OBSTETRICS
INSTRUCTION: CHOOSE THE LETTER OF THE BEST ANSWER. WRITE YOUR
ANSWER ON THE ANSWER SHEET PROVIDED. ERASURES ARE NOT ALLOWED.
1) A 36 weeks pregnant multigravida patient had profuse painless bleeding, you will NOT: a.
Do an internal examination
b. Insert IV fluid
c. Refer for ultrasound
d. Bring to a good hospital
2) Which is the denominator or point of reference in face presentation?
a. Achromial process c. Sacrum
b. Occiput d. Mentum
3) Which of the following immunizations is safe for pregnant mothers?
a. Rubella c. MMR
b. Tetanus toxoid d. Varicella zoster
4) As a Midwife, you are aware that when a client comes back for her DMPA after 3 months,
you cannot administer said contraceptive if you will not conduct:
a. Urinalysis c. Complete blood count
b. Pregnancy test d. Contraction stress test
5) A woman with her second pregnancy delivered by NSVD and is now on the taking-hold
phase. The most applicable descriptive term for her is:
a. Parturient c. Puerpera
b. Multigravida d. Nullipara
6) Crowning of the fetal head is identified when:
a. The head is at the level of the ischial spines.
b. The biparietal diameter is encircled by the introitus
c. The head is at the level of the linea terminales
d. The anterior fontanel is at the level of the ischial tuberosities
7) The infundibulum of the fallopian tube has a long projection that is always ready to catch
the mature egg as it is released during ovulation. What is the name of this structure?
a. Flagellia c. Fimbriae
b. Cilia d. Fimbria ovarica
8) Expulsion is accomplished when:
a. The occiput is under the symphysis pubis
b. The shoulders are both delivered
c. The entire fetal body is already out
d. The breech is at the outlet
9) Josefa reported to the midwife during a prenatal check-up that she is eating uncooked
rice. She cannot understand why. You explained the cause of this problem and advice
instead that she increase her intake of:
a. Folic acid rich foods c. Iron rich foods
b. Vitamin C rich foods d. Iodine rich foods
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10)The causative agent of Pelvic inflammatory disease is:
a. A bacteria c. A virus
b. A fungus d. A protozoa
11)Which abnormal condition affecting a woman will not predispose her to infertility?
a. Pelvic inflammatory disease
b. Endometriosis
c. Ectopic pregnancy
d. Pregnancy induced hypertension
12)Where is the living ligature located?
a. Fallopian tube c. Endometrium
b. Parametrium d. Myometrium
13)With the ascent from the pelvis, the uterus usually undergoes rotation with tilting to the
right side of the body. This is dextro-rotation. Which of the following is false? a. Dextro-
rotation is a normal maternal change during pregnancy
b. Dextro-rotation is an abnormal condition during pregnancy.
c. This is caused by the presence of the recto-sigmoid colon
d. None of these
14)The fertilized ovum will have the following chromosome:
a. XX, XY c. XX, XX
b. XX or XY d. XX only
15)Which of the following is not true about perineal laceration repair?
a. Repair the vagina by suturing above the angle of the wound using figure of eight
technique.
b. Close the skin with simple interrupted technique
c. Repair the lacerations in layer.
d. Avoid making the sutures too tight, allow allowance for edema.
16)You are preparing to administer IVF to a woman who is bleeding because of atony. You
are to use tourniquet in this procedure. What is the purpose of applying tourniquet near
the IV puncture site when administering IVF?
a. To make the vein large c) To prevent bleeding
b. To dilate the vein d) To allow easy insertion of needle
17)Which of the following is a sign that the IVF needle is out of the vein?
a. Redness c) Ecchymosis
b. Swelling of the site d) Warmth
18)Which of the following statements about the broad ligament is NOT correct?
a. It supports the sides of the uterus
b. It divides the pelvic cavity into anterior and posterior compartment
c. It is a wing like structure, from lateral margin of the uterus to the pelvic walls
d. It begins at the cornua of the uterus behind the uterine tubes and pass down the
ovaries
19)Which of the following is not an antero-posterior diameter of the inlet?
a. True conjugate c) Obstetric conjugate
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b. Intertuberous diameter d) Diagonal conjugate
20)Which of the following is a major fetal factor that balances the amniotic fluid volume?
a. Fetal urination c) Fetal swallowing
b. Fetal movement d) All of these
21)When is the best time to let the pregnant woman take folic acid supplement?
a. 4 weeks AOG c) 16 weeks AOG
b. 32 weeks AOG d) 38 weeks AOG
22)Cervical dilatation progress normally if it increase by how many centimeter every hour?
a. 1 cm b) 0.5 cm c) 1.5 cm d) 2 cm
23)Plotting the progress of labor in the Partograph is started when the woman is in active
labor and is contracting adequately. Adequate contraction refers to:
a. 1-3 contractions in 10 minutes c) 3-4 contractions in 10 minutes
b. 4-5 contractions in 10 minutes d) 3-5 contractions in 10 minutes
24)A normal progress of labor in the Partograph would mean:
a. Plotting stays on or towards the left of the alert line
b. Plotting passes the alert line
c. Plotting passes the action line
d. Plotting is both on the alert and action line
25)Which blood examination result can tell good perfusion of blood to body tissues?
a. Hematocrit count c) WBC count
b. Hemoglobin count d) Platelet count
26)A primigravida has the following result of labor pattern: Duration 80 seconds, Interval 1
min, Frequency of contractions in 10 minutes is 6-10, Intensity – very strong. This
information indicates:
a. Delivery may occur in 12 hours
b. Imminent delivery
c. The mother is in the latent phase – first stage
d. The mother is in the active phase – first stage
27)Variable deceleration of fetal heart tone indicates:
a. Uteroplacental insufficiency c) Head compression
b. Fetal distress d) Umbilical cord compression
28)The Midwife performs Leopold’s maneuvers and determine that the fetus is in the left
occiput anterior position. The Midwife interprets this to mean: a. The fetus is in oblique lie
b. The fetus is in complete breech presentation
c. The fetus is facing the maternal right pelvis
d. The fetus is in vertex presentation
29)After the mother shouted that the baby is coming, and you observed perineal bulging, how
will you coach the patient?
a. Push during contraction c) Breath through the mouth and pant
b. Blow, pant and push d) All of these are applicable
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30)The deepest part of the perineal body surrounding the urethra, vagina and rectum that
when damaged can result in cystocele, rectocele, and urinary stress incontinence is the:
a. Ischiocavernous muscle
b. Pubococcygeous muscle
c. Sphincter of urethra and anus
d. Bulbocavernous muscle
31)A client on her 8th week of pregnancy complains of having to go to the bathroom often to
urinate. You explain to the client that urinary frequency often occurs because the capacity
of the bladder during pregnancy is diminished. And this is common during the: a. First
and second trimester c) First, second and third trimesters
b. Second and third trimester d) First and third trimesters
32)Pregnancy is more likely to occur if coitus occurs at what time?
a. At ovulation c) 2 days after ovulation
b. 2 days before ovulation d) 1 day before ovulation
33)A woman at 32 weeks gestation is admitted in preterm labor. On your admission
assessment, which of the following findings would be the reason that the doctor will order
for a tocolytic agent?
a. Cervical dilatation of 5 cm
b. Mild to strong, regular contractions
c. Fetus in breech presentation
d. History of spontaneous abortion in a previous pregnancy
34)A woman has been diagnosed as having pregnancy-induced hypertension. Which of the
following is the most typical symptom?
a. Increased perspiration c) Leukocytosis
b. Weight gain and edema d) Glucose in urine
35)Before the midwife delivers the placenta, what should she observe first?
a. Signs of placental separation c) Sudden gush of fluid from vagina
b. Maternal complain of pain d) Change in maternal mental status
36)On the 10th day postpartum following a Cesarean birth, at which of the following locations
would you expect to palpate the woman’s fundus?
a. Behind the symphysis pubis c. Two fingers below the umbilicus
b. At the umbilicus d. Four fingers below the umbilicus
37)The purpose of this maneuver is to determine the fetal back of the fetus.
a. Pelvic grip b. Umbilical grip c. Fundal grip d. Pawlik’s grip
38)In order to prevent TB infection in the newborn, the best advice for the pregnant mother
with tuberculosis once she delivers her baby is?
a. The newborn must get a Bacille Calmette Guerin immunization.
b. The newborn must get the rifampicin, isoniazid, pyrazinamide, ethambutol
chemotherapy
c. The newborn must have a streptomycin prophylaxis.
d. The newborn must be separated from the mother until toddler stage.
39)Folic acid is to be taken by a pregnant mother to prevent neural tube defect. Which of the
following is false about Folic Acid?
a. It is found in most body tissues where it acts as a co-enzyme in metabolic processes.
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b. It is water soluble and heat labile and easily destroyed by cooking.
c. It is important for the normal formation of RBC and synthesis of DNA.
d. It is a mineral which cannot be stored in body tissues.
40)What is known as the ovulatory hormone?
a. Follicle stimulating hormone
b. Estrogen
c. Follicle stimulating hormone releasing hormone
d. Progesterone
41)If a woman missed taking her pills today. What should she do?
a. Take two pills the following day at the same time she is taking the pill regularly b. Stop
taking the pills
c. Take two pills, one in the morning and one in the evening the following day
d. Use a back-up method and take only 1 pill the following day
42)When oral contraceptives are prescribed for a client, the Midwife should teach the client
about the potential of developing:
a. Cervicitis c. Fibrocystic disease
b. Ovarian cyst d. Irregular bleeding
43)In physiologic anemia of pregnancy, a lower hematocrit and hemoglobin is due to the
following:
a. Increased blood volume
b. iron utilization for fetal needs
c. Transfer of RBC from mother to fetus
d. increased red cell mass
44)A client tells you that her last menstrual period began on April 11. When could be her
EDC?
a. January 30 c) December 20
b. January 19 d) December 18
45)The following are considered abnormality of the passenger EXCEPT:
a. Cephalopelvic disproportion
b. Military attitude
c. Breech presentation
d. Footling presentation
46)The phrase Gravida 4, Para 2 indicates which of the following prenatal histories?
a. A client has been pregnant 4 times and had 2 miscarriages
b. A client has been pregnant 4 times and had delivered a baby to period of viability
c. A client has been pregnant 4 times and has two cesarean sections
d. A client has been pregnant 4 times and had two spontaneous abortions
47)The obstetric conjugate can be measured by subtracting1.5 – 2 cm from:
a. Diagonal conjugate c) True conjugate
b. Bispinous diameter d) Bi-ischial diameter
48)What is the blood supply of the lower third of the vagina?
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a. Cervicovaginal branches of the uterine arteries
b. Inferior vesical arteries
c. Superior vesical arteries
d. Middle rectal and internal pudendal arteries
49)Which structure becomes more prominent in nulliparous women?
a. Clitoris c. Vulva
b. Fourchette d. Vestibule
50)What is the arterial blood supply to the upper third of the vagina?
a. Cervicovaginal branches of the uterine arteries
b. Inferior vesical arteries
c. Superior vesical arteries
d. Middle rectal and internal pudendal arteries
51) These are conditions that occur during the pre-labor phase which are acted upon by
uterotropins except:
a. false labor pains
b. ripening of cervix
c. lightening
d. Braxton Hicks contraction
52) The following are signs of impending delivery EXCEPT:
a. Increasing bloody show
b. Rectal pressure
c. Contractions more frequent and of shorter duration
d. Rupture of membrane
53) The initial action of the Midwife upon knowing that a client has watery vaginal discharge
is:
a. Instruct her to lie on bed
b. Monitor her fetal heart tone
c. Advise her to take nothing by mouth
d. Observe the characteristic of the discharge
54) A mother comes to you for check-up today. Based on LMP, EDC is expected in
June. According to Bartholomew’s rule, you would expect her uterus to be: a. large
for date
b. small for date
c. above the navel
d. below the navel
55) The smallest transverse diameter to which the fetus must pass is found in the:
a. Inlet c. mid pelvis
b. Outlet d. pelvic cavity
54) Deep muscles not sutured by midwife are:
1. Sphincter ani
2. Urethral muscles
3. levator ani
4. coccygeus
a. 1,2 & 3 b. 1 only c. 1 &2 d. 3&4
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55) Deep lacerations of the vulva may cause this complication which can lead to shock:
a. Uterine rupture c. hematoma
b. AF embolism d. all of these
56) Which among these situations is not considered an aim of OB?
a. A mother of 23 years old, mature, professional and healthy
b. Babies are screened right after birth to determine metabolic disorders
c. Mothers are advised to have only 2 kids
d. Immunizations, PNC are mandated to assure mother’s health
57)If the head is station +2, with 2 cm caput, the station is:
a. +1 c. 0
b. +2 d. –2
58)What is the Para of a woman with OB score of 6 –1 –2 –4?
a. 6 c. 7
b. 5 d. 4
59)Which lines the inner membrane of the uterus of a postpartum mother?
a. Perimetrium c. endometrium
b. Decidua d. epithelium
60)Examples of uterotonins:
1. Progesterone
2. Oxytocin, prostaglandin
3. Relaxin, prostaglandin
4. Estrogen, prostaglandin
a. 1 only b. 1,2&3 c. 2 only d. all of these
61)When a mother reaches 35 years and over, several perinatal complications occur. These
would include:
a. preterm delivery c. congenital anomalies
b. fetal growth retardation d. all of these
62)When the lower extremities in breech presentation is extended at the hips and flexed at
the knees, it is:
a. Compound presentation c. complete breech
b. Frank breech d. incomplete breech
63)A 37-year-old woman was admitted for convulsions, albuminuria and edema:
a. Severe hypertension
b. chronic Hypertensive disease
c. chronic Hypertensive pre-eclampsia
d. eclampsia
64)Which of the following statements best describes an internal rotation?
a. Allows the passage of the presenting part through the irregular pelvis.
b. The smallest antero-posterior diameter of the fetal head is presented to the pelvis.
c. The greatest biparietal diameter of the fetal head is presented to the pelvis.
d. The head descends as the chin is flexed more on the chest.
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65)What does synclitism/asyncliticism indicate?
a. confirms that mother is in labor
b. assess fetal adaptation to the pelvis
c. determines progress of labor
d. ascertains fetal well being
66)If the mother is less than 18 years old, which is the most likely condition that may
complicate her pregnancy?
a. gestational diabetes
b. risk of chronic HPN
c. prolonged nulliparous labor
d. increased risk of toxemia
67)Multiparas have increased risks of the following conditions:
a. placenta previa
b. postpartum hemorrhage
c. perinatal & maternal mortality
d. double ovum twinning
68)These would include support and comfort measures rendered to a woman in labor:
1. Breathing exercises, relaxation exercises
2. Provision of privacy & rest, positioning
3. Backrub, medications, application of heat or cold to lower back
4. Constant monitoring of fetal well-being, progress of labor and watching for
complications
a. 1 only
b. 1,2 & 3
c. 4 only
d. all of these
69)Mrs. Olivar, 31 years old, G2P1, returns to you for PNC visit at 28 weeks AOG. Which
laboratory test would you ask her to do?
a. Pap smear c. VDRL, HIV test
b. Diabetes screen d. Varicella antibody screen
70)When bulging of the perineum is observed, the Midwife has to prepare to:
a. Clamp the cord
b. Clear the mouth and nose of secretions
c. Apply abdominal (fundal) pressure
d. Apply Ritgen’s maneuver
71)You are called to attend to Myrna, G3P2, 38 weeks AOG at home. Upon assessment,
you diagnose her to be having placenta previa with bouts of bleeding. Your management
would consist of:
1. Place woman in T-position, monitor vital signs
2. Start IV – 1 liter of D5W, fast drip with 18 gauge intracatheter
3. Call for help or prepare for transfer to the hospital
4. Prepare delivery of the baby by ascertaining your asepsis and preparing
equipment needed.
a. 1 only
b. 1,2 &3
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c. all of these
d. 4 only
72)Women with the following conditions exhibit a higher incidence of polyhydramnios, except:
a. fetal twinning c. gestational diabetes
b. ABO/Rh diseases d. CPD, Pelvic abnormality
73)Which among these signs would not indicate post maturity syndrome:
a. long fingernails
b. wrinkled peeling skin
c. abundant vernix caseosa
d. less of subcutaneous fat
74)Regimen for heart disease in pregnancy would include all these except:
1. prevention/correction of anemia
2. increase in physical activity and strenuous work
3. prompt recognition and treatment of infections
4. low sodium diet, lateral position, adequate rest
75)1,2 & 3 b. 2 & 3 c. 2 only d. 4 only
a. Which are true of anemia in pregnancy:
i. There is a need to manage woman with hgb. level of less than 10 gms / dl
b. Iron is more readily absorbable from foodstuff than from oral iron medication
c. Those women with hgb. level at 10-12 gms/dl should be started on folic acid and
vitamin supplements
d. All of these
76)The daily recommended dose for iron in pregnancy would be:
a. 15 mg b. 30 mg c. 40 mg d. 50 mg
77)This screening test for diabetes makes use of ___gm of glucose, without fasting, 1 hour
later of which blood is drawn:
a. 25 gm b. 50 gm c. 60 gm d. 100 gm
78)All of the following are physiologic effects of progesterone, EXCEPT:
a. Movement of zygote through the oviduct
b. Slightly elevated basal body temperature
c. Formation of corpus luteum
d. Inhibition of uterine contractility during pregnancy
79)These conditions in the mother can cause Intra Uterine Growth Retardation (IUGR) in the
fetus except:
a. chronic HPN
b. multiple gestation
c. placental malformation
d. diabetes
80)These are increased either markedly or slightly during pregnancy & puerperium except:
1. Body’s O2 consumption is increased
2. Blood volume and red cell mass both increase
3. Hemoglobin concentration falls slightly
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4. Cardiac output is decreased especially during contractions 5.
A. 1,2 &3 b. 1 & 2 c. 2 & 3 d. 4 only
81)The main causes of postpartum hemorrhage are these:
a. uterine atony c. trauma and lacerations
b. bleeding disorders d. all of these
82)There are many functions of estrogen, one of which is:
a. Elevates basal body temperature during ovulation
b. Inhibits uterine contractility
c. Promotes lactation
d. Promotes female secondary sex characteristics
83)When suturing the peri-clitoris area, what preventive action is done by the health giver that
sutures the laceration?
a. Suture as soon as possible as it may cause profuse bleeding.
b. A catheter should be inserted to guide the needle away from it.
c. The RM can leave the laceration to heal by itself.
d. all of these
84)Fertility rate is the number of live births per ___ female population aged 15 to 44 years:
a. 100 c. 1,000
b. 10,000 d. 100,000
85)Which factor cannot be assessed by the RM during lE?
a. cervical consistency, dilatation and effacement
b. determine the size of the pelvis thru the diagonal conjugate
c. determine the position of the baby
d. determine possible congenital anomalies of fetal head
86)Which of the following is a diagnostic test for fertility?
a. PAPSMEAR
b. Coomb’s test
c. Culdocentesis
d. Hysterosalphingogram
87)Which does not refer to the transverse diameter of the outlet?
a. Biischial diameter
b. Bispinous
c. Bituberous diameter
d. intertuberous diameter
88)In which condition is Oxytocin stimulation indicated?
a. G3P2 – prolonged labor
b. Mother with gestational diabetes
c. G7P6 – fetal distress
d. Mother whose babies have an LS ratio of 2:1
89)Following ovulation, the ovum is normally viable for how many hours?
a. 8 c. 10
b. 24 d. 12
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90)Within the female reproductive tract, the sperm remains viable for how many days?
a. 5 c. 4
b. 1 d. 3
91)Elvie, A G3P3 just delivered mother experienced early postpartum bleeding. This means
that she lost 500cc or more of blood:
a. within 12 hours
b. after 24 hours
c. during the 1st 24 hours
d. after 2 hours postpartum
92)What is the attitude of the fetal head in brow presentation?
a. completely flexed c. completely extended
b. partially extended d. partially flexed
93)In cephalic presentation, when the anterior fontanel is lower than the posterior fontanel, it
is:
a. sincipital presentation c. brow presentation
b. face presentation d. vertex presentation
94)During puberty, there are about how many egg cells?
a. 2 million c. 400 to 600 thousand
b. 6.8 million d. 500,000
95)Syntocinon 1 amp. was injected to a mother one-hour post-delivery to control bleeding.
Potential side effects of this drug include which of the following?
a. sudden hypertension c. sudden dizziness
b. sudden hypotension d. uterine rupture
Situation:
Mona Santos is G3P2 pregnant woman who sought consultation at the lying in clinic due
to leg cramps and easy fatigability.
96)Multivitamins with iron supplements was ordered. The nurse instructs Mona to take this:
a. After each meal c. After breakfast
b. Every time she feels weak d. Before breakfast
97)Which of the following problems is likely to be associated with iron intake?
a. Nausea c. Constipation
b. Diarrhea d. Gas pain
98)Which of the following food will you advise to relieve her leg cramps?
a. Mongo, cheese, dilis
b. Pechay, squash, malunggay
c. Nuts, legumes, eggs
d. Rice, bread, root crops
99)Mona asked for a nutrition supplement to ease her leg cramps. Which of the following is
NOT to be advised?
a. Calci Aid c. Cal de Ce
b. Calcebone d. Calpol
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100) Mrs. Santos at 32 weeks AOG begins to experience labor pains. Which of the
following drugs would be ordered to her?
a. MgSO4, Ca gluconate c. Terbutaline, Ritodrine
b. Methergin, Syntocinon d. Amoxicillin, Nubain
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