6.

When teaching Aling Julia about her pregnancy, you

should include personal common discomforts. Which of
the following is an indication for prompt professional
supervision?
A. Constipation and hemorrhoids
B. Backache
NAME: _______________________________________ C. Facial edema
DATE:______________________ SCORE: _________ D. frequent urination

OB Set 1 7. Which of the following statements would be

BY: JEMIMA R. JACOT, BSN, RN
SITUATION 1: Aling Julia, a 32 year old fish vendor from
Barangay Matapat came to see you at the prenatal clinic.
She brought with her all her three children. Rose, 1 year
& 6 months, Joy, 3 and Mike, 7 years old. She mentioned
that she stopped taking oral contraceptives several
months ago and now suspects she is pregnant. She
cannot remember her LMP.
1. Which of the following would be useful in calculating
Aling Julia's EDC?
A. Appearance of linea negra
B. First FHT by fetoscope
C. Increase pulse rate
D. Presence of edema
appropriate for you to include in Aling Julia's prenatal
teaching plan?
A. Exercise is very tiresome, it should be avoided
B. Limit your food intake
C. Smoking has no harmful effect on the growth and
development of fetus
D. Avoid unnecessary fatigue, rest periods should be
included in your schedule
8. Which of the following is the best advice you can give
to Aling Julia regarding prevention of varicosities?
A. Raise the legs while in upright position and put it
against the wall several times a day
B. Lay flat for most hours of the day
C. Use garters with nylon stocking
D. Wear support hose

2. Which hormone is necessary for a positive pregnancy 9. In a 32 day menstrual cycle, ovulation usually occurs
test? on the:
A. Progesterone A. 14th day after menstruation
B. HCG B. 18th day after menstruation
C. Estrogen C. 20th day after menstruation
D. Placental Lactogen D. 24th day after menstruation

3. With this pregnancy, Aling Julia is a: 10. Placenta is the organ that provides exchange of
A. P3 G3 nutrients and waste products between mother and fetus.
B. Primigravida This develops by:
C. P3 G4
D. P0 G3 A. First month
B. Third month
4. In explaining the development of her baby, you C. Fifth month
identified in chronological order of growth of the fetus as D. Seventh month
it occurs in pregnancy as:
A. Ovum, embryo, zygote, fetus, infant 11. In evaluating the weight gain of Aling Julia, you know
B. Zygote, ovum, embryo, fetus, infant the minimum weight gain during pregnancy is:
C. Ovum, zygote, embryo, fetus, infant A. 2 lbs/wk
D. Zygote, ovum, fetus, embryo, infant B. 5 lbs/wk
C. 7 lbs/wk
5. Aling Julia states she is happy to be pregnant. Which D. 10 lbs/wk
behavior is elicited by her during your assessment that
would lead you to think she is stressed? 12. The most accurate method of measuring fundal
A. She told you about her drunk husband height among the following is:
B. She states she has very meager income from selling A. Millimeter
C. She laughs at every advice you give even when it’s B. Centimeter
not funny C. Inches
D. She has difficulty following instructions D. Fingerbreadths
13. To determine fetal position using Leopold's C. 2nd month
maneuvers, the first maneuver is to: D. 4th month
A. Determine degree of cephalic flexion and engagement
B. Determine part of fetus presenting into pelvis 20. When should you expect to hear FHR using Doppler
C. Locate the back,arms and legs Ultrasound?
D. Determine what part of fetus is in the fundus A. 8th week
B. 8th month
14. Aling Julia has encouraged her husband to attend C. 2nd week
prenatal classes with her. During the prenatal class, the D. 10th week
couple expressed fear of pain during labor and delivery.
The use of touch and soothing voice often promotes 21. The mother asks, what does it means if her maternal
comfort to the laboring patient. This physical intervention serum Alpha Feto Protein is 35 ng/ml? You should
is effective because: answer:
A. Pain perception is interrupted A. It is normal
B. Gate control fibers are open B. It is not normal
C. It distracts the client away from the pain C. 35 ng/ml indicates chromosomal aberration
D. Empathy is communicated by a caring person D. 35 ng/ml indicates neural tube defect

15. Which of the following could be considered as a 22. Which of the following mothers needs RHOGAM?
positive sign of pregnancy? A. RH + mother who delivered an RH - fetus
A. Amenorrhea, nausea, vomiting B. RH - mother who delivered an RH + fetus
B. Frequency of urination C. RH + mother who delivered an RH + fetus
C. Braxton hicks contraction D. RH - mother who delivered an RH – fetus
D. Fetal outline by sonography
23. Which family planning method is recommended by
SITUATION 2: Wide knowledge about different diagnostic the Department of Health more than any other means of
tests during pregnancy is an essential arsenal for a contraception?
health care provider to be successful. A. Fertility Awareness Method
B. Condom
16. The Biparietal diameter of a fetus is considered C. Tubal Ligation
matured if it is at least: D. Abstinence
A. 9.8 cm
B. 8.5 cm 24. How much booster dose does tetanus toxoid
C. 7.5 cm vaccination for pregnant women has?
D. 6 cm A. 2
B. 5
17. Quickening is experienced first by Multigravida C. 3
clients. At what week of gestation do they start to D. 4
experience quickening?
A. 16th SITUATION 3: Reproductive Health is the exercise of
B. 20th reproductive right with responsibility. A married couple
C. 24th has the responsibility to reproduce and procreate.
D. 28th
25. Which of the following is ONE of the goals of the
18. Before the start of a Non-stress test, The FHR is 120 reproductive health concept?
BPM. The mother ate the snack and the practitioner A. To achieve healthy sexual development and
noticed an increase from 120 BPM to 135 BPM for 15 maturation
seconds. How would you read the result? B. To prevent specific RH problem through counseling
A. Abnormal C. Provide care, treatment and rehabilitation
B. Non-reactive D. To practice RH as a way of life of every man and
C. Reactive woman
D. Inconclusive, needs repeat
26. Which of the following is NOT an element of the
19. When should you expect to hear the FHR using a reproductive health?
Fetoscope? A. Maternal and child health and nutrition
A. 2nd week B. Family planning
B. 8th week C. Prevention and management of abortion complication
D. Healthy sexual development and nutrition
27. In the international framework of RH, which one of the
following is the ultimate goal?
A. Women's health in reproduction
B. Attainment of optimum health
C. Achievement of women's status
D. Quality of life
28. Which one of the following is a determinant of RH
affecting woman's ability to participate in social affairs?
A. Gender issues
B. Socio-Economic condition
C. Cultural and psychosocial factors
D. Status of women
29. In the Philippine RH Framework, which major factor
affects RH status?
A. Women's lower level of literacy
B. Health service delivery mechanism
C. Poor living conditions lead to illness
D. Commercial sex workers are exposed to AIDS/STD.
30. Which determinant of Reproductive Health advocates
nutrition for better health promotion and maintain a
healthful life?
A. Socio-Economic conditions
B. Status of women
C. Social and gender issues
D. Biological, Cultural and Psychosocial factors
SITUATION 4: As a midwife, one should be aware of the
different reproductive problems.
31. When is the best time to achieve pregnancy?
A. Midway between periods
B. Immediately after menses end
C. 14 days before the next period is expected
D. 14 days after the beginning of the next period
32. A factor in infertility maybe related to the pH of the
vaginal canal. A medication that is ordered to alter the
vaginal PH is:
A. Estrogen therapy
B. Sulfur insufflations
C. Lactic acid douches
D. Na HCO3 douches
33. A diagnostic test used to evaluate fertility is the
Postcoital test. It is best timed:
A. 1 week after ovulation
B. Immediately after menses
C. Just before the next menstrual period
D. Within 1 to 2 days of presumed ovulation
34. A tubal insufflation test is done to determine whether
there is a tubal obstruction. Infertility caused by a defect
in the tube is most often related to a:
A. Past infection
B. Fibroid Tumor
C. Congenital Anomaly
D. Previous injury to a tube
35. Which test is commonly used to determine the
number, motility and activity of sperm is the:
A. Rubin test
B. Huhner test
C. Friedman test
D. Papanicolau test
36. In the female, Evaluation of the pelvic organs of
reproduction is accomplished by:
A. Biopsy
B. Cystoscopy
C. Culdoscopy
D. Hysterosalpingogram
37. You are caring for a woman in labor. The woman is
irritable, complains of nausea and vomits and has heavier
show. The membranes rupture. The midwife understands
that this indicates:
A. The woman is in transition stage of labor
B. The woman is having a complication and the doctor
should be notified
C. Labor is slowing down and the woman may need
oxytocin
D. The woman is emotionally distraught and needs
assistance in dealing with labor
SITUATION 5: Anna, a 32 year old, Primigravida at 39-40
weeks AOG was admitted to the labor room due to
Hypogastric and Lumbo-Sacral pains. IE revealed a fully
dilated, fully effaced cervix. Station 0.
38. She is immediately transferred to the DR table. Which
of the following conditions signify that delivery is near?
1 - A desire to defecate
2 - Begins to bear down with uterine contraction
3 - Perineum bulges
4 - Uterine contraction occur 2-3 minutes intervals
at 50 seconds duration
A. 1, 2, 3
B. 1, 2, 3, 4
C. 1, 3, 4
D. 2, 3, 4
39. Anna complains of severe abdominal pain and back
pain during contraction. Which two of the following
measures will be MOST effective in reducing pain?
1 - Rubbing the back with tennis ball
2 - Effleurage
3 – Imagery
 4 - Breathing techniques
46. Whose theory of labor pain that states that PAIN in
A. 2, 4 labor is caused by FEAR:
B. 2, 3 A. Bradley
C. 1, 4 B. Simpson
D. 1, 2 C. Lamaze
D. Dick-Read
40. Which is NOT the drug of choice for Epidural
anesthesia? 47. Which sign would alert the midwife that Belle is
A. Sensorcaine entering the second (2nd) stage of labor?
B. Xylocaine A. Increase frequency and intensity of contraction
C. Ephedrine B. Perineum bulges and anal orifice dilates
D. Marcaine C. Effacement of internal OS is 100%
D. Vulva encircles the largest diameter of presenting part
SITUATION 6: Belle is admitted to the hospital with the
following signs: Contractions coming every 10 minutes, 48. Important care during the second stage of labor
lasting 30 seconds and causing little discomfort. Intact should include:
membranes without any bloody shows. Stable vital signs. A. Careful evaluation of prenatal history
FHR = 130bpm. Examination reveals cervix is 3 cm B. Coach breathing, bear down with each contraction and
dilated with Vertex presenting at minus 1 (-1) station. encourage patient.
C. Shave the perineum
41. On the basis of the data provided above, you can D. Administer enema to the patient
conclude that Belle is:
A. In false labor 49. According to the WHO, when should the mother start
B. In the Active phase of labor breastfeeding the infant?
C. In the Latent phase of labor A. Within 30 minutes after birth
D. In the Transitional phase of labor B. Within 12 hours after birth
C. Within a day after birth
42. Pitocin drip has been started on Belle. Possible side D. After infant's condition stabilizes
effects of Pitocin administration include all of the
following, except: 50. The major cause of maternal mortality in the
A. Diuresis Philippines is:
B. Hypertension A. Infection
C. Water intoxication B. Hemorrhage
D. Cerebral hemorrhage C. Hypertension
D. Other complications related to labor, delivery and
43. The normal range of FHR is approximately: puerperium
A. 90 to 140 bpm
B. 120 to 160 bpm Situation 7: As a midwife, you should be able to respond
C. 100 to 140 bpm to certain cases in different settings.
D. 140 to 180 bpm
51. A client is in the second (2nd) stage of labor and has
44. A negative 1 (-1) station means that: been pushing for almost an hour. Which of the following
A. Fetus is crowning interventions is the most appropriate for the client as this
B. Fetus is floating stage?
C. Fetus is engaged A. Offer clear fluids in between contractions
D. Fetus is at the Ischial spine B. Encourage ambulation
C. Instruct the client to push with each contraction
45. Which of the following is the characteristic of False D. Encourage frequent changes in position.
labor:
A. Bloody show 52. Your colleague calls you into a labor room as Sara’s
B. Contraction that are regular and increase in frequency baby is about to be born and she wants a second
and duration midwife. What is the second midwife’s role?
C. Contraction are felt in the back and radiates towards 1 – To resuscitate baby if needed.
the abdomen 2 – To give oxytocic drug (active mgt of 3rd stage)
D. None of the above 3 - To support the first midwife
4 – To critique the performance of the first midwife

A. 1, 2
B. 1, 2, 3
C. 1, 4
D. 3, 4
53. You are caring for Louisa in recovery after an
emergency cesarean section due to Pre-eclampsia.
Louisa is receiving a Magnesium Sulfate infusion of 1 g
per hour. The following are signs and symptoms of
Magnesium Sulfate toxicity, except:
A. Flushing
B. Double vision
C. Loss of deep tendon reflexes
D. Muscle spasms
54. What drug is used as the antidote to Magnesium
Sulfate?
A. Potassium chloride
B. Calcium gluconate
C. Tetracycline
D. Oxycodone
55. Which of the following is/are non-pharmacological
methods used to treat postpartum hemorrhage by a
midwife or any healthcare provider?
A. Apply uterine packing
B. Rubbing up contraction
C. Internal and external bimanual compression
D. All of the above
56. The Sepsis Six (6), a care bundle for management for
sepsis to be used in conjunction with ABCDE, should be
implemented within 1 hour of suspected sepsis diagnosis.
This consists of the following, except:
A. Give high flow Oxygen
B. Take blood cultures
C. Give IV antibiotics
D. Place in Trendelenburg position
57. A client at 38 weeks gestation comes to the facility
after experiencing leakage of clear fluid from the vagina
without contractions. Premature rupture of membranes
(PROM) is suspected. Which of the following actions by
the midwife would be inappropriate for a client with this
condition?
A. Perform digital vaginal examination
B. Administer ampicillin IV
C. Assess the client’s cervix and vaginal cavity through
sterile speculum vaginal examination
D. Order L/S ratio
58. A midwife is monitoring a client in labor who is
receiving IV Oxytocin. The FHR monitor tracing reveals
decelerations occurring 35 seconds after the onset of
each contraction and continuously past the end of each
contraction. Which of the following is the priority action of
the midwife?
A. Change the client’s position to side-lying position
B. Position the client to Trendelenburg position
C. Stop the administration of Oxyctocin
D. Administer oxygen
59. A midwife is assessing a client and her infant one
week after delivery. The infant’s birth weight was 7.5
pounds. Which of the following findings indicate that the
infant is getting enough milk?
1 – The mother reports that the infant is wetting 6-8
diapers a day.
2 – The mother informs the midwife that the infant
appears content between feedings.
3 – The infant’s weight is 6.8 pounds.
4 – The mother reports that the infant quietly swallows
during breastfeeds.
A. 1, 2
B. 1, 2, 3
C. 1, 2, 4
D. All of the above
60. On assessment, the midwife notes that a female
newborn has pink patches at the nape of the neck. The
midwife informs the mother that these patches:
A. Occur more often in males than in females.
B. Are caused by an injury during labor.
C. Do not fade.
D. Disappear by school age without treatment.
61. A client is given Oxytocin for the induction of labor.
The midwife should monitor the client for which of the
following side effects of Oxytocin?
A. Vomiting
B. Increased urine outflow
C. Hypertension
D. Bradycardia
62. A midwife is monitoring a client who is in labor.
Assessment findings reveal that the fetus is in LOA
position. The midwife notes that the presenting part of the
fetus is at 0 station. This finding indicates that:
A. The presenting part is at the perineum and the fetal
head is crowing.
B. The presenting part is at the level of the ischial spines
and the fetal head is engaged.
C. The presenting part is above the level of the ischial
spines and the fetal head is floating.
D. The presenting part has descended to within the pelvic
inlet.
63. A midwife is monitoring a client who was admitted to
the labor and delivery unit about 5 hours ago. The
midwife notes a cervical dilatation of 5 cm. The
contractions occurring every 5 minutes usually last
between 50 and 55 seconds. The client is in which phase
of labor?
A. Latent Phase
B. Active Phase
C. Transition Phase
D. 2nd stage of labor
64. A midwife is monitoring a client with a cervical
dilatation of 3 cm. The midwife determines that the client
has contractions occurring every 3 minutes. Each
contraction lasts for 50 seconds. The FHR is determined
at 100 bpm. Which of the following is the priority action of
the midwife?
A. Encourage the client to push with every contraction
and to rest in between contractions.
B. Administer Oxygen via face mask.
C. Document the findings as normal.
D. Encourage frequent change of position.
65. A midwife is reviewing the FHR monitor tracing
obtained from a G2P1 client who is in labor. The midwife
notes decelerations at unpredictable times in relation to
contractions. The midwife suspects which of the following
conditions?
A. Cephalopelvic disproportion
B. Good fetal well-being
C. Uteroplacental insufficiency
D. Cord compression
66. A midwife is teaching a female client how to perform
breast self-examination. On return demonstration, which
of the following actions by the client indicates that further
teaching is necessary?
A. The client uses the tips of her 2nd, 3rd and 4th fingers to
press every part of her breast.
B. Using the right hand to examine the left breast, the
client examines the entire breast using small circular
motions in a spiral pattern.
C. In a supine position, the client places a folded towel
under her right shoulder and puts her right hand behind
her head. Using the left hand, she palpates her right
breast.
D. In a standing position, the client places her hands on
her hips and presses down firmly.
67. A midwife is assessing four clients who recently gave
birth through vaginal delivery. A part of the examination is
measuring the fundal height. Which of the following
clients needs further evaluation?
A. A client who gave birth 24 hours ago; the fundus is 1
fingerbreadth below the umbilicus.
B. A client who gave birth1 hour ago; the fundus is at the
level of the umbilicus.
C. A client who gave birth 72 hours ago; the fundus is 2
cm below the umbilicus.
D. A client who gave birth 10 days ago; the fundus is
non-palpable.
68. A pregnant client is admitted to the facility due to
alcohol abuse. During the 1st 24 hours, which of the
following interventions is the least appropriate?
A. Orient the client frequently.
B. Initiate seizure precautions.
C. Provide a quiet, non-stimulating environment.
D. Initiate bleeding precautions.
69. A midwife is managing the care of a 25-year-old
postpartum client who gave birth 18 hours ago. No
complications were noted during the labor process. The
newborn is brought to the client for feeding and to have
the mother and child bond for the night. The client says,
“I’m too tired. Please get her back to the nursery, just for
tonight. I need to get some sleep.” Which of the following
is the most appropriate action of the midwife?
A. Create a teaching plan for the mother that focuses on
breastfeeding.
B. Encourage the client to join a parenting skill class.
C. Accept the client’s behavior as an indication that she is
in the taking-in phase.
D. Accept the client’s behavior as an indication that she is
in the taking-hold phase.
70. A midwife is assessing a mature female neonate born
to a 21-year-old G3P2 client. Which of the following
findings suggests that further evaluation and notification
of the physician is necessary?
A. Birth length = 53 cm
B. Head circumference = 35 cm
C. Birth weight = 11 pounds
D. Chest circumference is 2 cm less than the head
circumference.
71. A client who gave birth to a healthy newborn
experiences crying and expresses feelings of sadness
and emptiness. The client delivered her baby 3 days ago.
The midwife suspects that the client has:
A. Postpartum depression
B. Postpartum blues
C. Postpartum psychosis
D. A normal behavior during the taking-hold phase
72. A client had a cesarean delivery. The client informs
the midwife that she intends to breastfeed her baby.
Which of the following instructions is the most effective
for a client who wants to breastfeed after cesarean
delivery?
A. “Use the football hold when breastfeeding.”
B. “Choose the position that is most comfortable during
breastfeeding.”
C. “Breastfeeding is withheld for the 1st 12 hours of life.”
D. “Breastfeed the newborn every 4 to 8 hours.”
73. A client at 11 weeks gestation complains of severe
and extreme nausea and vomiting. During history taking,
the midwife learns that the client vomits at least 3x a day.
An ultrasound is performed and reveals that the client is
negative for hyatidiform mole and multiple pregnancy.
The midwife suspects a case of hyperemesis gravidarum.
The client is admitted for monitoring. Which of the
following interventions is the least appropriate for the
client?
A. Increase oral intake of fluids.
B. Administer 3,000 ml of Ringer’s Lactate
C. Administer Metoclopramide
D. Monitor fluid intake and urinary output
74. A midwife tells a client who is trying to get pregnant to
eat fresh fruits and vegetables before conceiving. The
midwife also recommends 400 mcg of Folic acid a day.
Once she gets pregnant, the midwife may recommend
that the client increase her Folic acid intake to 600 mcg
per day during the 1st trimester. Which of the following is
not a benefit of folic acid supplementation before and
during pregnancy?
A. It prevents the formation of large but ineffective RBCs.
B. It prevents neural tube defects.
C. It decreases the baby’s risk for cleft lip or palate.
D. It ensures proper functioning of the thyroid gland.
75. A client is in her 18th week of pregnancy. Which of the
following psychosocial changes is expected at this time?
A. The client is ambivalent about being pregnant.
B. The client begins to imagine how she will feel during
the delivery.
C. The client is excited to attend childbirth educational
classes.
D. The client engages in nest-building activities.
76. The midwife is creating a teaching plan for a program
that encourages women to have their regular Pap smear.
Which of the following groups of women is the midwife’s
priority?
A. Women infected with Treponema Pallidum
B. Women with a history of genitalia herpes
C. Women who are on oral contraceptives
D. Women who have plans of conceiving within the next
year.
Situation 8: The following questions revolve around the
Antepartum period.
77. How can a primigravida client most readily meet her
increased daily Iron requirements?
A. Consuming at least four glasses of milk daily.
B. Adding an extra source of red meat to her daily diet.
C. Taking an Iron supplement with a Vitamin C source.
D. Including an extra source of fruits or vegetables.
78. A primigravida client is experiencing Braxton-Hicks
contractions. Which statement is TRUE concerning this
type of contraction?
A. Are intensified by walking about.
B. Are confined to the lower back.
C. Do not increase in intensity or frequency.
D. Result in cervical effacement and dilation.
79. A client is 37 weeks pregnant and is admitted to the
hospital with bright red vaginal bleeding, complaining of
abdominal discomfort, but no contractions. After
assessing the client’s vital signs and determining the
FHR, what is the most important information to obtain?
A. The amount of cervical dilatation that is present.
B. The exact location of her abdominal discomfort.
C. The station of the presenting part.
D. At what time the client last ate.
80. A client reports that her last menstrual period was
November 6. She asks the midwife, “When will my baby
be due?”. What is the best answer?
A. “July 3”
B. “August 30”
C. “Around the middle of September.”
D. “The first or second week of August.”
81. A young woman calls the clinic and reports missing
her period. She states that she used a home pregnancy
test last night and the results were negative. She tells the
midwife that her breasts are tender and that she feels
nauseated most of the day. What does the midwife
understand about home pregnancy tests?
A. They are RIA (radioimmunoassay) type tests, which
are quick and most accurate.
B. Home pregnancy tests are more reliable if collected on
a random specimen.
C. The test is accurate and she is not pregnant.
D. False-negative results should be followed up in the
presence of pregnancy symptoms.
82. Which statement would the midwife make to the client
about striae gravidarum?
A. Occur in 100% of pregnancies.
B. Are silvery streaks that appear especially during the
last trimester.
C. Can be decreased by a local application of cocoa
butter or other types of emollient creams.
D. Will fade from their present reddish appearance.
83. A 26-year-old client comes into the emergency room
complaining of lower left side abdominal pain. It began
suddenly and has gotten worse over the past few hours.
What is the most important information for the midwife to
obtain?
A. Whether she has had an appendectomy or a
cholecystectomy.
B. What she has had to eat over the last 24 hours.
C. Whether she has recently been diagnosed with a
sexually transmitted disease.
D. The date of her last menstrual period and whether she
could be pregnant.
84. A client is at 30 weeks gestation when she comes in
for her regular prenatal check-up. What assessment
findings would cause the most concern?
A. Increased vaginal discharge, weight gain of 3 lb, and
decreased activity tolerance.
B. Presence of 2 gm of protein in a 24-hour urine
collection, swelling of the face and hands, weight gain of
7 lb.
C. Complaints of backache and contractions that occur
randomly and are uncomfortable.
D. State she is dizzy when she stands up from sitting,
states she has leg cramps and her feet are swelling.
85. The midwife is caring for a client who is not pregnant
but who is considering pregnancy. A rubella titer has
been done, and the titer was negative. What will be
important for the midwife to tell this client?
A. The client should get a rubella vaccine now and not
get pregnant for at least 3 months.
B. Because the rubella titer was negative, there should
be no problems with getting pregnant.
C. It is important for the client to get pregnant as soon as
possible because the titer was negative.
D. The client can get pregnant now, but she should
receive the rubella vaccine during the 1st trimester.
Situation 9: The following questions revolve around the
Intrapartum and Postpartum period.
86. The midwife is caring for a 20-year-old primigravida
who has been in the first stage of labor for about 8 hours.
What assessment findings would indicate that the client is
progressing into the 2nd stage of labor?
A. Uterine contractions about 10 minutes apart, cervical
dilatation of 6 cm.
B. Cervical effacement at 100% dilatation at 10 cm.
C. Scant to moderate blood mucus showing, station +2.
D. Fetal station at -2 and FHR noted at level of umbilicus.
87. The labor monitor tracing shows repeated, mild,
variable decelerations. What complication would the
midwife anticipate is occurring?
A. Cord compression
B. Fetal hypoxia
C. Placental insufficiency
D. Head compression
88. The midwife is assessing a client 12 hours after a
prolonged labor and delivery. What assessment data
would cause the midwife the most concern?
A. Oral temperature of 100.6 degrees F
B. Moderate amount of dark red lochia.
C. Episiotomy area bruised with small amount of dark
bloody drainage.
D. Uterine fundus palpated to the right of the umbilicus.
89. The midwife is caring for a client in labor. How are
contractions timed?
A. End of one to the beginning of the next.
B. Beginning of one to the end of the next.
C. End of one to the end of the next.
D. Beginning of one to the beginning of the next.
90. What is the length of time of the 2nd stage of labor in a
woman who is a primipara?
A. 20 – 30 minutes
B. 50 – 60 minutes
C. 2 hours
D. 3 hours
91. During the 1st stage of labor, the cervix becomes thin
and indistinct form the body of the uterus. What is the
term the midwife would use to describe this observation?
A. Dilation
B. Attitude
C. Effacement
D. Transition
92. The client complains of severe perineal pain the 1st
hour after delivery. What should the midwife assess for?
A. A soft, boggy uterus
B. Swollen, discolored area on the perineum
C. Presence of a cervical laceration
D. Increase in vaginal flow caused by retained placental
fragments
93. The midwife is checking a laboring client. Her
assessment reveals the head at +3 station. What will the
midwife do?
A. Prepare for the delivery of the infant.
B. Begin administration of Oxygen at 6 L/min.
C. Determine if contractions are increasing.
D. Determine the FHR.
94. A woman who gave birth 3 weeks ago calls the
midwife to ask what she should do for her sore, cracked
nipples. What will the midwife tell her to do?
A. Stop breastfeeding the infant until the nipples heal.
B. Make sure all of the areola is in the infant’s mouth
when she breastfeeds.
C. Cleanse the nipples with half-strength peroxide and air
dry.
D. Place a cool compress on the nipples after
breastfeeding.
95. The midwife is caring for a client who is at 38 weeks
gestation and is scheduled for a cesarean delivery.
Which assessment finding would indicate a need for the
midwife to contact the physician?
A. Urinary output of 75 ml/hr.
B. Contractions occurring 3 minutes apart and lasting 2
minutes.
C. Complaints of burning and bloody urine on voiding.
D. Maternal heart rate regular at 98 bpm.

96. A client complains of abdominal cramping and pain

after breastfeeding. What does the midwife explain to the
client about this type of pain?
A. All women experience abdominal discomfort during the
postpartum period.
B. Breastfeeding causes the release of Oxytocin, which
causes uterine contractions.
C. Abdominal cramping is frequently associated with
endometriosis.
D. Abdominal discomfort is a sign of subinvolution and
may occur for 3 to 4 weeks.

97. The midwife is monitoring a client during labor and

observes an erratic FHR pattern on the monitor at the
height of the contraction. What is the first action?
A. Position the mother on her right side.
B. Check the monitor leads for placement.
C. Begin Oxygen administration at 4 L/min and observe
mother’s respirations and FHR.
D. Determine if contractions are increasing in duration,
intensity and frequency.

98. The midwife assesses the psychological status of the

mother and promotes bonding during delivery and after
delivery. Which of the following maternal observations
would cause the midwife to be concerned regarding the
bonding process?
A. She is not interested in breastfeeding after birth.
B. She hands the infant to the father to hold immediately
after delivery.
C. She is tired and does not want to see the infant at
birth.
D. She is concerned regarding the newborn’s
acrocyanosis and molding of the head.

99. A 31-year-old multipara is admitted to the birthing

room after initial examination reveals her cervix to be at 8
cm, completely effaced (100 %), and at 0 station. What
phase of labor is she in?
A. Latent phase
B. Expulsive phase
C. Transitional phase
D. Active phase

100. While the postpartum client is receiving herapin for

thrombophlebitis, which of the following drugs would the
midwife expect to administer if the client develops
complications related to heparin therapy?
A. Protamine sulfate
B. Methylegonovine (Methergine)
C. Nitrofurantoin (macrodantin)
D. Calcium gluconate