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Republic of the Philippines

Professional Regulation Commission


Manila City
Board of Midwifery

Obstetrics and Gynecology


SET A
1. The midwife is using Doppler ultrasound to assess a pregnant woman. When should the
midwife expect to hear fetal heart tones?
a. 7 weeks
b. 11 weeks
c. 17 weeks
d. 21 weeks
2. The midwife is caring for a 16-year-old pregnant client. The client is taking an iron
supplement. What should this client drink to increase the absorption of iron?
a. A glass of milk
b. A cup of hot tea
c. A liquid antacid
d. A glass of orange juice
3. A primigravida, admitted to the hospital at 12 weeks' gestation complaining of abdominal
cramping, exhibits bright red vaginal spotting without cervical dilation. The midwife
determines that the client is most likely experiencing which of the following types of
abortion?
a. Missed.
b. Threatened.
c. Inevitable.
d. Complete.
4. A pregnant woman states that she frequently ingests laundry starch. When assessing the
client, for which of the following should the midwife be alert?
a. Muscle spasms.
b. Lactose intolerance.
c. Diabetes mellitus.
d. Anemia.
5. Which of the following would the midwife most likely expect to find when assessing a
pregnant client with abruptio placenta?
a. Excessive vaginal bleeding.
b. Rigid, boardlike abdomen.
c. Tetanic uterine contractions.
d. Premature rupture of membranes.

6. The midwife is caring for a client during the first postpartum day. The client asks the
midwife how to relieve pain from her episiotomy. What should the midwife instruct the
woman to do?
a. Apply an ice pack to her perineum.
b. Take a Sitz bath.
c. Perform perineal care after voiding or a bowel movement.
d. Drink plenty of fluids.
7. The midwife is assessing a client on the second postpartum day. Under normal
circumstances, the tone and location of the client's fundus is:
a. soft and one fingerbreadth below the umbilicus.
b. firm and two fingerbreadths below the umbilicus.
c. firm and to the right or left of midline.
d. soft and at the level of the umbilicus.
8. A 23-year-old primigravida delivers a healthy boy by vaginal delivery. During an
assessment the next day, the midwife is examining her lower extremities for signs and
symptoms of thrombophlebitis. Which of the following signs should be assessed?
a. Chadwick's sign
b. Hegar's sign
c. Homans' sign
d. Goodell's sign
9. The midwife is caring for a client on her second postpartum day. The midwife should
expect the client's lochia to be:
a. red and moderate.
b. continuous with red clots.
c. brown and scant.
d. thin and white.
10. The midwife is helping to prepare a client for discharge following childbirth. The
midwife instructs the client to do Kegel exercises. What's the purpose of these exercises?
a. To prevent urine retention
b. To relieve lower back pain
c. To tone the abdominal muscles
d. To strengthen the perineal muscles
11. The client, 11 weeks pregnant, tells the midwife that she has been vomiting after
breakfast nearly every morning. Which of the following measures should the midwife
suggest to help the client cope with early morning nausea and vomiting?
a.
b.
c.
d.

Limiting fluid intake between meals.


Increasing her intake of high-fat foods.
Eating dry, unsalted crackers before arising.
Drinking a carbonated beverage before bedtime

12. The midwife should anticipate that hemorrhage related to uterine atony may occur
postpartally if this condition was present during the delivery:
A.Excessive analgesia was given to the mother
B.Placental delivery occurred within thirty minutes after the baby was born
C.An episiotomy had to be done to facilitate delivery of the head
D.The labor and delivery lasted for 12 hours
13. According to Rubins theory of maternal role adaptation, the mother will go through 3
stages during the post partum period. These stages are:
A.Going through, adjustment period, adaptation period
B.Taking-in, taking-hold and letting-go
C.Attachment phase, adjustment phase, adaptation phase
D.Taking-hold, letting-go, attachment phase
14. A client makes a routine visit to the prenatal clinic. Although shes 14 weeks pregnant,
the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr. Diaz
diagnoses gestational trophoblastic disease and orders ultrasonography. The midwife
expects ultrasonography to reveal:
a.an empty gestational sac.
b.grapelike clusters.
c.a severely malformed fetus.
d.an extrauterine pregnancy.
15. Midwife Roy is caring for a client in labor. The external fetal monitor shows a pattern of
variable decelerations in fetal heart rate. What should the midwife do first?
a.Change the clients position.
b.Prepare for emergency cesarean section.
c.Check for placenta previa.
d.Administer oxygen.
16. A 39-year-old at 37 weeks gestation is admitted to the hospital with complaints of
vaginal bleeding following the use of cocaine 1 hour earlier. Which complication is most
likely causing the clients complaint of vaginal bleeding?
a.Placenta previa
b.Abruptio placenta
c.Ectopic pregnancy
d.Spontaneous abortion
17. During a prenatal visit at 4 months gestation, a pregnant client asks whether tests can be
done to identify fetal abnormalities. Between 18 and 40 weeks gestation, which
procedure is used to detect fetal anomalies?
a.Amniocentesis.
b.Chorionic villi sampling.
c.Fetoscopy.
d.Ultrasound

18. The uterine fundus right after delivery of placenta is palpable at


A.Level of Xyphoid process
B.Level of umbilicus
C.Level of symphysis pubis
D. just below umbilicus

19. The fetus pregnancy is a_____


a. parasite
b. passive passenger
c. foreign body
d. dynamic force producing bioactive agent essential to pregnancy

20. Menstruation is ultimately due to______


a. progesterone stimuli
b. progesterone withdrawal
c. estrogen withdrawal
d. estrogen stimulation

21. Which of the following EPI diseases is caused by the bordetella species of bacteria?
A.pertussis
B.tetanus
C.diphtheria
D.poliomyelitis

22. Which of the following test can be done by a midwife to check for presence of albumin in
the urine?

A.heat and acetic test


B.benedict's test
C.clinitest
D.GTT

23. The immunologic test for pregnancy is based on the presence of.

A.chrorionic gonadotropin
B.estrogen
C.progesterone
D. FSH

24. "Oplan Alis Disease" held last april 21,1993 (National Imminization Day) was celebrated
with the provision of vaccination nationwide in various.
A.drop centers
B."PATAK centers"
C.disease centers
D. bite center

25. The endocrine changes of pregnancy are a consequence of_______


A.fetal placenta function
B.maternal ovarian function
C.uterine hormone production
D.pituitary function

26. You attended to a mother who delivered a harelip baby,which of the following traits do
you think you should posses in order to help the mother accept the situation:
A.Eympathy
B.Sympathy
C.Pity
D.Shame

27. Professional conduct should be observed by a midwife, an example of which is:


A.performing the task and functions that is only within the scope of midwifery
practice.
B.performing the function of a midwife since nursing care can be done by the
midwives effectively.
C.operating a lying-in clinic which charged exorbitant fee
D. Choosing patient

28. Which of the following is true about the code of ethics for midwives?
A.a midwife should work with interest and concern and may join a health team at her
discretion.
B.a midwife is bound by professional ethics so she has the reason to reveal any
information given by her patient.
C.a midwife who has accepted to the take care of a patient should render service
to the patient to the best of her ability.
D. a midwife who choose client and charged exorbitant fee

29. When teaching a group of adolescents about male hormone production, which of the
following would the midwife include as being produced by the Leydig cells?
A.
Follicle-stimulating hormone
B.
Testosterone
C.
Leuteinizing hormone
D.
Gonadotropin releasing hormone

A
.

30. When preparing a woman who is 2 days postpartum for discharge, recommendations for
which of the following contraceptive methods would be avoided?
Diap
hrag
m
Female condom
Oral contraceptives
Rhythm method

B.
C.
D
.
31.

A patient is in labor and has just been told she has a breech presentation. The
midwife should be particularly alert for which of the following?
Quickening
Ophthalmia neonatorum

A.
B.
C P
. i
c
a
D
Prolapsed umbilical cord
.
32.
The midwife documents positive ballottement in the clients prenatal record. The
midwife understands that this indicates which of the following?
A.
Palpable contractions on the
abdomen
B.
Passive movement of the unengaged
fetus
C.
Fetal kicking felt by
the client
D
Enlargement and softening of the uterus
.
33.
Which of the following actions would be least effective in maintaining a neutral
thermal environment for the newborn?
A.
Placing infant under radiant warmer after bathing
B.
Covering the scale with a warmed blanket prior to weighing
C.
Placing crib close to window for family viewing
D
Covering the infants head with a knit stockinette
.
34.
When teaching a group of adolescents about variations in the length of
the menstrual cycle, the midwife understands that the underlying mechanism is due
to variations in which of the following phases?
A.
Menstrual phase
B.
Proliferative phase
C.
Secretory phase
D
Ischemic phase
.
35.
Which of the following would the midwife use as the basis for the teaching plan
when caring for a pregnant teenager concerned about gaining too much weight

A.
B.
C.
D
.
36.
A.
B.
C.
D
.
37.
A.
B.
C.
D
.
38.

during pregnancy?
10 pounds per trimester
1 pound per week for 40 weeks
pound per week for 40 weeks
A total gain of 25 to 30 pounds
To differentiate as a female, the hormonal stimulation of the embryo that must
occur involves which of the following?
Increase in maternal estrogen secretion
Decrease in maternal androgen secretion
Secretion of androgen by the fetal gonad
Secretion of estrogen by the fetal gonad
A multigravida at 38 weeks gestation is admitted with painless, bright red bleeding
and mild contractions every 7 to 10 minutes. Which of the following assessments
should be avoided?
Maternal vital sign
Fetal heart rate
Contraction monitoring
Cervical dilation
A postpartum client has a temperature of 101.4F, with a uterus that is tender when
palpated, remains unusually large, and not descending as normally expected.
Which of the following should the midwife assess next?

A L
. o
c
hi
a
B Br
. ea
sts
C In
. cis
io
n
D
Urine
.
39.
A.
B.
C.
D

During a prenatal class, the midwife explains the rationale for breathing techniques
during preparation for labor based on the understanding that breathing techniques
are most important in achieving which of the following?
Eliminate pain and give the expectant parents something to do
Reduce the risk of fetal distress by increasing uteroplacental perfusion
Facilitate relaxation, possibly reducing the perception of pain
Eliminate pain so that less analgesia and anesthesia are needed

.
40.
A.
B.
C.
D
.
41.

A.
B.
C.
D
.
42.
A.
B.
C.
D
.
43.
A.
B.
C.
D
.
44.

A.
B.
C.
D
.
45.
A.

During a pelvic exam the midwife notes a purple-blue tinge of the cervix. The
midwife documents this as which of the following?
Braxton-Hicks sign
Chadwicks sign
Goodells sign
McDonalds sign
A client 12 weeks pregnant come to the emergency department with abdominal
cramping and moderate vaginal bleeding. Speculum examination reveals 2 to 3 cms
cervical dilation. The midwife would document these findings as which of the
following?
Threatened abortion
Imminent abortion
Complete abortion
Missed abortion
The midwife assesses the postpartum vaginal discharge (lochia) on four clients.
Which of the following assessments would warrant notification of the physician?
A dark red discharge on a 2-day postpartum client
A pink to brownish discharge on a client who is 5 days postpartum
Almost colorless to creamy discharge on a client 2 weeks after delivery
A bright red discharge 5 days after delivery
The client tells the midwife that her last menstrual period started on January 14 and
ended on January 20. Using Nageles rule, the midwife determines her EDD to be
which of the following?
September 27
October 21
November 7
December 27
When taking an obstetrical history on a pregnant client who states, I had a son
born at 38 weeks gestation, a daughter born at 30 weeks gestation and I lost a baby
at about 8 weeks, the midwife should record her obstetrical history as which of the
following?.
G2 T2 P0 A0 L2
G3 T1 P1 A0 L2
G3 T2 P0 A0 L2
G4 T1 P1 A1 L2
A postpartum primipara asks the midwife, When can we have sexual intercourse
again? Which of the following would be the midwifes best response?
Anytime you both want to.

B.
C.
D
.
46.
A.
B.
C.
D
.
47.
A.
B.
C.
D
.
48.
A.
B.
C.
D
.
49.
A.
B.
C.
D.
50.
A.
B
.
C
.

As soon as you choose a contraceptive method.


When the discharge has stopped and the incision is healed.
After your 6 weeks examination.

A newborn who has an asymmetrical Moro reflex response should be further


assessed for which of the following?
Talipes equinovarus
Fractured clavicle
Congenital hypothyroidism
Increased intracranial pressure
The postterm neonate with meconium-stained amniotic fluid needs care designed to
especially monitor for which of the following?
Respiratory problems
Gastrointestinal problems
Integumentary problems
Elimination problems
Which of the following should the midwife do when a primipara who is lactating
tells the midwife that she has sore nipples?
Tell her to breast feed more frequently
Administer a narcotic before breast feeding
Encourage her to wear a nursing brassiere
Use soap and water to clean the nipples
When measuring a clients fundal height, which of the following
techniques denotes the correct method of measurement used by the midwife?
From the xiphoid process to the umbilicus
From the symphysis pubis to the xiphoid process
From the symphysis pubis to the fundus
From the fundus to the umbilicus
Which of the following refers to the single cell that reproduces itself
after conception?
Chromosome

Blast
ocyst
Zy
go
te
D
Trophoblast
.

51.
A.
B.
C.
D
.
52.
A.
B.
C.
D
.
53.
A.
B.
C.
D
.
54.

For the client who is using oral contraceptives, the midwife informs the
client about the need to take the pill at the same time each day to accomplish which
of the following?
Decrease the incidence of nausea
Maintain hormonal levels
Reduce side effects
Prevent drug interactions
When preparing to administer the vitamin K injection to a neonate, the midwife
would select which of the following sites as appropriate for the injection?
Deltoid muscle
Anterior femoris muscle
Vastus lateralis muscle
Gluteus maximus muscle
A client at 24 weeks gestation has gained 6 pounds in 4 weeks. Which of the
following would be the priority when assessing the client?
Glucosuria
Depression
Hand/face edema
Dietary intake

The amniotic fluid of a client has a greenish tint. The midwife interprets this to be
the result of which of the following?
A.
Lanugo
B Hydra
. mnios
C.
Meconium
D
Vernix
.
55.
A.
B.
C.
D
.
56.
A
.

A client at 8 weeks gestation calls complaining of slight nausea in the morning


hours. Which of the following client interventions should the midwife question?
Taking 1 teaspoon of bicarbonate of soda in an 8-ounce glass of water
Eating a few low-sodium crackers before getting
out of bed
Avoiding the intake of liquids in the morning hours
Eating six small meals a day instead of thee large meals

When teaching a client about contraception. Which of the following would the
midwife include as the most effective method for preventing sexually transmitted
infections?
Spermi
cides

B
.
C.
D
.

Diaphr
agm
Condoms
Vasect
omy

57. 57. For which of the following clients would the midwife expect that an intrauterine device
would not be recommended?.
A.
Woman over age 35
B.
Nulliparous woman
C.
Promiscuous young adult
D
Postpartum client
.
58. When performing a pelvic examination, the midwife observes a red swollen area on
the right side of the vaginal orifice. The midwife would document this as enlargement
of which of the following?
A Cl
. it
or
is
B.
Parotid gland
C.
Skenes gland
D
Bartholins gland
.
59.
A.
B.
C.
D
.
60.
A.
B.
C.
D
.
61.
A.
B.

Which of the following would be the priority for a client with an


ectopic pregnancy?
Risk for infection
Pain
Knowledge Deficit
Anticipatory Grieving
When preparing to listen to the fetal heart rate at 12 weeks gestation, the midwife
would use which of the following?
Stethoscope placed midline at the umbilicus
Doppler placed midline at the suprapubic region
Fetoscope placed midway between the umbilicus and the xiphoid process
External electronic fetal monitor placed at the umbilicus
With a fetus in the left-anterior breech presentation, the midwife would expect the
fetal heart rate would be most audible in which of the following areas?
Above the maternal umbilicus and to the right of midline
In the lower-left maternal abdominal quadrant

C.
D
.

In the lower-right maternal abdominal quadrant


Above the maternal umbilicus and to the left of midline

62.
A.
B.
C.
D
.
63.
A.
B.
C.
D
.
64.
A.
B.
C.
D
.
65.
A.
B.
C.
D.

The midwife understands that the fetal head is in which of the following positions
with a vertex presentation?
Completely flexed
Completely extended
Partially extended
Partially flexed
During the first 4 hours after a male circumcision, assessing for which of the
following is the priority?
Infection
Hemorrhage
Discomfort
Dehydration
A client in her third trimester tells the midwife, Im constipated all the
time! Which of the following should the midwife recommend?
Daily enemas
Laxatives
Increased fiber intake
Decreased fluid intake
A client has a midpelvic contracture from a previous pelvic injury due to a motor
vehicle accident as a teenager. The midwife is aware that this could prevent a fetus
from passing through or around which structure during childbirth?
Symphysis pubis
Sacral promontory
Ischial spines
Pubic arch

66. During this phase of menstrual cycle the corpus luteum degenerates and the hormones
progesterone and estrogen declines making mood changes as part of the discomforts of
menstruation. As a midwife you know this is phase is?
A Secretory Phase
B
Proliferative Phase
C
Menstrual Phase
D Pre-Menstrual Phase

67. In the menstrual cycle, this phase is the determining time for conception. As a midwife you
know this as
A
B
C
D

Secretory Phase
Proliferative Phase
Menstrual Phase
Pre-Menstrual Phase

68. The phase would normally start between Day 6 to Day 14 wherein the Follicle
Stimulating Hormone would increase while the progesterone and estrogen declines.
Ovulation is being initiated in this stage.
A Secretory Phase
B
Proliferative Phase
C
Menstrual Phase
D Pre-Menstrual Phase

69. As a midwife you know the normal menstrual cycle as:


A Pre-Menstrual, Menstrual, Secretory Phase, Proliferative Phase
B
Menstrual, Proliferative, Secretory, Pre-Menstrual
C
Proliferative, Menstrual, Secretory, Pre-Menstrual
D Menstrual, Secretory, Proliferative, Pre-Menstrual
70. You are assigned in a Reproductive Clinic, as a midwife it is your task to give counsel to
young couples. These are the natural methods except:
A Abstinence
B
Coitus Interruptus
C
Calendar Guided -Pills
D Calendar Method

71. During the initial stages of pregnancy, what happens during the 4th week?
A Sex Differentiation
B
Cardiovascular system functioning
C
Heartbeat is audible
D Facial Features becomes distinct
72. When is the earliest time in pregnancy that heartbeat can be heard by a Doppler?
A 10 weeks
B
12 weeks

C
D

14 weeks
18 weeks

73. As a midwife, how can you determine that the pregnancy is on its 20th week?
A Heartbeat is audible by Doppler
B
Heartbeat is audible by Stethoscope
C
Quickening is felt by the mother
D Both A & B
74. When is the earliest time the baby can be born?
A 30 weeks
B
35 weeks
C
26 weeks
D 38 weeks
75. Which of the following time of pregnancy denotes optimum time for survival of the
child?
A 32 weeks
B
34 weeks
C
36 weeks
D 40 weeks
76. A 23-year-old lady came in to the clinic one day claiming that she is pregnant. As a
midwife which of the following signs and symptoms of pregnancy denotes presumptive
signs of pregnancy?
A Enlargement of abdomen
B
Ballottement
C Amenorrhea
D Positive pregnancy test
77. As a midwife, you know that these are probable signs of pregnancy except:
A Quickening
B
Hegars Sign
C
Ballottement
D McDonalds Sign
78. A pregnant mother complained of excessive vaginal discharge. Which of the following
assessment would signal a referral to the doctor?
A Excess discharge
B
Itching sensation
C
Discomfort
D Wet feeling
79. Pica is one of the common problems that a pregnant woman experience. As a midwife,
you know that this is associated with?

A
B
C
D

Increase energy needs


Tiredness
Iron-deficiency anemia
Hyperacidity

80. As a midwife, these are the danger signs of pregnancy except:


A Vaginal bleeding
B
Chills and fever
C
Ballottement
D Persistent vomiting
81. In pregnancy induced hypertension, which sign would alarm the health care team?
A Blurring of vision
B
Flashing of light or dots
C Increase in blood pressure
D Bipedal Edema
82. Rina, a primigravida has an expected date of delivery on December 26, 2012. When is
her last date of menstrual period?
A March 20, 2011
B
March 20, 2012
C
March 19, 2012
D March 21, 2012
83. As a midwife you were assigned to a patient with G5P3 (2123), what does this mean?
A. Two were born after 37 weeks, one was born between 20-37 weeks, 2 pregnancies
were ended either with abortion, three were number of children currently alive
B. Three were born after 37 weeks, one was born between 20-37 weeks, 2 pregnancies
were ended either with abortion, two were number of children currently alive
C. Two were born after 37 weeks, one was born between 20-37 weeks, 1 pregnancy was
ended either with abortion, two were number of children currently alive
D.Three were born after 37 weeks, one was born between 20-37 weeks, 2 pregnancies
were ended either with abortion, 3 number of children currently alive

84. When will be the weekly visit if with no complications to the OB-Gyne indicated?
A 4th week 16th week
B
20th -30th week
C
32nd 36th weeks
D 36th 40th weeks

85. As a midwife, when a patient has Diabetes on pregnancy, these are complications that
must be prevented except:
A Polyhydramios
B
Stillbirth
C
Low birth weight
D Pregnancy Induced Hypertension
86. As a midwife, which of the following happens when the placenta is abnormally implanted
near to or over the internal cervical os?
A Abruptio Placenta
B
Placenta Previa
C
Premature Rupture of Membranes
D None of the above
87. Aling Nita, has had multiple pregnancies. She now has 2 twins and 5 more children. With
this present pregnancy, she is most likely to develop?
A Seizure
B
Diabetes Mellitus
C
Hyperemesis gravidarum
D Placenta Previa
88. When the patient has a complete previa, what is the recommendation for the delivery of
the child?
A Water birth
B
Normal Spontaneous Vaginal Delivery
C
Caesarean Section
D Termination of pregnancy
89. As a midwife, in pregnancy, this process involves the physiologic and mechanical
processes in which the baby placenta and fetal membranes are propelled through the
pelvis. This is simply called:
A Premature rupture of Membranes
B
Birth of Placenta
C
Labour
D Delivery
90. In the third trimester of pregnancy, a patient experiences lightening. After lightening, the
expectant mother may complain of :
a. cramps in her legs
b. reduced pelvic pressure
c. shortness of breath
d. decreased urinary frequency
91. This is the term in determining the number of times a woman has been pregnant.
a. Parity
c. Abortion
b. Gravida
d. Ovulation

92. It is called abortion if the fetusis terminated at.


a. 21weeks
c. 16weeks
b. 38weeks
d. 24weekS
93. We can tell that the baby is premature if he is born at.
a. 16weeks
c. 38weeks
b. 36weeks
d. 44weeks
94. This of the period of pregnancy where rapid deposition of fats,thus,period of most rapid
growth takes place.
a. First trimester
c. Second trimester
b. Third trimester
d. Post partum
95. All but one is presumptive sign of pregnancy.
a. Amenorrhea
c. Quickening
b. Urinary frequency
d. Hegars sign
96. All but one is probable sign of pregnancy.
a. Hegars sign
c. Goodles sign
b. Fetal heart rate
d. Ballottement
97. On the prenatal check-up, the mother states, this is my first pregnancy, the mother is.
a. Primipara
c. Nullipara
b. Primigravida
d. Nulligravida
98. Another client visit the health care facility and claimed, i have never been pregnant and
im not pregnant right now. You classify the client as.
a. Primipara
c. Nullipara
b. Primigravida
d. Nullgravida
99. The next day, a mother came to your facility and claimed, I was pregnant but lost my
baby 16weeks and have not been pregnant again. You correctly assessed the mother as.
a. Nullipara
c. Nulligravida
b. Primipara
d. Primigravida
100.
In your healthcare facility, you are assessing a pregnant mother who states, this
is my first pregnancy. Im a on my 27 week. I have not been pregnant before. Using the
GTPAL,how do you score the mother?
a. 1-0-1-0-0
c. 1-1-1-0-0
b. 1-1-0-0-0
d. 1-0-0-0-0