Obs

1. Which of the underlisted position is the most appropriate position for the woman to lie in
during pregnancy?
A. Left lateral position
B. Semi-recumbent position
C. Supine position

2. Miss Deladem aged 16 years was brought to your facility by her mother with complains of
swollen abdomen, nausea and vomiting, abdominal pain and not knowing her last menstrual
cycle. She is to undergo urine or blood test to confirm pregnancy. Which of the following
hormones serves as a basis for pregnancy test?
A. Human Chorionic Corticotrophin (HCC)
B. Human Chorionic Gonadotropin (HCG)
C. Human Placental Lactogen (HPL)

3. Mrs. Akrofi aged 34 years reported at the ANC unit for the first time. On assessment her
obstetrical history was G3P2A, fundal height 12cm, LMP 12/8/18 and complained of having
nausea and vomiting, and frequency in micturition. What accounts for the urinary frequency
during pregnancy?
A. Growing uterus compresses the bladder
B. It is due to urinary tract infection
C. It is evidence of gestational diabetes

. 4. Mrs Afua Danso aged 27 years G4P1A+2 reported to the ANC at your CHPS zone for the
first time. On assessment, gestational age was 24 weeks, vital signs were within normal
range. With your knowledge in respectful maternity care, which of the following activities
would you provide privacy and confidentiality when caring for Efiba?
I. Counselling on health issues
II. Physical examination
III. Handling of records
IV. Taking health history
A. I, II and III
B. I, II, III and IV
C. II, III and IV

5. Pregnancy may be detected by a woman herself even before she has missed her period
because she experiences some body changes. These changes could be probable signs of
pregnancy which include ………………………………
A. Amenorrhoea
B. Foetal heart sound
C. Osiander’s sign

6. You are a newly posted nurse to Mabre Health Center. Madam Hannah Boye was brought to
the clinic with a history of labour pains. On examination, the cervical dilatation was 7cm with
cephalic presentation with no foetal heart rate. What would you use to monitor the case?
A. Labour chart
B. Nurses notes
C. Partograph

7. Which of the following bones make up the pelvis?

A. Trochanter, hip socket, ischium, sacrum & pubis.
B. Ilium, ischium, pubis, sacrum & coccyx.
C. Ilium, ischium & pubis.

8. The pelvic floor consists of muscles that support the pelvic and abdominal organs. They
are divided into superficial and deep muscle layers. Which of the following muscles fall under
the superficial muscle layers?
I. Bulbocavernosus
II. Illiococcygeous
III. Perineal body
IV. Sphincter ani externus
A. I, II, and III.
B. I, III, and IV.
C. II, III, and IV.

9. Which of the following BEST describes the sacrum?

I. It is a fusion of five sacral vertebrae
II. Lies like a wedge between the left and right innominate bone
III. Form the upper two fifths of the acetabulum
A. I and II.
B. I and III
C. II and III.

10. Which of the following signs is a positive sign of pregnancy?

A. Amenorrhea
B. Auscultation of fetal heart
C. Nausea and vomiting

11. Which of the following is TRUE regarding fertilization?

A. Fertilization occurs in the ampulla of the fallopian tube.
B. The second meiotic division is completed before fertilization.
C. The trophoblast invades the endometrium and differentiates into outer cytotrophoblast
and inner syncytiotrophoblast

12. In the process of fertilization, which of the following is TRUE?

A. Only one sperm reaches the egg and enters it
B. Only the acrosome of the sperm enters the egg
C. The entry of sperm activates the egg for completing meiosis

13. The term for milk production is known as?

A. Lactation
B. Menstruation
C. Parturition

14. The mature follicle is also called?

A. Graafian follicle
B. Primary follicle
C. Secondary follicle

15. The increase in blood volume in normal pregnancy is made up of:

A. More Erythrocytes than plasma
B. More plasma than erythroblasts
C. Plasma only

16. Which of the following is the placenta made up of?

A. Maternal and foetal surface
B. Oxygen and water
C. Plasma

17. At 38 weeks’ gestation, where would you expect to find the uterine fundus?
A. Halfway between umbilicus and xiphisternum
B. Umbilicus
C. Xiphisternum
18. At what duration does spermatogonium take to transform into spermatozoa?
A. 62 days
B. 72 days
C. 82 days

19. The luteal phase of the menstrual cycle is associated with?

A. High luteinizing hormone level
B. High progesterone levels
C. High prolactin level
20. Gestational diabetes is associated with an increased risk of all the following, EXCEPT?
A. Fetal macrosomia
B. Intrauterine growth restriction
C. Shoulder dystocia

21. In foetal circulation, there is a structure that shunts blood from the right atrium to the left
making both oxygenated blood to mix up with deoxygenated blood. This accounts for
acrocyanosis present in the baby at birth. What is the name of this structure?
A. Ductus arteriosus.
B. Foramen ovale.
C. Rt. Ventricle.

22. The Expected date of delivery of a human pregnancy can be calculated:

A. As 280 days from the last full moon.
B. As 40 weeks after the last menstrual period.
C. From a change in the patient's weight.

23. In the days after ovulation, all of the following occurs EXCEPT:
A. The basal temperature rises.
B. The endometrium undergoes secretory changes.
C. The plasma progesterone concentration falls.

24. The nurse is assessing the pH level of the vaginal environment of a 26-year-old client.
Which of the following would be an expected finding for this client?
A. pH level of 4.6
B. pH level of 5.7
C. pH level of 6.9

25. When should a woman book for antenatal care?

A. Immediately she notices she is pregnant.
B. When she first feels fetal movements
C. When she is 28 weeks pregnant

26. A 38-year-old woman is seen for the evaluation of a swelling in her right vulva. She has
also noted pain in this area when walking and during coitus. On examination, a mildly tender
fluctuant mass was noticed just outside the introits in the right vulva. What is the most likely
diagnosis?
A. Bartholin's abscess.
B. Chancroid.
C. Vulva carcinoma
27. Which period of gestation does the 1st trimester represent?
A. 1-10 weeks
B. 1-11 weeks
C. 1-12 weeks

28. During a prenatal visit, a patient tells you her last menstrual period was May 21, 2016.
Based on Naegele's Rule, when is the estimated due date of her baby?
A. February 27, 2016
B. April 16, 2016
C. February 28, 2017

29. How is the foetal condition best determined during the antenatal period?
A. Counting the fetal heart rate
B. Measuring the patient’s blood pressure
C. Weighing the patient at every antenatal visit

30. How should you define pre-eclampsia?

A. Hypertension and proteinuria presenting before the start of pregnancy
B. Hypertension and proteinuria presenting in the first half of pregnancy
C. Hypertension and proteinuria presenting in the second half of pregnancy

31. Which fetal condition is common in pregnancies complicated by pre-eclampsia?

A. Congenital malformations
B. Heart failure due to hypertension
C. Intra-uterine growth restriction

32. Which of the following women has the highest risk of pre-eclampsia?
A. A patient with a history of preterm delivery in her previous pregnancy
B. A patient with a history of pre-eclampsia from a previous pregnancy
C. Grande multiparas

33. What drug is used to prevent and manage eclampsia?

A. Alpha-methyldopa (Aldomet)
B. Magnesium sulphate
C. Magnesium trisilicate

34. What is the definition of an antepartum haemorrhage?

A. Any vaginal haemorrhage between 28 weeks gestation and delivery
B. Any vaginal haemorrhage between conception and delivery
C. Any vaginal haemorrhage during labour
35. Which of the following is a complication of Antepartum haemorrhage?
A. Both the mother and fetus may die.
B. It is a common cause of iron-deficiency anaemia.
C. The fetus may become anaemic.
36. Which of the following develop into the placenta?
A. Decidua
B. Inner cell mass of the blastocyst
C. Outer cell mass of the blastocyst

37. Which hormone causes delayed gastric emptying during pregnancy?

A. Estrogen
B. Human placental lactogen
C. Progesterone

38. What is the most common reason for spontaneous abortion in the first trimester?
A. Chromosomal abnormality
B. Endocrine disorder
C. Uterine abnormality

39. Which of the below is/are appropriate for the prevention of ectopic pregnancy?
A. Limiting sexual partners
B. Smoking
C. High blood pressure

40. Which of the following medication is used to stop cell growth in an early ectopic
pregnancy without unstable bleeding?
A. Depo-provera
B. Methotrexate
C. Xeljanz

41. Which of the following medical abortion regimens is the most effective if available?
(95-99% efficacy)
A. Methotrexate and misoprostol
B. Mifepristone and misoprostol
C. Misoprostol alone

42. When is medical abortion known to be complete?

A. A urine home pregnancy test shows a negative result one week after the medical
abortion.
B. No sac is seen on a follow-up ultrasound.
C. The woman experiences vaginal bleeding.

43. Which of the following is a complication of surgical evacuation of products of conception

from the uterus?
A. Infection
B. Injury to the intestine
C. The uterus is perforated by a surgical instrument

44. What intervention would be the top priority when there is cord prolapse?
A. Covering the cord in sterile gauze soaked in saline
B. Placing the woman in the knee-chest position
C. Preparing the woman for a cesarean birth

45. A woman at five weeks gestation presents to your facility with the history of severe
nausea and vomiting in a previous pregnancy. The first line therapy to treat this condition
during the current pregnancy is……………….
A. Admission to the hospital for intravenous fluids at 10 weeks gestation.
B. Suppressive therapy with Ondantrestron.
C. Vitamin B6 plus Doxylamine

46. You are a student preparing to perform a physical examination on a post partum client.
What statement BEST explains why the nurse must wear gloves during this examination?

A. Gloves is used as a standard precaution in infection prevention.

B. Gloves may protect the client against infections.
C. Gloves protect the client against the nurse’s cold hands.

47. Madam Cynthia Akoto has been admitted for induction of labour. Which of the following
hormones will be suitable for cervical ripening?
A. Oxytocin.
B. Prostaglandins.
C. Syntometrine.

48. You are a staff nurse assisting a student Midwife during delivery and noticed that there
was cord around the neck of the baby. What would you tell the student?
A. If not tight cut the cord and deliver.
B. Slip it over the head and deliver.
C. Stop her and continue the delivery.

49. A 24 year old G2P1 had her last menstrual period 9 weeks ago. She presented with
bleeding and passage of tissues per vaginum. Bleeding is associated with lower
abdominal pain. What would be her most likely diagnosis?
A. Ectopic pregnancy.
B. Incomplete abortion
C. Threatened abortion.

50. Which of the following will you recommend to a client who complains of constipation
during pregnancy?
A. Continue taking iron medications.
B. Eat fruits and vegetables.
C. Take frequent laxatives.

51. Management of postpartum endometritis is MOST effective if it includes which of the

following?
A. Ampicillin as monotherapy.
B. Broad spectrum antibiotics.
C. Culture of affected area.

52. Madam Mawunyo a 24-year-old G4P3AA reported at the clinic with lower abdominal pain
and bleeding. Upon examination, cervix was patulous, and product of conception could be
seen at the cervix. Madam Mawunyo may likely be suffering from which of the under listed
abortions.
A. Complete.
B. Inevitable
C. Missed.

53. Madam Azuma has been diagnosed of ectopic pregnancy. Which of the following places
in the fallopian tubes does ectopic pregnancy usually occurs? In the
A. Ampulla.
B. Fimbria.
C. Isthmus.

54. During pregnancy physiological changes occur in the reproductive system. Which of the
following weeks in pregnancy does the uterus becomes spherical in shape?
A. 12.
B. 16.
C. 20

55. The Breast-Feeding Policy in Ghana recommends exclusive breastfeeding until how many
months of life?
A. 3 months.
B. 6 months.
C. 9 months

56. A 30weeks old pregnant woman complains of heart burns, which of the following
education will be appropriate to give her?
I. Avoid fatty diet
II. It is less common in the third trimester
III. Drink milk
IV. Eat foods that are less spicy
A. I and IV
B. II and III
C. III and IV

57. The midwife is preparing to discharge a multiparous woman 24hours after

delivery. She has already started breastfeeding, The midwife instructs the mother that if
engorgement occurs she should……….
A. Apply warm moist heat to the breast.
B. Restrict fluid intake to 1000mls daily.
C. Wear a tight fitting brassiere or breast binder.

58. The following are all minor disorders affecting the digestive system EXCEPT:
A. Constipation.
B. Haemorrhoids.
C. Ptylism

59. Madam Felicia Koka, G5P4(2A +2) came to the ANC 25/12/ 2020 with history of
amenorrhoea. LMP was 27/02/2020. Her booking BP was 110/60mmHg, urine protein
negative and has no complaint. How many children does Mrs. Akrasi have At home?
A. 2.
B. 4.
C. 8.
60. Miss Evelyn Ofori, G6P5(2A (1set of twins)) 2D came to the ANC with history of
amenorrhoea. And complaining of nausea and vomiting. How many children does Miss
Evelyn have at home?
A. 2.
B. 3.
C. 4.
61. After artificial rupture of membranes, which of the following is most likely to
occur.....................…
A. Cord prolapse.
B. Early deceleration of Fetal Heart Rate.
C. Inefficient uterine

62. Madam Sekyiwaa G1P0 meet you in a public transport on your way to the hospital where
you are having your clinical practice in obstetrics. She complained to you that she usually
craves for the soil, and she sometimes has to dig up a mud house in her locality to eat. What
is the term given to this craving?
A. Nausea
B. Pica
C. Ptylism

63. Madam Jackie Appiah walks into your antenatal clinic limping with wasting of muscles of
the leg. Which of these clinical assessments of the pelvis will be of use to the midwife?
A. History.
B. Observation
C. Palpation.

64. A 29-year-old P2 had a vaginal delivery followed by postpartum hemorrhage of 2.5 liters.
She presents to you after 8 months with complaints that she has not restarted
her Menstruation yet. She is bottle feeding and states she was unable to breastfeed due to
inadequate milk supply. Her home pregnancy test is negative followed by a negative beta
HCG level. Which of the following is the most likely reason for amenorrhoea?
A. Lactational Amenorrhea.
B. Pregnancy.
C. Sheehan's Syndrome.

65. An 19 year old primipara complains of excessive micturition which is disturbing her sleep
at night. At what weeks in pregnancy is this sign noticed?
A. 4-14.
B. 6-12.
C. 16-20.

66. After suffering from 3 continuous abortions Madam Esivi Narh has been admitted for
management of cervical incompetence. Which of the following would be adopted?
A. Administration of corcolytics.
B. Cervical cerclage
C. Complete bed rest.

67. During labour, the birth companion should be included in the care of the woman. What is
the education you will give the birth companion to perform as part
of the health team?
I. Massaging the woman’s back.
II. Assisting with breathing techniques.
III. Supporting client regarding pain management.
IV. Ensuring adequate hydration in labour.
A. I and II.
B. I, II and III.
C. II, III and IV.

68. During the performance of abdominal examination at the antenatal clinic certain
techniques are used to examine the client. Which of the following technique is not used at
the antenatal clinic.
A. Auscultation.
B. Palpitation.
C. Percussion

69. Madam Adiza Mariama complained of lower abdominal pains since a week ago, she
reported to her closed friend whose mother has a pharmacy shop to get some
medications. The friends mother in turn asked her to report to one of the hospitals in their
vicinity. Upon seeing the Dr. Some laboratory investigation were requested. All the
underlisted would be carried out during a veneral disease research laboratory (VDRL)
EXCEPT
A. Gonorrhoea.
B. Rubella.
C. Syphillis.

70. A 16 year JSS 1 student visited your ANC with 10weeks amenorrhoea with
complaints of brownish vaginal discharge with no signs of pregnancy. The midwife will
immediately suspect which of the following?
A. Inevitable.
B. Missed.
C. Threatened.

71. What is the term given to the first menstrual cycle?

A. Menarch
B. Menopause
C. Ovulation

72. Capacitation of sperm occurs in which of the following?

A. Female genital tract
B. Penis
C. Vagina

73. When is the fetal head engaged?

A. When the greatest diameter of the fetal head (i.e. the suboccipito-bregmatic
diameter) has passed through the pelvic brim
B. When the vertex has passed through the pelvic brim
C. When the widest transverse diameter of the fetal head (i.e. the biparietal diameter) has
passed through the pelvic brim

74. What position should the patient adopt when she delivers?
A. She should choose whichever position she prefers as long as it is practical under the
clinical circumstances.
B. She should lie on her back
C. She should lie on her side

75. A prolonged second stage of labour is diagnosed when:

A. The infant is not delivered within 30 minutes after the cervix has reached full
dilatation in a multigravida, and within 45 minutes in a primigravida.
B. The infant is not delivered within 30 minutes after the cervix has reached full dilatation in
a multigravida, and within 60 minutes in a primigravida.
C. The infant is not delivered within 30 minutes after the patient has started bearing down in
a multigravida, and within 45 minutes in a primigravida.

76. What should be the initial management of impacted shoulders (i.e. shoulder dystocia)?
A. An immediate attempt must be made to deliver the infant’s posterior arm.
B. Arrangements must be made for an emergency Caesarean section.
C. Pressure should be applied to the fundus of the uterus in order to deliver the infant
quickly.

77. What is a dangerous complication of an overdose of pethidine?

A. Convulsions
B. Excessive drowsiness
C. Respiratory depression in the patient
78. What is the colour of amniotic fluid?
A. Clear pale straw colour
B. Dark colour
C. Yellow colour

79. The midwife is preparing to discharge a multiparous woman 24hours after

[Link] has already started breastfeeding, The midwife instructs the mother that if
engorgement occurs she should
A. Apply warm moist heat to the breast.
B. Restrict fluid intake to 1000mls daily.
C. Wear a tight fitting brassiere or breast binder

80. Mrs. Wateson, on the 3rd post day delivery became quiet and would not talk to
anybody. She was sad and teary all the time. The midwife would conclude the mother
may be suffering from…..
A. Postnatal Blues.
B. Postnatal Depression.
C. Postnatal Psychosis.
@ 3 in 1