarding amniotic
(d) Umbilical cord comes out of the uterus with or fluid
before the presenting part of the fetus (a) Maintains optimum temperature of the fetus
ANSWER KEY
(b) Contains fetal urine, fetal lanugo and epithelial
1. [d] 2. [c] 3. [a] 4. [a] 5. [a]
cells
6. [d] 7. [c] 8. [d] 9. [c] 10. [a]
(c) Provides cushion against injury to the fetus
11. [d]
❑❑❑ (d) All of the above
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OBSTETRICS AND GYNAECOLOGY
8. Polyhydramnios’s is a condition when the
amniotic fluid volume exceeds more than ANTE NATAL CARE
..............ML.
1. The amount of elemental iron in one iron tablet
(a) 1000
for mother is:
(b) 1500 (a) 60 mg (b) 60 g
(c) 2000 (c) 50 g (d) 50 mg
(d) 2500 2. A Nurse is caring for a 16–year–old pregnant
9. Amniotic fluid volume during pregnancy client. The client is taking an iron supplement.
What should this client drink to increase the
is............................
absorption of iron?
(a) 500-700ml (a) A cup of hot coffee (b) A glass of milk
(b) 700 -1000ml (c) A glass of orange juice (d) Antacid solution
(c) 1000 -1500ml 3. Which among the following is correct regarding
(d) Above 1500ml iron supplementation?
(a) Take it along with milk
10. An amniotic fluid index of less than 5 cm
(b) Take it along with lemon juice
indicates: (c) Take it along with water
(a) Anhydramnios (d) Take it after having food
(b) Hydramnios 4. Most widely used oral iron preparation during
pregnancy is:
(c) Polyhydramnios
(a) Ferrous gluconate (b) Ferrous sulphate
(d) Oligohydramnios (c) Ferrous fumarate (d) Ferrous succinate
11. Oligohydramnios is a condition when amniotic 5. A prenatal client with a history of heart disease
fluid is less than: has been instructed on care at home. Which
(a) 75 mL at term statement if made by the client would indicate
that the client understand her needs?
(b) 100 mL at term
(a) There is no restriction on people who visit me
(c) 150 mL at term (b) I should avoid stressful situations
(d) 200 mL at term (c) My weight gain is not important
12. Amniotic Fluid Index (AFI) is measured by (d) I should rest on my right side
(a) Abdominal girth 6. Constipation may be a problem during
pregnancy due to proximity of the rectum and
(b) Ultrasonography
uterus. Rectum is located
(c) Leopold maneuver (a) In front of the uterus
(d) Ballottement (b) At the back of the uterus
13. What is the normal color of amniotic fluid (c) To the left of the uterus
when the bag of waters ruptures? (d) Above the uterus
7. What is the common cause of constipation
(a) As like water
during pregnancy?
(b) Bluish (a) Lack of fluid intake
(c) Brownish (b) Decreased fiber intake
(d) Yellowish (c) Reduced intestinal motility
(d) Lack of activity
8. Which of the following instructions should nurse
ANSWER KEY
give to a client who is 26 weeks pregnant and
1. [b] 2. [a] 3. [d] 4. [a] 5. [a]
complain of constipation?
6. [d] 7. [d] 8. [c] 9. [b] 10. [d] (a) Encourage her to increase intake of roughage
11. [d] 12. [b] 13. [a] and to drink at least six glasses of water per day
❑❑❑ (b) Tell her to go to the evaluation unit because
constipation may cause contractions
(c) Tell her to ask her caregiver for a mild laxative
(d) Suggest the use of an over–the–counter stool
softener

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OBSTETRICS AND GYNAECOLOGY
9. Which of the following diseases may result in 18. As a client progresses through pregnancy, she
serious teratogenic defect in offspring? develops constipation. The primary cause of this
(a) Rubella (b) Rubeola problem during pregnancy is
(c) Variola (d) Varicella
(a) Decreased appetite
10. The nurse preparing to administer the Rubella
vaccine to a two days postpartum woman. The (b) Inadequate fluid intake
nurse should caution the client to avoid: (c) Prolonged gastric emptying
(a) Sunlight for 3 days (d) Reduced intestinal motility
(b) Scratching the injection site 19. What can be the cause of low estradiol level
(c) Pregnancy for 2 to 3 months after the vaccine
during pregnancy?
(d) Sexual intercourse for 2 to 3 months after the
vaccination (a) Trisomy 18 (b) Down syndrome
11. A Primigravida client at 25 weeks gestation visits (c) Neural tube defect (d) All of the above
the clinic and tells the nurse that her lower back 20. A women is now at 16 weeks of gestation. After
aches when she arrives home from work. The how many weeks of gestation the midwife need
nurse should suggest that the client perform:
to instruct the women to return for a follow up
(a) Leg lifting (b) Tailor sitting
visit?
(c) Side lying (d) Squatting exercises
12. Injection TT is given to pregnant women to (a) One (b) Two
prevent: (c) Three (d) Four
(a) Typhoid (b) Maternal tetanus 21. Calcium requirement during pregnancy is
(c) Neonatal tetanus (d) Both b and c (a) 15 gm/day (b) 20 gm/day
13. WHO recommended minimum antenatal visit in (c) 25 gm/day (d) 30 gm/day
the developing country is.........
22. Additional amount of calorie that should be
(a) 3 (b) 4
taken by a pregnant woman
(c) 6 (d) 8
14. Identify the incorrect statement regarding (a) 300 Kcal
immunization in pregnant woman (b) 500 Kcal
(a) Live vaccines are contraindicated in pregnancy (c) 1000 Kcal
(b) Immunization against tetanus can be given
(d) 100 kcal
(c) Tetanus immunization protect both mother and
23. Folic acid deficiency during the pregnancy will
baby
(d) 3 dose of tetanus one in each trimester is lead to..................
recommended (a) Exstrophy bladder
15. Which of the following vaccine is contraindicated (b) Esophageal atresia
in pregnancy? (c) Neural tube defect
(a) Measles (b) Rubella
(d) Congenital diaphragmatic hernia
(c) Varicella (d) All of the above
16. As per Govt. of India guidelines, the 24. Pallor, bradycardia, sweating, nausea,
recommended daily dose of elemental iron for hypotension and dizziness occurs when a
prophylaxis during pregnancy pregnant woman lies on her back is known
(a) 50 mg/day for 100 days as……..
(b) 50 mg/day for 150 days (a) Malignant hypothermia
(c) 100 mg/day for 100 days
(b) Orthostatic hypotension
(d) 100 mg/day for 150 days
(c) Respiratory distress syndrome
17. A client has come to the clinic for her prenatal visit.
Nurse should include which of the following (d) Supine hypotensive syndrome
statements about using drugs safely during any in ANSWER KEY
her teaching? 1. [a] 2. [c] 3. [b] 4. [b] 5. [b]
(a) “All medications are safe after you've reached the 6. [b] 7. [c] 8. [a] 9. [a] 10. [c]
5th month of pregnancy"
11. [b] 12. [d] 13. [b] 14. [d] 15. [d]
(b) “Consult with your health care provider before
16. [c] 17. [b] 18.[d] 19. [d] 20. [d]
taking any medications"
21. [a] 22. [a] 23. [c] 24.[d]
(c) “During the first 3 months, avoid all medications
❑❑❑
except ones prescribed by your caregiver"
(d) “Medications that are available over the counter are
safe for you to use, even early on"
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OBSTETRICS AND GYNAECOLOGY
1. In a normal pregnancy the primary change in (c) Distended neck veins
a woman's cardiovascular system is a marked (d) Diastolic murmur
increase in cardiac output. What is the major 8. What blood vessel carries blood from the
cause of increased cardiac output in the first placenta to the fetus?
half of pregnancy? (a) Umbilical artery (b) Umbilical vein
(a) Increased heart rate (c) Ductus arteriosus (d) None of the above
(b) Increased systemic vascular resistance 9. What structure in the fetal cardiovascular
(c) Decreased vascular resistance system allows blood to flow from the inferior
(d) Increased stroke volume vena cava to the left atrium?
2. What hormone is responsible for the decrease (a) Ductus arteriosus (b) Foramen ovale
in systemic vascular resistance during (c) Ductus venosus (d) Pulmonary artery
pregnancy? 10. The fetus has a structure that allows blood to
(a) Progesterone flow directly from the pulmonary artery to the
(b) Estrogen aorta. What is found in adults as a result of the
(c) Vasopressin closure of that structure?
(d) Human chorionic gonadotropin (a) Ductus arteriosus
3. What results would you find if you were to take (b) Foramen ovale
an arterial blood gas during a typical (c) Ligamentum arteriosum
pregnancy? (d) Umbilical ligament
(a) Compensated metabolic acidosis 11. The primary source of amniotic fluid is fetal
(b) Metabolic alkalosis urine. What is the typical range of fetal urine
(c) Compensated respiratory alkalosis production?
(d) Respiratory acidosis (a) 400-1200 mL/day (b) 4-12 mL/day
4. If you were to check a woman's thyroid status (c) 4-12 L/day (d) 200-500 mL/day
throughout a normal pregnancy what would 12. What two substances are needed for a
you typically find? developing fetus to grow male genitalia?
(a) An enlarged thyroid gland with (a) Wolffian factor and Mullerian inhibitory factor
hypothyroidism (b) Testosterone and Mullerian inhibitory factor
(b) An overall euthyroid state (c) Wolffian factor and Testosterone
(c) No change in gland size, but moderate (d) Mullerian factor and Testosterone
hyperthyroidism 13. A fetus does not have a fully developed
(d) Enlarged thyroid gland with a hyperthyroid immunologic system and needs to receive help
state from the maternal system. Which
5. During pregnancy most pulmonary volumes immunoglobulin’s can cross through the
and capacities change from the non-pregnant placenta to provide passive immunity for the
state. What value remains relatively fetus?
unchanged? (a) IgA and IgG
(a) Vital capacity (b) IgM and IgG
(b) Functional residual capacity (c) Only IgM
(c) Residual volume (d) Only IgG
(d) Tidal volume ANSWER KEY
6. What is the major cause of the decrease in 1. [d] 2. [a] 3. [c] 4. [b] 5. [a]
residual volume in a pregnant woman? 6. [c] 7. [d] 8. [b] 9. [b] 10. [c]
(a) Increased respiratory rate 11. [a] 12. [b] 13. [d]
(b) Increase of the overall vital capacity ❑❑❑
(c) Elevation of the diaphragm
(d) Estrogen and progesterone hormonal
interactions
7. Which of the following is NOT considered a
normal finding in a cardiovascular
examination during pregnancy?
(a) A low-grade systolic ejection murmur
(b) A split second heart sound with inspiration
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OBSTETRICS AND GYNAECOLOGY
9. A significant predictor of fetal well–being is, if
DIAGNOSIS OF PREGNANCY fetal heart rate is:
(a) 100–120 beats/min (b) 180–200 beats/min
(c) 110–160 beats/min (d) 160–200 beats/min
1. The confirmatory sign early in the pregnancy
10. Violet coloration of the mucus membrane of
is:
cervix and vagina at 4th week of pregnancy is
(a) Auscultation of fetal heart rate
termed:
(b) Ultrasonography findings
(a) Chadwick's sign (b) Hegar's sign
(c) Palpation of fetal part
(c) Goodell’s sign (d) Rovsing's sign
(d) All of the above
11. Purple blue tinge of the cervix is
2. What is the positive sign of pregnancy?
(a) Hegar sign (b) Goodell’s sign
(a) Frequency of micturition
(c) Chadwick's sign (d) McDonald's sign
(b) Vomiting
12. Jacquemier's sign is also known as:
(C) Braxton Hicks contractions
(a) Osiander’s sign (b) Chadwick's sign
(d) Fetal outline by sonography
(c) Goodells sign (d) Hegar's sign
3. Positive–definite sign of pregnancy is:
13. The dusky hue of the vestibule and anterior
(a) Visualization of fetus by ultrasound
vaginal wall due to local vascular congestion is
(b) Uterine enlargement
called as:
(c) Amenorrhea
(a) Osiander's sign (b) Chadwick's sign
(d) Quickening
(c) Goodell’s sign (d) Homan's signs
4. A positive over–the–counter pregnancy test is
14. The extreme softening of the cervix during the
considered as:
first trimester is known as:
(a) Possible sign of pregnancy
(a) Chadwick's sign (b) Osiander's sign
(b) Presumptive sign of pregnancy
(c) Piskacek's sign (d) Goodells sign
(c) Probable sign of pregnancy
15. Changes occur to cervix during pregnancy
(d) Positive sign of pregnancy
is………
5. Which of the following tests can be used to
(a) Softening of cervix
diagnose pregnancy on the first day of the
(b) Hypertrophy and hyperplasia of elastic
missed period (28th day of cycle)?
connective tissues
(a) Two site sandwich immune assay
(c) Increased vascularity
(b) Enzyme–linked immune assay
(d) All of the above
(c) Agglutination inhibition test
16. Axillary tail, Montgomery’s tubercles are
(d) Direct latex agglutination test
occur during the time of pregnancy because of
6. The uterus has already risen out of the pelvis
the changes in.........
and is experiencing further growth into the
(a) Skin (b) Breast
abdominal area at about:
(c) Blood volume (d) Uterus
(a) 8th week of pregnancy
17. Normal range of fetal heart rate is........
(b) 10th week of pregnancy
(a) 80–100 (b) 120–160
(c) 12th week of pregnancy
(c) 120–170 (d) >150
(d) 18th week of pregnancy
18. Hormone responsible for hyperemesis
7. A nurse is aware that the best place to detect
gravidarum is:
fetal heart sound in the first trimester of
(a) Human chorionic gonadotropin
pregnancy?
(b) Human placental lactogen
(a) Above the symphysis pubis
(C) Progesterone
(b) Above the umbilicus
(d) Relaxin
(c) At the umbilicus
19. The perception of active fetal movement felt
(d) Below the symphysis pubis
by the mother during pregnancy is known as:
8. With the ordinary stethoscope, the fetal heart
(a) Ballottement (b) Engagement
sounds can be detected earliest between –
(c) Quickening (d) Lightening
weeks of pregnancy:
20. Quickening occurs at:
(a) 6 to 8 (b) 18 to 20
(a) 8–10 weeks (b) 16-20 weeks
(c) 24 to 26 (d) 8 to 10
(c) 12–16 weeks (d) 20-24 weeks

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OBSTETRICS AND GYNAECOLOGY
21. Rhythmic contraction felt during bimanual 31. Correctly statement regarding changes occurs
examination is known as: in the alimentary system during pregnancy
(a) Quickening (b) Hegar's sin is.................
(c) Palmer's sign (d) Chloasma (a) Increased reflux esophagitis
22. Cholasma will appear on........ Body part (b) Muscle tone and motility will decrease
(a) Breast and nipples (b) Cheeks and nose (c) Risk for peptic ulcer reduces
(c) Abdomen (d) Limbs (d) All of the above
23. What is the total weight gain in singleton 32. Correct statement regarding changes occur in
pregnancy? the respiratory system during pregnancy
(a) 5–7 kg (b) 7–9 kg is................
(c) 10–12 kg (d) 12–14 kg (a) Subcostal angle decreases
24. The first seen is pregnancy is (b) Chest circumference increases
(a) Quickening (b) Amenorrhea (c) Increase in tidal volume
(c) Hegar's sign (d) None (d) All of the above
25. All of the following are recognized causes of 33. The causes of physiological anemia in
intrauterine growth retardation (IUGR) pregnancy is:
except: (a) Heamodilution
(a) Hypertension (b) Hemolysis
(b) Smoking (c) Hematopoiesis
(c) Hypercholesterolemia (d) None
(d) Diabetes 34. Physiological anemia during pregnancy is a
26. Positive sign of pregnancy is: result of:
(a) Cullen's sign (a) Increased blood volume
(b) Hegar's sign (b) Increased detoxification demands on
(c) Fetal movement mother's liver
(d) Morning sickness (c) Decreased dietary intake
27. It is the dusky hue vestibule and anterior (d) Decreased erythropoiesis after first trimester
vaginal wall visible in pregnancy– 35. Which of the following conditions is common
(a) Jacquemier's sign (b) Osiander’s sign in pregnant clients in the 2nd trimester
(c) Piskacek's sign (d) Palmer sign pregnancy?
28. Cardiac activity of the fetus seen through (a) Breast abscess
ultrasound by.................. (b) Metabolic acidosis
(a) 3 weeks (b) 4 weeks (c) Physiologic anemia
(c) 5 weeks (d) 7 weeks (d) Respiratory alkalosis
29. Pregnant woman, who is 4 months pregnant 36. Fall in hematocrit value observed during
asks the nurse how much and what type of pregnancy because............
exercise she should get during pregnancy. (a) Heamodilution
How should nurse counsel her? (b) Hemoconcentration
(a) "Exercise to raise the heart rate above 140 (c) Blood loss
beats/minute for 20 minute daily" (d) Due to progesterone hormone
(b) “Perform gentle back–lying exercises for 30
minutes daily" ANSWER KEY
(c) "Try high–intensity aerobics, but limit sessions 1. [b] 2. [d] 3. [a] 4. [d] 5. [a]
to 15 minutes daily" 6. [c] 7. [a] 8. [b] 9. [c] 10. [a]
(d) “Walk briskly for 10 to 15 minutes daily, and 11. [c] 12. [b] 13. [b] 14. [d] 15. [d]
gradually increase this time 16. [b] 17. [b] 18. [a] 19. [c] 20. [b]
30. Which of the following is NOT advised for a 21. [c] 22. [b] 23. [c] 24. [b] 25.[c]
pregnant woman with a complaint of varicose 26. [c] 27. [a] 28. [d] 29. [d] 30. [b]
veins? 31. [d] 32. [d] 33. [a] 34. [a] 35. [c]
(a) Wear support stockings 36. [a]
(b) Stand for long periods ❑❑❑
(c) Exercise the calf muscles
(d) Elevate legs when sitting
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 OBSTETRICS AND GYNAECOLOGY
14. The passage of bi-parietal diameter through
FEMALE PELVIS AND FETAL SKULL the pelvic inlet is referred as………
(a) Descent (b) Flexion
(C) Engagement (d) Extension
1. Number of bones in female pelvis is... 15. Which one of the following pairs regarding
(a) 1 (b) 2 pelvis is NOT correct?
(c) 3 (d) 4 (a) Gynecoid: Female type
2. Which bone is the part of pelvis? (b) Android: Male type
(a) Innominate bone (b) Sacrum (c) Anthropoid: Wedge type
(c) Coccyx (d) All of the above (d) Platypelloid: Flat type
3. True pelvis is divided as.......... 16. The suture line between two parietal bones is
(a) Inlet, cavity, outlet (b) Brim, cavity, outlet called:
(c) Brim, inlet, outlet (d) Brim, inlet, exit (a) Coronal (b) Lambdoidal
4. The innominate bone consists of
(c) Frontal (d) Sagittal
(a) Ilium, Ischium, pubis, sacrum and coccyx
17. Largest diameter in pelvic inlet is..........
(b) Ischium, ischium, sacrum and coccyx
(c) Ilium, ischium and coccyx
(a) Anterior Posterior
(d) Ilium, ischium and pubis (b) Transverse Diameter
5. The pelvic shape has the poorest prognosis (c) Oblique Diameter
from vaginal delivery is………. (d) None of these
(a) Platypelloid (b) Anthropoid 18. Transverse diameter of inlet of pelvis is about
(c) Android (d) Gynecoid (a) 11 cm (b) 12cm
6. Which one of the following is the female (c) 13 cm (d) 14 cm
pelvis? 19. Pelvis is composed of...........
(a) Android (b) Gynecoid (a) Innominate bones (b) Sacrum
(c) False pelvis (d) Anthropoid (c) Coccyx (d) All of the above
7. Brim of Gynecoid pelvis is.......in shape. 20. Angle of inclination in human pelvis is……
(a) Heart (b) Kidney (a) 45° (b) Between 55°-60°
(c) Oval (d) Round (c) 65° (d) 75°
8. The ideal pelvis for child bearing 21. Landmark used while assessing the descend of
is..........................pelvis head during the process of delivery?
(a) Anthropoid (b) Platypelloid (a) Ischial spines (b) Pubic symphysis
(c) Gynecoid (d) Android (c) Coccyx (d) Sacrum
9. Deep transverse arrest occurs in --------- 22. Anatomical anteroposterior conjugate is also
(a) Gynecoid pelvis (b) Platypelloid pelvis known as
(c) Android pelvis (d) Anthropoid pelvis (a) True conjugate
10. Absence of one sacral ala of pelvis is called (b) Obstetric conjugate
as…………….. (c) Diagonal conjugate
(a) Rickety flat pelvis (b) Naegele's pelvis (d) External conjugate
(c) Robert's pelvis (d) Kyphotic pelvis 23. The pelvic diameter which he measured from
11. The brim of the anthropoid pelvis is........ the tip of the sacral promontory to the most
Shape. bulging point on the back of symphysis pubis
(a) Kidney (b) Round is known as
(c) Heart (d) Oval (a) Obstetric conjugate
12. The type of pelvis in which the features are heart (b) Diagonal conjugate
shaped brim, narrow fore pelvis and sciatic notch (c) Anatomical conjugate
with prominent ischial spines and suprapubic angle (d) Oblique diameter
< 90°: 24. The pelvic diameter which is measured from
(a) Gynecoid pelvis (b) Android Pelvis middle of sacral promontory to the upper inner
(c) Anthropoid pelvis (d) Platypelloid pelvis surface of the pubic symphysis is known as:
13. The innominate bone of the pelvis is not (a) Obstetric conjugate (b) Diagonal conjugate
composed of the (c) Anatomical conjugate (d) Oblique diameter
(a) Sacrum (b) Ilium
(c) Pubis (d) Ischium
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OBSTETRICS AND GYNAECOLOGY
25. The distance between middle of sacral 36. Identify the correct statement regarding
promontory to lower inner border of posterior fontanel
symphysis pubis is known as. (a) It is formed by two sutures or three bones
(a) Obstetric conjugate (b) It is triangular in shape
(b) Diagonal conjugate (c) It generally close in 6-8 weeks of birth
(c) Anatomical conjugate (d) All of the above
(d) Oblique diameter 37. The diameter extends from the nape of the
26. The measurement between one sacroiliac joint neck to the center of the bregma is called
and the opposite ileopubic eminence as.................
(a) Obstetric conjugate
(a) Suboccipito bregmatic
(b) Diagonal conjugate
(b) Suboccipito frontal
(c) Anatomical conjugate
(d) Oblique diameter (c) Occipito frontal
27. The average Submentovertical diameter is: (d) Submento bregmatic
(a) 95 cm (b) 10 cm 38. Engaging diameter of face presentation is
(c) 115 cm (d) 135 cm (a) Mento bregmatic
28. In the fetal skull, the bregma is found: (b) Sub-Mento bregmatic
(a) At the junction of the sagittal, coronal and (c) Mento vertical
frontal sutures (d) Sub-mentovertical
(b) At the junction of the Lambdoidal and sagittal 39. Suboccipito bregmatic diameter measures
sutures about.........
(c) Between the two halves of the frontal bone (a) 95 cm (b) 10 cm
(d) Between the frontal bones and parietal bones (c) 115 cm (d) 14 cm
29. The suture run between parietal and frontal 40. Suboccipito-frontal diameter measures
bone is.................... about...
(a) Coronal (b) Sagittal (a) 95 cm (b) 10 cm
(c) Frontal (d) Lambdoid (c) 115 cm (d) 14 cm
30. The sagittal sutures lies between: 41. Occipito frontal diameter measures
(a) Occipital bone and two parietal bones about................
(b) Parietal and frontal bone (a) 95 cm (b) 10 cm
(c) Two frontal bones (c) 115 cm (d) 14 cm
(d) Two parietal bones 42. Mento-vertical diameter measures
31. The suture lies between two parietal bone is about.............
known as. (a) 95 cm (b) 10 cm
(a) Sagittal (b) Longitudinal (c) 115 cm (d) 14 cm
(c) Coronal (d) Both A and B 43. Submentovertical diameter measures
32. Denominator in breech presentation? about........
(a) Occiput (b) Sacrum (a) 95 cm (b) 10 cm
(c) Frontal eminence (d) Mentum (c) 115 cm (d) 14 cm
33. Identify correct statement regarding anterior 44. Submento bregmatic diameter measures
fontanels about.......
(a) Formed by joining four bones (4 bones or 2 (a) 95 cm (b) 10 cm
sutures) in the midline (c) 115 cm (d) 14 cm
(b) Shape is like a diamond 45. Bi parietal diameter in fetal skull is.......
(c) Ossified by 18 months of age (a) 95 cm (b) 85 cm
(d) All of the above (c) 8 cm (d) 75 cm
34. Wide gap in the suture is------- 46. Super-sub parietal diameter is..........
(a) Diameter (b) Circumference (a) 95 cm (b) 85 cm
(c) Fontanelles (d) Inlet (c) 8 cm (d) 75 cm
35. Soft spot in the skull in between the sutures is 47. Bi temporal diameter is
known as................. (a) 95 cm (b) 85 cm
(a) Attitude (b) Vertex (c) 8 cm (d) 75 cm
(c) Diameter (d) Fontanelles
-:: 14 ::-
OBSTETRICS AND GYNAECOLOGY
48. Bi mastoid diameter is.......................
(a) 95 cm LABOUR
(b) 85 cm
(c) 8 cm
1. Perinatal Period corresponds to:
(d) 75 cm
(a) 28 weeks of gestation to 7 days after birth
49. Which of the following is the largest diameter
(b) Period of Labor to new born period
of the fetal skull?
(c) Third trimester of pregnancy to new born
(a) Mento vertical
period
(b) Submento vertical
(d) 36 weeks of gestation to 3 days after birth
(c) Biparietal
2. Labor is divided into how many stages?
(d) Suboccipito bregmatic
(a) Two (b) Three
50. What will be the attitude of head during face
(c) Four (d) Five
and brow presentation?
3. First stage of labor is also called as:
(a) Well flexed
(a) Cervical stage (b) Expulsive stage
(b) Complete extension
(c) Propulsive stage (d) Vaginal stage
(c) Adduction
4. A Primigravida patient is admitted to the labor
(d) Abduction
delivery area. Assessment reveals that she is
51. Universal attitude is........
early part of the first stage of labor. Her pain is
(a) Well flexed
likely to be
(b) Complete extension
(a) Around the pelvic girdle
(c) Adduction
(b) Around the pelvic girdle and in the upper arms
(d) Abduction
(c) Around the pelvic girdle and at the perineum
52. Denominator in vertex presentation?
(d) At the perineum
(a) Occiput
5. What you mean by first stage of labor?
(b) Mentum
(a) Onset of true labor pain till full dilation of
(c) Frontal eminence
cervix
(d) Sacrum
(b) Full dilation of cervix to expulsion of fetus
53. Denominator in face presentation?
(c) Expulsion of fetus to expulsion of placenta
(a) Occiput
(d) Observation for at least 1 hour after the
(b) Mentum
expulsion of placenta
(c) Frontal eminence
6. The expulsion of cervical mucus plug from the
(d) Sacrum
vagina mixed with blood is known as:
54. Denominator in brow presentation?
(a) Amniotic fluid (b) Descend
(a) Occiput (b) Mentum
(c) Cervical discharge (d) Show
(c) Frontal eminence (d) Sacrum
7. Other name for normal labor is..............
(a) Eutocia (b) Dystocia
ANSWER KEY
(c) Eutonia (d) Precipitated labor
1. [d] 2. [d] 3. [a] 4. [d] 5. [c]
8. Characteristics of true labour pain include
6. [b] 7. [d] 8. [c] 9. [c] 10. [b]
(a) Effacement and dilatation of cervix
11. [d] 12. [b] 13. [a] 14. [c] 15. [c]
(b) Uterine contraction at regular interval
16. [d] 17. [b] 18. [c] 19. [d] 20. [b] (c) Frequency of contraction increases gradually
21. [a] 22. [a] 23. [a] 24. [c] 25. [b] (d) All of the above
26. [d] 27. [c] 28. [a] 29. [a] 30.[d] 9. True labor is characterized by:
31. [d] 32. [b] 33. [d] 34. [c] 35. [d] (a) Effacement and dilatation of cervix
36. [d] 37. [a] 38. [b] 39. [a] 40. [b] (b) Painful uterine contraction
41. [c] 42. [d] 43. [c] 44. [a] 45. [a] (c) Frequency of contractions increase gradually
46. [b] 47. [c] 48. [d] 49. [a] 50. [b] (d) All of the above
51. [a] 52. [a] 53. [b] 54. [c] 10. Most reliable indicator of true labor is
❑❑❑ (a) Effacement and dilatation of cervix
(b) Painful uterine contraction
(c) Supra pubic discomfort at regular interval
(d) All of the above

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OBSTETRICS AND GYNAECOLOGY
11. Instrument of the choice for clamping the 20. Ripening of the cervix occurs during the….
umbilical cord is............... (a) First stage of labor
(a) Allis tissue forceps (b) Second stage of labor
(b) Kocher's haemostatic forceps (c) Third stage of labor
(c) Long straight hemostatic forceps (d) Fourth stage of labor
(d) Multiple toothed vulsellum 21. Initiation of second stage of labor and
12. Which of the following the characteristics of false cessation of first stage of labor occur
labor pain?
when………..
(a) Not associated with the hardening of the uterus
(a) The baby is delivered
(b) Frequency of contraction increases
(b) The cervix is completely dilated
(c) Associated with 'show’
(c) After the delivery of placenta
(d) Progressive dilation of cervix
(d) After clamping and cutting the umbilical cord
13. False labor manifestation are as follows,
22. Complete dilation of cervix to birth of a baby is
EXCEPT
staged as
(a) Contraction lessen with activity or rest
(a) Stage 1 of labor (b) Stage 2 of labor
(b) Cervix progressively effaced and dilated
(c) Stage 3 of labor (d) Stage 4 of labor
(c) Abdominal discomfort
23. A 31 year old multipara is admitted to the
(d) Contractions irregular
birthing room after initial examination reveals
14. Which among the following is NOT a feature of
her cervix dilation to be 8 cm, completely
false labor pain?
effaced (100%), and at 0 station. What phase of
(a) Pain is confined to lower abdomen and groin
labor is she in?
(b) No effects on dilatation of cervix
(a) Active phase (b) Expulsive phase
(c) Relieved by enema
(c) Latent phase (d) Transitional phase
(d) Formation of bag of waters
24. In a primi mother duration of second stage of
15. To promote comfort during labor, Nurse
labor is..........
advises a client to assume certain positions
(a) 15 to 30 minutes (b) 30 to 60 minutes
and avoid others. Which position may cause
(c) 1 hour to 2 hours (d) 2 hours to 35 hours
maternal hypotension and fetal hypoxia?
25. In the second stage of labor which of the
(a) Lateral position (b) Squatting position
following injections is given to improve
(c) Supine position (d) Standing position
uterine contractions?
16. The most important observation for a patient
(a) Prostaglandin (b) Oxytocin
in labor in Pitocin augmentation is:
(c) Phenergan (d) Diazepam
(a) Monitoring FHS
26. Delayed cord clamping is contraindicated
(b) Monitoring TPR
in…………
(c) Preparing for emergency CS
(a) Baby born to anemic mother
(d) Monitoring and recording the length of
(b) Baby with birth weight more than 3 kg
contraction
(c) Rh–incompatibility
17. Primary power of labor is.............
(d) Preterm baby
(a) Abdominal contraction
27. which of the following stages of labor would be
(b) Intrathoracic pressure
nurse assess "crowning"?
(c) Pushing effort of the mother
(a) First stage (b) Second stage
(d) Uterine contractions
(c) Third stage (d) Fourth stage
18. In which stage of labor lower uterine segment
28. Cardinal movement occur before expulsion is?
will form?
(a) Engagement (b) Crowning
(a) 1st stage of labor (b) 2nd stage of labor
(c) Internal rotation (d) External rotation
(c) 3rd stage of labor (d) 4th stage of labor
29. The normal rate of dilation of cervix in a
19. All among indicate transition from first stage
normal labor of primigravida women in
to second stage, EXCEPT
latent/active phase is:
(a) Increase intensity of uterine contraction
(a) 05–09 cm/hr
(b) Urge to defecate with descent of the
(b) 10–12 cm/hr
presenting part
(c) 12–15 cm/hr
(b) Complete dilation of cervix
(d) 15–20 cm/hr
(d) Relaxation in mother

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OBSTETRICS AND GYNAECOLOGY
30. Correct process which reduces surface area at
the placental site and helpful in separation of PUERPERIUM
placenta is known as
(a) Constriction 1. A nurse is assessing the apical and radial
(b) Contraction pulses of a postpartum client 3 hours after the
(c) Detachment birth of her second child. Which clinical finding
(d) Retraction does the nurse expect?
31. The realignment of fetal head with the body (a) Thready pulse
after the head comes out: (b) Slow heartbeat
(a) Expulsion (c) Bounding pulse
(b) Descent (d) Irregular heartbeat
(c) Engagement 2. During the postpartum period it is expected
(d) Restitution for women to have an increased cardiac
32. Labor starts with pain and ends with the output with tachycardia. This knowledge
delivery of: should motivate a nurse who is caring for a
(a) Umbilical cord client with cardiac problems to monitor for:
(b) Fetus (a) An irregular pulse
(c) Placenta (b) Respiratory distress
(d) None (c) Hypovolemic shock
33. The alternate term of normal labor is: (d) An increase in vaginal bleeding
(a) Procidentia 3. How should a nurse screen a new-born of a
(b) Eutocia diabetic mother for hypoglycaemia?
(c) Dystocia
(a) Test for glucose tolerance
(d) None
34. In the second stage of labor, the important (b) Draw blood for a serum glucose level
factor determine the expulsion of the fetus (c) Arrange for a fasting blood glucose level
from birth canal is………….. (d) Test heel blood with a glucose-oxidase strip
(a) Maternal bearing down efforts 4. What does a nurse anticipate will be provided
(b) Cervical dilatation for a new-born of a mother with a history of
(c) Uterine contractions
long-standing diabetes?
(d) Adequate pelvic size
(a) Fast-acting insulin
35. The fetal head is born by the process of
(a) Crowing (b) Special high-risk care
(b) Restitution (c) Routine new-born care
(c) Extension (d) Limited glucose intake
(d) Internal rotation 5. A nurse anticipates that new-borns of mothers
who have diabetes often have tremors,
ANSWER KEY
periods of apnoea, cyanosis, and poor sucking
1. [a] 2. [c] 3. [a] 4. [a] 5. [a]
ability. With what complication are these signs
6. [d] 7. [a] 8. [d] 9. [d] 10. [a]
associated?
11. [b] 12. [a] 13. [b] 14. [d] 15. [c]
16. [d] 17. [d] 18. [a] 19. [d] 20. [a] (a) Hypoglycaemia
21. [b] 22. [b] 23. [d] 24. [c] 25. [b] (b) Hypercalcemia
26. [c] 27. [b] 28. [d] 29. [b] 30. [d] (c) Central nervous system edema
31. [d] 32. [c] 33. [b] 34. [a] 35. [c] (d) Congenital depression of the islets of
❑❑❑ Langerhans
ANSWER KEY
1. [b] 2. [b] 3. [d] 4. [b] 5. [a]

-:: 17 ::-
OBSTETRICS AND GYNAECOLOGY
7. All of the following circumstances should
POSTPARTUM HEMORRHAGE alert an obstetrician to an increased
likelihood of postpartum haemorrhage
1. Regarding postpartum hemorrhage: EXCEPT:
(a) May occur as a consequence of Antepartum (a) Prolonged labour
(b) Rapid labour
hemorrhage
(c) Postdate pregnancy
(b) Ends with Hypercoagulable state
(d) Oxytocin stimulation
(c) Hysterectomy is the first line of treatment 8. In DIC (Disseminating intravascular
(d) Always complicate intrauterine fetal death coagulation)
(IUFD) (a) The level of FDP (Fibrinogen degeneration
2. Regarding Secondary postpartum products) is low
hemorrhage: (b) Platelet count is high
(c) Bleeding time is prolonged
(a) Is diagnosed when bleeding occurs 72 hours
(d) PT and aPTT are normal
after delivery 9. Clinical Presentation of DIC include the
(b) Contraindicate breast feeding following EXCEPT:
(c) The commonest cause is the cervical tears (a) Bleeding from IV sites
(d) Choriocarcinoma could be a cause (b) Hematuria
3. In Abruptio placenta: Which is true? (c) Failure active surgical hemostasis
(d) Increase temperature (fever)
(a) It is bleeding from abnormally situated
10. Clinical causes of DIC (disseminated
placenta
intravascular coagulation) include the
(b) Has minimum effect on the fetus following EXCEPT:
(c) Causes painless bleeding (a) Ectopic pregnancy
(d) Can be a cause of post-partum hemorrhage (b) Septic abortion
4. Atonic Postpartum hemorrhage is best (c) Mild pre-eclampsia
managed with: (d) The use of tampons
11. The treatment of DIC may include the
(a) Intra-venous progesterone
following EXCEPT:
(b) 05 mg oral ergometrine and uterine
(a) Heparin
massage (b) Packed RBCs
(c) 5 units oral Syntocinon and uterine massage (c) Platelet transfusion
(d) Uterine massage with 40 units Syntocinon in (d) Leukocyte transfusion
500 ml D5 % NS to be given intravenously
ANSWER KEY
5. Postpartum hemorrhage can occur due to
1. [a] 2. [d] 3. [d] 4. [d] 5. [d]
all of the followings EXCEPT:
6. [d] 7. [c] 8. [c] 9. [d] 10. [c]
(a) Fetal macrosomia 11. [d]
(b) Polyhydramnios
(c) Placenta praevia
(d) Postdate pregnancy
6. Disseminated intravascular coagulation
(DIC) :
(a) Can be managed by leukocyte transfusion
(b) Can cause decrease fibrinogen
degeneration products
(c) Can cause decrease PT , aPTT
(d) Can be encountered in case of IUFD
-:: 18 ::-
 OBSTETRICS AND GYNAECOLOGY
8. Management of a patient with threatened
ABORTION abortion includes all the followings EXCEPT:
(a) Ultrasound
1. Regarding missed abortion, all of the following are (b) Physical exam
CORRECT, EXCEPT: (c) CBC
(a) Patient may present with loss of the symptoms of (d) Immediate dilation and curettage
pregnancy 9. Abortion:
(b) Per vaginal bleeding may be one of the presenting
(a) Has an incidence of 15% of all pregnancy
symptom
(b) 18 weeks missed abortion is usually managed
(c) Immediate evacuation should be done once the
diagnosis is made with suction curettage
(d) Disseminated intra-vascular coagulation may occur (c) In threatened abortion, the cervix is always
as a sequele of missed abortion open
2. 14 weeks pregnant woman had abortion and (d) 1st trimester abortion is usually causes by
she was told that it is a complete abortion. This incompetent cervical os
is true regarding complete abortion: 10. Etiological factors in spontaneous abortion
(a) Uterus is usually bigger than date include:
(b) Cervical OS is opened with tissue inside the (a) Chromosomal abnormalities
cervix (b) Placental abnormalities
(c) Need to have evacuation of the uterus (c) Maternal disease
(d) After complete abortion there is minimal or no (d) All of the above
pain and minimal or no bleeding 11. A major hazard of a late missed abortion:
3. In patients with three consecutive (a) A positive human chorionic gonadotropin
spontaneous abortion in the second trimester (HCG) titer
the most useful investigation is: (b) Systemic allergies
(a) Chromosomal analysis (c) Bone marrow depression
(b) Hysterosalpingogram (d) Coagulopathy
(c) Endometrial biopsy 12. A missed abortion is:
(d) Post coital test (a) Death of the fetus at 36 weeks of gestation
4. Regarding cervical incompetence, all of the (b) In which the products of conception are
following are true, EXCEPT: expelled completely
(a) Typically causes painful abortions (c) In which the products of conception are
(b) Typically causes mid-trimester abortions partially expelled
(c) Is treated by Shirodkar suture (cervical (d) Death of the fetus before 24 weeks gestation
cerclage) which is best preformed early in the 13. Cervical cerclage:
second trimester (a) Closure of incompetence cervix
(d) May lead to premature rupture of the (b) Effective in prevention of all types of abortion
membrane (c) Should be removed at 32 weeks of pregnancy
5. Causes of first trimester abortion (d) Protect against exposure of the pregnant lady
(a) Chromosomal abnormalities to infection
(b) Cervical incompetence 14. Regarding Cervical incompetence, one is true:
(c) Bicornuate uterus (a) Cone biopsy is not a predisposing factor
(d) Gestational hypertension (b) Cerclage is contraindicated
6. In case of threatened abortion: (c) In not encountered with uterine anomalies
(a) Fetal heart rate is present (d) Best diagnosed by History
(b) Cervix is dilated
(c) There is a history of passing tissue per vagina
ANSWER KEY
(d) Patients needs immediate evacuation
1. [c] 2. [d] 3. [b] 4. [a] 5. [a]
7. Missed abortion may cause one of the
6. [a] 7. [d] 8. [d] 9. [a] 10. [d]
following complication:
11. [d] 12. [d] 13. [a] 14. [d]
(a) Bone marrow depression
❑❑❑
(b) Rupture uterus
(c) High positive serum β-hCG
(d) Coagulopathy
-:: 19 ::-
OBSTETRICS AND GYNAECOLOGY

ECTOPIC PREGNANCY MOLAR PREGNANCY

1. In a woman with molar pregnancy with a

1. Acceptable management of possible rupture
uterus size of 28 weeks, the treatment of
ectopic pregnancy would include all of the
choice is?
following EXCEPT:
(a) Exploratory laparotomy (a) Medical induction with prostaglandins
(b) Diagnostic laparoscopy (b) Hysterectomy
(c) Partial salpingectomy (c) Hysterectomy
(d) Observation followed by Methotrexate (d) Suction evacuation
2. If the above described patient has had a previous 2. The most common karyotype of a partial mole
term pregnancy prior to her ectopic pregnancy, is ?
her chances of subsequent intrauterine (a) Diploid 46 XX (b) Diploid 46 XY
pregnancy would be about: (c) Triploid (d) Haploid
(a) 80% (b) 60% ANSWER KEY
(c) 40% (d) 20% 1. [d] 2. [c]
3. The commonest site of ectopic pregnancy is :
(a) Peritoneal cavity
(b) Mesosalpinx
(c) Ovary
ANTEPARTUM HEMORRHAGE
(d) Ampulla of the fallopian tube
4. Etiological factor of ectopic pregnancy include all 1. A pregnant woman presents with a complete
of the following EXCEPT: placenta previa and fetus has lethal congenital
(a) Gonococcal Salpingitis (b) Tubal surgery anomalies. Which of the following will be the
(c) Combined OCP (d) TB salpingitis best management?
5. In ectopic pregnancy: (a) Caesarean section
(a) Rarely diagnosed before 12 weeks of gestation
(b) Oxytocin drip
(b) Usually present as obstetric emergency before
(c) Rupture of membrane
12 weeks gestation
(d) Induce with PGE2
(c) IM progesterone is useful
2. A patient with two previous caesarean
(d) 50% continued up to term
sections presents at 35 weeks of gestation
6. Patient with ectopic pregnancy:
(a) Present with heavy per-vaginal bleeding with a painless vaginal blood loss of 400 ml.
(b) Methotrexate is the treatment of the choice in She is ‘unbooked,’ that is, she has not
patient with ruptured one presented for any previous antenatal
(c) May complain of shoulder pain appointments so far in this pregnancy. Clinical
(d) Present with cardio vascular collapse in all the finding are as follows: Blood pressure 120/75
cases mmHg, Pulse 78 bpm, No clinical evidence of
7. Methotrexate Treatment in ectopic pregnancy is hypovolemia, Urinalysis Normal, Examination
contraindicated if: Abdominal mass is soft, not tender, with a
(a) β-hCG < 1500 mIU/mL transverse lie, CTG Normal. What is the most
(b) No fetal heart likely cause of the blood loss?
(c) Hemoperitoneum (a) Cervical fibroid degeneration
(d) Gestational sac < 3 cm (b) Likely abruption
8. The quantitative β sub unit of HCG in a serum of (c) Likely Placenta previa
patient with ectopic pregnancy will: (d) Likely vasa previa
(a) Rise in a rate greater than expected
3. 20 Weeks pregnancy with a complete placenta
(b) Rise at rate consistent with the normal curve
praevia with IUFD. Which of the following is
(c) Rise at a slower than expected
the best management?
(d) Plateau
(a) Caesarean section
ANSWER KEY
(b) Oxytocin drip
1. [d] 2. [a] 3. [d] 4. [c] 5. [b]
(c) Rupture of membranes
6. [c] 7. [c] 8. [c]
(d) Induce with PGE2

-:: 20 ::-
OBSTETRICS AND GYNAECOLOGY
4. Which of the following patients would be most 10. Most common cause of abruptio placenta
likely to have a placenta previa? (a) Hypertension
(a) 19-year-old G1, P0, Vertex presentation (b) Defective decidua
(b) 24-year-old G2, P1, cephalic presentation, 2/5 (c) Accident
palpable (d) None of this
(c) 34-year-old G5, P3+ 1(abortion), vertex 11. A nurse is assessing a pregnant client in the
presentation 2nd trimester of pregnancy who was admitted
(d) 36-year-old G3, Previous 2 LSCS, P2, transverse to the maternity unit with a suspected
lie diagnosis of abruptio placenta. Which of the
5. Common causes of antepartum hemorrhage following assessment findings would the
(APH, bleeding from the genital tract from 24 nurse expect to note if this condition is
weeks gestation) include all of the following, present?
except? (a) Absence of abdominal pain
(a) Vasa previa (b) A soft abdomen
(b) Placenta previa (c) Uterine tenderness/pain
(c) Uterine rupture (d) Painless, bright red vaginal bleeding
(d) Placental abruption 12. A maternity nurse is preparing for the
6. Regarding placenta previa, which of the admission of a client in the 3rd trimester of
following are true? pregnancy that is experiencing vaginal
(a) Placenta previa complicates about 04% of
bleeding and has a suspected diagnosis of
pregnancies at term
placenta previa. The nurse reviews the
(b) Placenta previa cannot be diagnosed with
ultrasound physician’s orders and would question which
(c) The majority of ‘low-lying’ placentas order?
diagnosed at 20 weeks will remain so at term (a) Prepare the client for an ultrasound
(d) The patient should be routinely managed (b) Obtain equipment for external electronic fetal
under inpatient care with delay of delivery until heart monitoring
the patient labour, at which time caesarean
(c) Obtain equipment for a manual pelvic
section will be performed
7. A pregnant client is diagnosed with partial examination
placenta previa. In explaining the diagnosis, (d) Prepare to draw a Hb and Hct blood sample
the nurse tells the client that the usual
treatment for partial placenta previa is which 13. An ultrasound is performed on a client at term
of the following? gestation that is experiencing moderate
(a) Activity limited to bed rest
vaginal bleeding. The results of the ultrasound
(b) Platelet infusion
indicate that an abruptio placenta is present.
(c) Immediate caesarean delivery
(d) Labour induction with oxytocin. Based on these findings, the nurse would
8. Placenta previa is characterized by all of the prepare the client for:
following except? (a) Complete bed rest for the remainder of the
(a) Painless bleeding pregnancy
(b) Present in 1st trimester (b) Delivery of the fetus
(c) Causeless bleeding
(c) Strict monitoring of intake and output
(d) Recurrent bleeding
(d) The need for weekly monitoring of
9. You’re performing a head-to-toe assessment
on a patient admitted with abruption coagulation studies until the time of delivery
placenta. Which of the following assessment ANSWER KEY
findings would you immediately report to the 1. [d] 2. [c] 3. [d] 4. [d] 5. [c]
physician? 6. [a] 7. [a] 8. [b] 9. [b] 10. [c]
(a) Vaginal bleeding
11. [c] 12. [c] 13. [b]
(b) Hard abdomen
❑❑❑
(c) Oozing around the IV site
(d) Tender Uterus
-:: 21 ::-
OBSTETRICS AND GYNAECOLOGY
7. What is an important sign of pre-eclampsia
HYPERTENSIVE DISORDER with severe features?
(a) Increased tendon reflexes
(b) A diastolic blood pressure of 100 mm Hg
1. What is the definition of hypertension in
(c) Tenderness on palpating the calves
pregnancy?
(d) 3+ proteinuria
(a) A diastolic blood pressure of 80 mm Hg or
8. A patient with pre-eclampsia has a diastolic
above and/or a systolic blood pressure of 120 mm
blood pressure of 95 mm Hg and 1+
Hg or above
proteinuria. She complains of flashes of light
(b) A diastolic blood pressure of 90 mm Hg or
in front of her eyes and upper abdominal pain.
above and/or a systolic blood pressure of 140 mm
In which of the following grades of pre-
Hg or above
eclampsia should you put this patient?
(c) A diastolic blood pressure of 100 mm Hg or
(a) Gestational hypertension
above and/or a systolic blood pressure of 160 mm
(b) Pre-eclampsia with severe features
Hg or above
(c) Eclampsia
(d) A rise in diastolic blood pressure of 10 mm Hg
(d) Pre-eclampsia
2. What is the definition of significant
9. Which of the following women has the highest
proteinuria in pregnancy?
risk of pre-eclampsia?
(a) 1+ protein or more (b) 2+ protein or more
(a) A patient with a history of a preterm delivery
(c) 3+ protein (d) A trace of protein
in her previous pregnancy
3. How should you define pre-eclampsia?
(b) Grand multiparas
(a) Hypertension and proteinuria presenting in
(c) A patient who previously had a twin pregnancy
the first half of pregnancy
(d) A patient with a history of pre-eclampsia
(b) Hypertension and proteinuria presenting in
starting early in the third trimester of a previous
the second half of pregnancy
pregnancy
(c) Hypertension and proteinuria presenting any
10. Which one of the following may be an early
time in pregnancy
warning sign of pre-eclampsia?
(d) Hypertension and proteinuria presenting
(a) Generalised oedema especially of the face
before the start of pregnancy
(b) Oedema of the feet at the end of the day
4. What is the correct definition of chronic (c) Pain on passing urine
hypertension? (d) Weight loss during the last months of pregnancy
(a) Hypertension, together with proteinuria, that 11. What is the management of a patient with pre-
is present in the first half of pregnancy eclampsia?
(b) Hypertension that is present in the first half of (a) Diuretics to reduce oedema
pregnancy, plus proteinuria that presents in the (b) Hospitalisation
second half of pregnancy (c) A loading dose of magnesium sulphate
(c) Hypertension alone which is present at the (d) Oral antihypertensive drugs
time of booking at 28 weeks 12. Which one of the following is the method of
(d) Hypertension, without proteinuria, that is delivery usually chosen in a patient with pre-
present in the first half of pregnancy eclampsia?
5. Which fetal condition is common in (a) Surgical induction followed by vaginal delivery at
pregnancies complicated by pre-eclampsia? 32 weeks
(a) Heart failure due to hypertension (b) Surgical induction followed by vaginal delivery if
(b) Haemorrhagic disease of the newborn 34 weeks gestation has been reached
(c) Intra-uterine growth restriction (c)Waiting until 40 weeks for a spontaneous onset of
(d) Congenital malformations labour
6. Pre-eclampsia may cause fetal distress (d) Caesarean section
because it results in: 13. What is an important complication of pre-
(a) Fetal hypertension eclampsia?
(b) Severe protein loss in the mother’s urine (a) Oedema of the face
(c) Congenital abnormalities caused by (b) Glycosuria
antihypertensive drugs (c) Intracerebral haemorrhage
(d) A decrease in placental blood flow (d) Placenta praevia

-:: 22 ::-
OBSTETRICS AND GYNAECOLOGY
14. Which of the following is the correct method of
treatment for a patient with severe pre-
HYPERTENSIVE DISORDERS
eclampsia?
(a) The patient should immediately be rushed to IN PREGNANCIES
the nearest level 3 hospital for stabilisation
(b) The patient should be managed at a level 1
1. Therapeutic termination of early pregnancy is
hospital
indicated in:
(c) The infant must immediately be delivered by
(a) Uterine fibroid
Caesarean section at a level 2 hospital
(b) Maternal pulmonary hypertension
(d) The patient should be stabilised first, then be
(c) Placenta previa
moved to a level 2 hospital for further
(d) Maternal blood sugar >12 mmol/L
management
2. In Pre-eclampsia, right upper quadrant part
15. What drug is used to manage a diastolic blood
abdominal pain is due to
pressure of 110 mm Hg or more?
(a) Nifedipine (Adalat) (a) Tension of the liver capsule
(b) Diazepam (Valium) (b) Cholecystitis
(c) Propranolol (Inderal) (c) Pancreatitis
(d) Alpha-methyldopa (Aldomet) (d) Gastric ulcer
16. What is an important sign of magnesium 3. In eclampsia; which is true?
sulphate overdose? (a) Caesarean section must be carried out in all
(a) Hyperventilation cases
(b) A urine output of less than 20 ml per hour (b) Hypotensive drugs should not be used
(c) Depressed tendon reflexes (c) Urinary output is increased
(d) Vomiting (d) Ergometrine should be avoided in the third
17. What drug is used to prevent and manage stage of labor
eclampsia? 4. Immediate appropriate response to an initial
(a) Magnesium trisilicate eclamptic seizure include all of the following,
(b) Alpha-methyldopa (Aldomet) EXCEPT:
(c) Diazepam (Valium) (a) Ultrasound for fetal growth
(d) Magnesium sulphate (b) Maintain adequate oxygenation
18. How should a patient, who feels well but has a (c) Administer magnesium sulphate
diastolic blood pressure of 90 mm Hg at 36 (d) Prevent maternal injury
weeks gestation, be managed? At all her 5. The most important reason to give
previous antenatal visits, her blood pressure antihypertensive drug for hypertension in
was normal, and she has no proteinuria. pregnancy is to decrease the:
(a) She must be hospitalised (a) Incidence of IUGR
(b) Alpha methyldopa (Aldomet) must be (b) Incidence of oligohydramnios
prescribed and weekly antenatal visits should be (c) Incidence of fetal death
arranged with additional visits if necessary (d) Risk of maternal complications such as stroke
(c) A full blood count should be done to exclude a 6. Risk factors for pre-eclampsia include all of the
low platelet count following, EXCEPT:
(d) She must be given an intramuscular injection (a) Elderly primigravida
of dihydralazine (Nepresol) (b) African ethnicity
(c) Positive family history of hypertension
ANSWER KEY (d) Positive history of macrosomic baby
1. [b] 2. [c] 3. [b] 4. [d] 5. [c] 7. Pre-eclampsia is associated with an increased
6. [d] 7. [d] 8. [b] 9. [d] 10. [a] risk of all of the following, EXCEPT:
11. [b] 12. [d] 13. [c] 14. [a] 15. [a]
(a) Delivery of a small for gestational age infant
16. [c] 17. [d] 18. [b]
(b) Placental abruption
(c) Pulmonary edema
(d) Prolonged duration of labor

-:: 23 ::-
OBSTETRICS AND GYNAECOLOGY
8. Eclampsia occurring prior to 20 weeks of
gestation is most commonly seen in women POST MATURITY
with:
(a) A history of chronic hypertension 1. What is Post-Mature Pregnancy?
(b) Multiple gestation
(a) Pregnancy beyond 42 completed weeks
(c) Gestational trophoblastic diseases
(d) A history of seizure disorder (b) Pregnancy beyond 28 completed weeks
9. The most common complication of eclampsia (c) Pregnancy beyond 37 completed weeks
is: (d) Pregnancy beyond 40 completed weeks
(a) Mg intoxication 2. Post term pregnancy is the pregnancy that
(b) Recurrent seizures following administration of
continues beyond:
Mg sulphate
(c) Intracranial hemorrhage (a) 274 Days
(d) Maternal death (b) 286 Days
10. If a woman with pre-eclampsia is not treated (c) 294 Days
prophylactically to prevent eclampsia, her risk (d) 306 Days
of seizure is approximately:
3. Foetal hypoxia may occur in post maturity
(a) 1/10 (b) 1/25
(c) 1/75 (d) 1/200 because of:
11. All of the following antihypertensive drugs are (a) Low oxygenation
considered safe for short-term use in (b) Placenta praevia
pregnancy EXCEPT: (c) Aging placenta
(a) Captopril (b) Methyldopa
(d) None of these
(c) Hydralazine (d) Nifedipine
12. The reason to treat severe chronic 4. Still-birth rate includes babies death after
hypertension in pregnancy is to decrease the: (a) 20 wks
(a) Incidence of IUGR (b) 24 wks
(b) Incidence of Placental abruption
(c) 28 wks
(c) Incidence of Preeclampsia
(d) 32 wks
(d) Risk of Maternal Complications such as Stroke
13. The reason of using antihypertensive treatment 5. In post term pregnancy usually liquor amnni
in pregnancy is to: (a) Diminishes
(a) Reduce the placental blood flow (b) Remains same
(b) Reduce the risk of CVA in the fetus
(C) Adequate
(c) Reduce the risk of CVA in the mother
(d) Prevent hypertensive renal disease
(d) Nothing significant
14. Which of the following laboratory tests would 6. Saffron coloured meconium seen in :
be most suggestive of preeclampsia? (a) Post maturity
(a) Elevated bilirubin (b) TB
(b) Decreased hematocrit
(c) Breech
(c) Elevated lactate dehydrogenase (LDH)
(d) Elevated uric acid (d) Normal in appearance
15. HELLP Syndrome includes all the followings
EXCEPT: ANSWER KEY
(a) Hemolysis (b) Increased AST 1. [a] 2. [c] 3. [c] 4. [c] 5. [a]
(c) Increased platelets (d) Increased ALT 6. [a]
ANSWER KEY ❑❑❑
1. [b] 2. [a] 3. [d] 4. [a] 5. [d]
6. [d] 7. [d] 8. [c] 9. [c] 10. [d]
11. [a] 12. [d] 13. [c] 14. [d] 15. [c]
❑❑❑

-:: 24 ::-
OBSTETRICS AND GYNAECOLOGY
9. In the diagnosis of premature rupture of the
PREMATURE LABOR AND PROM membrane, all of the following are true EXCEPT:
(a) History of fluid loss per vagina
(b) Visualization of amniotic fluid in the vagina by
1. All of these drugs can be used as tocolytic to stop
sterile speculum
labour, EXCEPT:
(c) Positive Nitrazine test
(a) Salbutamol ventolin
(d) Positive methylene blue test
(b) Diazepam (valium)
10. Rupture of membranes is suspected with all of
(c) Calcium channel blocker
the followings EXCEPT:
(d) Indomethacin non-steroidal anti-inflammatory
(a) Positive Nitrazine test
drugs
(b) Positive Fern test
2. In cases with premature rupture of membranes,
(c) Pooling of amniotic fluid on speculum
all the following are acceptable in the
examination
conservative management except:
(d) Contractions seen on the CTG.
(a) Frequent vaginal examination to assess cervical
11. All the followings are causes of preterm labour
dilatation
EXCEPT:
(b) Serial complete blood count to diagnose rising of
(a) Multiparity (b) Placenta previa
WBC
(c) Polyhydramnios (d) Multiple pregnancy
(c) Close monitoring of maternal vital signs
12. The following are known causes of preterm
(d) Ultrasound to assess fetal weight and amount of
labour EXCEPT:
liquor
(a) Maternal hypoxia (b) Intrauterine fetal death
3. Regarding Lung Surfactant is correct:
(c) Polyhydramnios (d) Cervical incompetence
(a) Is secreted by type I pneumocystis
13. Preterm labour is defined as labour which starts:
(b) Are glycoprotein
(a) Before 24 weeks of gestation
(c) After 38 weeks the ratio of lecithin to
(b) Before 37 completed weeks
sphingomyelin is 2:1
(c) Before the viability of the fetus
(d) Its secretion is suppressed by betamethasone
(d) When the fetus weighing < 1000 gm
4. The following has a recognized relation with
14. Premature rupture of membrane is:
spontaneous preterm labour:
(a) Rupture of membranes before the onset of labor
(a) Fetus with anencephaly
(b) Rupture of membranes before fetal lung
(b) Oligohydramnios
maturity
(c) Maternal hypothyroidism
(c) Rupture of membranes before term
(d) Bacterial Vaginosis
(d) Rupture of membranes before 28 weeks
5. All the following are possible of premature
gestation
labour, EXCEPT:
15. All of these drugs can be used as tocolytic to stop
(a) Multiple pregnancy (b) Polyhydramnios
labour, EXCEPT:
(c) Bicornuate uterus (d) Anencephaly
(a) Salbutamol ventolin
6. A positive nitrazine test is:
(b) Methotrexate
(a) Strong evidence of rupture of the membranes
(c) Calcium channel blocker
(b) Presumptive evidence of intact membranes
(d) Indomethacin non-steroidal anti-inflammatory
(c) An evidence of intact membranes
drugs
(d) Presumptive evidence of intact membranes
16. The following are known contraindications to the
7. The most serious complication of preterm
usage of Tocolysis in pregnancy EXCEPT:
premature rupture of membrane (PPROM) at 28
(a) Cardiac disease
weeks:
(b) Severe hypertension
(a) Fetal compression anomaly
(c) Clinical chorioamnionitis
(b) Pulmonary hypoplasia
(d) Intrauterine death
(c) Intrauterine infection
ANSWER KEY
(d) Limb contraction
8. The following are obstetrics causes for 1. [b] 2. [a] 3. [c] 4. [d] 5. [d]
premature labor EXCEPT: 6. [a] 7. [c] 8. [b] 9. [d] 10. [d]
(a) Multiple pregnancy 11. [a] 12. [a] 13. [b] 14. [a] 15. [b]
(b) Multiparity 16. [d]
(c) Premature preterm rupture of the membrane ❑❑❑❑
(d) Cervical incompetence

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OBSTETRICS AND GYNAECOLOGY
9. Monozygotic twins, All of the following are
MULTIPLE PREGNANCY correct EXCEPT:
(a) Has a constant incidence of 1:250 births
1. Multiple pregnancy increases (b) Has a constant incidence 1:600 births
(a) In white people more than black (c) Is not related to induction of ovulation
(b) With advancing maternal age (d) Constitutes 1/3 of twins
(c) With Bromocriptine use for infertility treatment 10. Twins pregnancy:
(d) If first pregnancy
(a) Presentation of the second twin dictate the
2. In twin deliveries; Which is true?
mode of delivery
(a) The first twin is at greater risk than the second
(b) They usually go post date (b) Internal podalic version should not be
(c) Epidural analgesia is best avoided performed for the second twin
(d) There is increased risk of postpartum (c) Monozygotic twins always bearing same sex
hemorrhage (d) Commonly goes post mature
3. The most common cause of uterine size date ANSWER KEY
disproportion: 1. [b] 2. [d] 3. [c] 4. [d] 5. [a]
(a) Fetal macrosomia
6. [a] 7. [c] 8. [a] 9. [b] 10. [c]
(b) Polyhydramnios
(c) Inaccurate last menstrual period date
(d) Multiple pregnancy
HYPEREMESIS GRAVIDARUM
4. The major cause of the increased risk of
morbidity & mortality among twin gestation
is: 1. What percentage of pregnant women suffer
(a) Gestational diabetes (b) Placenta previa from hyperemesis gravidarum?
(c) Malpresentation (d) Preterm delivery (a) 02% to 36%
5. The most common cause of perinatal death in (b) 40% to 62%
mono-amniotic twin is: (c) 10% to 12%
(a) Cord entrapment (d) 10% to 20%
(b) Cord prolapse 2. Which of the following is part of the definition
(c) Twin-twin transfusion syndrome of hyperemesis gravidarum?
(d) Lethal congenital anomalies (a) Vomiting that persists for the entire pregnancy
6. If twin A is in a transverse lie & twin B is (b) Vomiting upon arising more than five days per
vertex. The most appropriate route for week
delivery is: (c) Vomiting that appears after the 20th week of
(a) C-section pregnancy
(d) Severe nausea and vomiting with weight loss
(b) Internal podalic version followed by breech
greater than 5% of prepregnancy body weight
extraction
3. Thiamine (vitamin B1) deficiency results in
(c) Both
which potential maternal complication of
(d) Neither
hyperemesis gravidarum?
7. All of the following increased in multiple
(a) Renal failure
gestation EXCEPT: (b) Esophageal rupture
(a) Blood loss at delivery (c) Wernicke encephalopathy
(b) The incidence of congenital anomalies (d) Osmotic demyelination syndrome
(c) The incidence of cephalo-pelvic 4. Which of the following gestational hormones
disproportion is hypothesized to be correlated with
(d) The incidence of placental abruption hyperemesis gravidarum?
8. Regarding Hyperemesis gravidarum, which (a) Oestrogen
one of the following items is TRUE? (b) Testosterone
(a) Is a complication of multiple pregnancy (c) Human placental lactogen (HPL)
(b) Not known to happen in molar pregnancy (d) Human chorionic gonadotropin (HCG)
(c) Worsen in missed abortion
(d) Liver function test is not required
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OBSTETRICS AND GYNAECOLOGY
5. Nurses should make which of the following 12. If a patient with hyperemesis gravidarum is at
recommendations regarding prenatal vitamins risk for fluid volume deficit, nursing
to the patient with hyperemesis gravidarum? assessment may reveal
(a) Take prenatal vitamins after eating (a) Hypertension
(b) Take prenatal vitamins before eating (b) Increased potassium
(c) Add an iron supplement to the prenatal vitamins (c) Decreased hemoglobin
(d) Stop taking prenatal vitamins containing iron (d) Dry mucous membranes
until vomiting is resolved
13. The diagnosis of impaired tissue integrity,
6. Which of the following dietary recommendations
especially in the oral mucous membranes, is
are effective in the management of hyperemesis
due to
Gravidarum?
(a) Vitamin E deficiency
(a) Eating high-fat foods
(b) Drinking fluids with meals (b) Dehydration and vomiting
(c) Removing salt from the diet (c) Breathing through the mouth
(d) Eating small, frequent meals (d) Increased vitamin consumption
7. Thiamine replacement is essential prior to
initiating hydration therapy in the patient ANSWER KEY
with hyperemesis gravidarum because 1. [a] 2. [d] 3. [c] 4. [d] 5. [d]
(a) Severe anaemia may occur 6. [d] 7. [d] 8. [a] 9. [d] 10. [a]
(b) Vomiting may be exacerbated 11. [d] 12. [d] 13. [b]
(c) it may result in over hydration
(d) Dextrose causes the body to metabolize GYNAECOLOGY
thiamine stores, which may result in Wernicke
encephalopathy
8. Which of the following is inappropriate for the
UTERINE FIBROIDS (LEIOMYOMAS)
patient receiving intravenous therapy for
hyperemesis?
1. The Commonest uterine fibroid to cause
(a) Keeping the patient cool
excessive bleeding is :
(b) Monitoring intake and output
(c) Maintaining patency of the IV site (a) Submucous fibroid
(d) Counseling the patient regarding diet (b) Subserous fibroid
9. Which of the following signs and symptoms (c) Intramural fibroid
(d) Cervical fibroid
would the nurse expect to find in a patient
with hyperemesis gravidarum? 2. Acceptable treatment for uterine fibroids
(a) Elevated pulse includes all of the following EXCEPT:
(b) Ketotic breath smells (a) No treatment
(b) Myomectomy during pregnancy if red
(c) Dry mucous membranes
degeneration occurs
(d) All of the above
10. Which of the following might the nurse find (c) Myomectomy
evidence of in a urine dipstick analysis in the (d) Hysterectomy
patient with hyperemesis gravidarum? 3. Uterine fibroid: Which is true?
(a) Ketonuria (b) Glycosuria (a) Is commoner in white people than black
(c) Proteinuria (d) Albuminuria (b) All should be treated immediately
11. According to the North American Nursing (c) Sarcomatous change occurs in 1%
Diagnosis Association (NANDA), an (d) Can cause obstructed labor
appropriate nursing intervention for the 4. The following is TRUE regarding degenerative
patient with nausea is changes in uterine fibroids:
(a) Consuming fried or greasy foods (a) Sarcoma occurs in 2%
(b) Cystic degeneration is common with the use
(b) Adding spices to foods while cooking
(c) Lying supine for 30 minutes after eating of oral contraceptive pills
(d) Drinking fluids in between small, frequent (c) Hyaline degeneration causes acute pain
meals (d) Red degeneration should be managed
conservatively

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OBSTETRICS AND GYNAECOLOGY
5. The following are TRUE about Leiomyomas 12. Uterine fibroid:
EXCEPT: (a) Commonly associated with endometriosis
(a) Usually multiple (b) Are tumors of Striated muscle?
(b) Usually malignant (c) Commonly present with post-menopausal
(c) Usually discrete bleeding
(d) Usually spherical or irregular lobulated (d) Progesterone dependent tumor
6. Fibromyoma of the uterus: 13. Regarding red degeneration in fibroids, all are
(a) Is pre malignant tumor true EXCEPT:
(b) Symptoms are related to the site (a) Common during pregnancy
(c) Estrogen dependent tumor (b) Causes acute abdominal pain
(d) Can be associated with endometriosis & (c) Surgery is the 1ST line treatment
endometrial hyperplasia (d) Caused by ischemic necrosis
7. These are possible symptoms caused by 14. Regarding Submucous uterine fibroids all of
fibroids EXCEPT: the following are correct EXCEPT:
(a) Pelvic pain (a) May become polypoidal
(b) Subfertility (b) Can become infected
(c) Pressure symptoms (c) Frequently cause infertility
(d) Deep vein thrombosis (d) Often present with menorrhagia
8. True statement regarding leiomyomas is: 15. Regarding uterine leiomyomata may undergo
(a) The severity of the bleeding is proportional to the following changes EXCEPT:
the size and the number of myomas (a) Hyaline degeneration
(b) Intermenstrual pain is present in more than (b) Squamous metaplasia
50% of women with myomas that have not (c) Atrophy
undergone degeneration (d) Calcification
(c) Intermenstrual bleeding is the most common 16. Uterine leiomyomata generally require no
menstrual disorders treatment. When treatment is indicated, it is
(d) The majority of the women with multiple most frequently because of:
myomas are fertile (a) Interference with reproductive function
9. A 20 year old lady pregnant in 1st trimester (b) Rapid enlargement with the hazards of
came complaining of lower abdominal pain, in Sarcomatous degeneration
examination a mass continued with the uterus (c) Pain
(d) Excessive uterine bleeding
was found what the diagnosis is:
17. A patient with uterine leiomyoma
(a) Red degeneration of fibroid
accompanied by excessive uterine bleeding
(b) Ectopic pregnancy should be initially evaluated and /or treated
(c) Uterine rupture by:
(d) Rupture placenta (a) Myomectomy
10. Types of uterine fibroid degeneration include (b) Hysterectomy
all EXCEPT: (c) Irradiation
(d) Hysteroscopy with endometrial biopsy
(a) Red degeneration
ANSWER KEY
(b) Yellow degeneration
1. [a] 2. [b] 3. [d] 4. [d] 5. [b]
(c) Calcification 6. [c] 7. [d] 8. [d] 9. [a] 10. [b]
(d) Hyaline degeneration 11. [d] 12. [d] 13. [c] 14. [c] 15. [b]
11. Regarding uterine fibroid in pregnancy, all are 16. [d] 17. [d]
true EXCEPT: ❑❑❑
(a) Are often asymptomatic
(b) May present with abdominal pain
(c) May cause obstructed labor
(d) Should be removed surgically if it becomes
symptomatic

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