NORMAL LABOUR

Anatomy Q1)Which of the following peritoneum in the uterus is BEST for the attachment of the
placenta?

A)Anterior-posterior

B) Anterior -Superior

C) Posterior -Inferior

D) Posterior -Superior

Q2)The placenta performs the following functions for the fetus during intrauterine life EXC

A)Excretory

B) Nutritive

C) Reproductive

D) stability

Q3)At what gestational age can the gender of the fetus be determined during the intrauterine
life?.............weeks

A)2-4

B)5-10

C)11-16

D)20 and above

Anatomy Q4)The size of the female breast is determined by the following factors EXCEPT

A)Age

B)Fatty tissue

C) Height

D) Hereditary

Q5) Which of the under listed are constituents of colostrum?

I.Blood

II.Leucocyteso
III.Mineral salts

IV.Protein

A)I,II and III

B)II,III and IV

C)I,III and IV

D)I,II and IV

Q6)The term used to describe the neuromuscular harmony that prevails between the two poles of
segment of the uterus throughout labour is

A) Contraction

B)Fundal dominance

C) Segment formation

D)Polarity

Q7) Which of the under listed structures can directly affect labour?

A)Ishcial spines

B) Ishcial tuberosity

C)Lesser sciatic notch

D)Obsturator foramen

Q8)The intensity of contraction is determined by:-

A) Asking the woman how she is experiencing it

B) Indenting your fingers into the uterus during contraction

C) Keeping your fingers lightly on the fundus

D)Hearing the woman shouting at the height of contraction

Q9) Which of the under listed explains fundal dominance?

I.Each uterine contraction starts from the fundus

II.Contractions spread across the fundus first

III.Peak of contractions is reached first at the fundus

IV.The contraction is intense and lasts longest in the fundus

A)I and II

B)I,II and III

C)I,II and IV

D)I,III and IV

Q10)The partograph which is a graphical representation of the events and progress of labour used by
health workers is important because it helps to

A)Detect foetal abnormalities

B) Identify high risk condition in labour

C)Manage all categories of women in labour

D)Provides guidelines for abnormal labour

Q11)The following are true signs of labour in a multiparous woman.

I.Appearance of show

II.Cervical os dilates to 3cm

III.Feeling of lightness

IV.Painful regular contraction

A)I and II

B)I and III

C)I,II and III

D)I,II and IV

Q12)The following are the side effects of Ergometrine.EXCEPT

A)Headache

B) Hypertension

C)Vaso -dilatation

D) Vomiting

Q13)The part of the foetus which lies at the pelvic brim is refer to as.
A) Denominator

B)Lie

C) Position

D) Presenting part

Q14)A well flexed head,the midwifes examining fingers must locate which of these fontanelle?

A) Anterior

B) Parietal

C) Posterior

D)Temporal

Q15)One of the functions of the amniotic fluid is to

A)Absorb waste products of fetal metabolism

B) Maintain body temperature of the fetus

C)Prevent improper implantation of placenta

D)Prevent the cord from wrapping around the fetus

Q16)Which of the following is NOT a normal composition of amniotic fluid?

A) Enzymes

B)Lanugo

C)Maternal blood

D)Vernix caseosa

Q17)At what gestational age in weeks does the placenta reach its full development?

A)12

B)24

C)28

D)32

Q18)Which of the following hormones aids cell division during morula stage?
A)Oestrogen

B) Progesterone

C) Prostaglandin

D)Relaxin

Q19)Which of the following occurs soon after fertilization?

A) Embedment

B) Meiosis

C) Mitosis

D) Segmentation

Q20)In labour and delivery the foetus goes through series of manoeuvres in order to be born.what is the
normal sequence

A) Flexion, descent, extension,internal rotation, external rotation and restitution

B) Descent, extension, restitution,flexion, internal rotation, and external rotation

C) Descent, flexion, restitution, extension, internal rotation and external rotation

D) Descent, flexion, internal rotation, extension, restitution and external rotation

Q21)The third stage of labour.

A)Last from the birth of the baby until six hours after delivery

B) Involves the separation and expulsion of the placenta and control of Haemorrhage

C)Starts with active management and end in 5-10minutes

D)Is the most dangerous stage for the foetus

Q22) Examination reveals that the presenting part of the foetus in the cephalic presentation passed the
pelvic inlet and is at the level of the ischial spines The nurse interprets this mean that the presenting
part is.........

A)Crowing

B) Engaged

C) Floating

D)At-station 1
Q23) Cervical dilatation occurs as a result of which of the following?

I.Cervical effacement

II.Pressure from intact membrane

III Pressure from presenting part

IV.Uterine action

A)I and II

B)I and III

C)I,II and III

D)II,III and IV

Q24)which of these statement best describes effacement of the cervix?

A)The force of uterine contraction stretches and opens up the cervical Os

B)The cervix stretches and merges with the lower uterine segment

C) When the cervix can be felt as a thin ring over the presenting part.

D) When the cervix is soft and can be distended easily by the care provider

Q25)Mrs Esi Darlington a primipara is in labour and she is worried that Auntie Akorfa who was admitted
some hours after her has delivered before her,You tried to explain to her that the duration of labour is
influenced by some factors.Which of the underlisted factors will you include in your explanation?

I.Birth interval

II.Psychological state

III.Support person

IV.Stage of Labour

A)I,II and III

B)II,III and IV

C)I,II and IV

D)I,III and IV

Q26) A 3rd year student midwife is trying to explain the term Fundal dominance to a 1st year student
midwife,Which of the underlisted explains fundal dominance
I.Each uterine contraction starts from the fundus

II.Contractions spreads across the fundus first

III.Peak of contractions is reached first at the fundus

IV.The contraction is intense and lasts longest in the fundus

A)I and II

B)I,II and III

C)I,II and IV

D)II,III and IV

Q27)How often do you have to check and record the foetal heart beat on the partograph during the
active phase of Labour?

A)Every 15minutes

B)Every 20minites

C)Every 30minutes

D)Every hour

Q28)The first stage of labour is said to have terminated when

A) Regular 3 minutes contractions have been established

B)The bag of water have been ruptured and drained

C)The cervix has been completely effaced and dilated

D)The Presenting part is visible during contractions

Q29)Which of the following occurs FIRST in a woman with 36weeks cyesis before TRUE Labour begins?

A) Braxton Hicks contractions

B) Descent of the foetal head

C) Engagement

D) Lightening

Q30)In a vertex presentation the head is born across the perineum by

A) Expulsion
B) Extension

C) Flexion

D) Restitution

Q31)Which method would be most effective for the midwife to use when assessing the intensity of a
client's uterine contractions?

A)Asking the woman to rate the intensity

B) Auscultating with a pinna stethoscope

C)Observing the woman's facial expression

D) Palpating the uterine fundus

Q32)The underlisted are premonitory signs of labour EXCEPT

A) Appearance of show

B) Cervical effacement

C) Frequency of micturition

D) Gastrointestinal upsets

Q33) Which of the following mechanisms suggests to the midwife that the foetus is ready to be
delivered?

A) Extension of the head

B) External rotation of the head

C) Internal rotation of the head

D) Restitution of the head

Q34)The diameters which distends the perineum when the head is fully flex in crowning are

A)Occipito posterior and bi-parietal diameters

B)Sub-occipito posterior and bi-parietal diameters

C) Sub-occipito bregmatic and bi-parietal

D) Occipito bregmatic and bi-parietal

Q35)The ideal time to give episiotomy is when there is

A) Crowning

B) Engagement

C) Extension

D) Restitution

Q36)Respiratory depression in the newborn from Pethidine can be countered injecting the baby
with..............

A)Meptazinal

B)Mentoxin

C)Neloxone

D) Nystatin

Q37) Student midwife Adama is conducting a delivery under the supervision of a midwife.which of the
steps below should she take after observing the external rotation of the foetal head?

A)Clean baby's face

B)Deliver head by extension

C)Deliver anterior shoulder

D)Deliver baby's body

Q38) Carbohydrates is stored in the placenta as

A) Energy

B) Glucose

C) Glycogen

D) Nutrient

Q39)Which of the following statements about the umbilical cord is CORRECT?

I.It contains two arteries

II.It contains two viens

III.Oxygenated blood is carried in a vein

IV.Wharton's jelly protects it's vessels

A) I,III and IV

B)I,II and IV

C)I,II and III

D)II, III and IV

Q40) Vertex of the fetal skull can be located between

I.Anterior fontanelle

II.Occipital protuberance

III.Parietal eminences

IV.Posterior fontanelle

A)I,II and III

B)I,II and IV

C)I, III and IV

D)II, III and IV

Q41) Which of the following statement is TRUE about the normal fetal circulation?

A) Descending aorta connects the pulmonary vein with the aorta

B) Foramen ovale connects the two atria

C)The two hypogastric arteries carry oxygenated blood from the lower extremities

D)The two ventricles communicate through a septal defect

Q42)Which of the following statements can a student midwife use to describe the bregma?it.......

A)Closes soon after birth

B)Has three suture lines running into it

C)Is a Diamond in shape

D)Is the posterior fontanelle

Q43) Which of the following is true about amniotic fluid?

I.acts as a shock absorber

II.contains protein

III.contains fetal urine

IV.Is bactericidal

A)I,II and IV

B)II, III and IV

C)I,III and IV

D)I,II and III

Q44) What is the name given to the fertilized ovum at the time of embedment?

A) Amniotic sac

B) Blastocyst

C) Mesoderm

D)Yolk sac

Q45) Polycythemia is a blood condition where the red blood cells in circulation is............. the normal
level

A) Above

B) Below

C) Between

D) Exactly at

Q46)A double layer of amnion and chorion around the circumference of the placenta,giving appearance
of a colour is referred to as a placenta................

A)Accreta

B)Bipartita

C) Circumvallate

D) Velamentous

Q47) Which of the following fetal conditions are associated with Oligohydramnios?

I.Dry and leathery skin

II.Fetal malformation

III.Stable lie

IV.Renal agenesis

A)I,II and III

B)I,III and IV

C)II, III and IV

D,)I,II and IV

Q48)The functional unit of the placenta is.......with

A)Aneboring

B)Bortanic

C) Nutritive

D) Protective

Q49) When blood from the placenta in the umbilical vein stops after the third stage of labour, pressure
from the inferior vena cava...........

A)Decreases

B)Equalizes

C)Increases

D)Stops

Q50)The chorion can be described as...........

A) Attached to the uterine cavity

B)Covers the umbilical cord

C)Tough,shiny and transparent membrane

D)Very difficult to tear

Q51) During the embryonic period the ectoderm develops into

A) Fetal skin,teeth,nerve tissue and genital tract

B) Digestive tract,liver,lungs and bladder

C) Muscles,circulatory system, ureters and kidney

D)Ureters,Kidneys,Circulatory and lymphatic system

Q52)The main function of the layer of Nitabuch is to.........

A)Allow maternal blood to mix with that of fetus

B)Permit fetal capillaries to withdraw more blood

C) Prevents maternal blood from mixing with that of the fetus

D) Separates used blood from fresh blood

Q53)Which of the following temporal structures of the fetal circulatory system becomes a supporting
ligament of the liver after delivery?

A)Ductus arteriosus

B)Ductus venosus

C) Foramen ovale

D) Hypogastric arteries

Q54)The midwife can BEST reduce the incidence of congenital anomalies if the pregnant mother is
provided with education and counseling during.............period

A) Antenatal

B) Labour

C) Postnatal

D) Preconception

Q55)The fetal head is said to be engaged in late pregnancy when the....... .diameter has passed through
the pelvic brim

A) Anterior posterior

B) Bi-parietal

C) Bitemporal

D) Occipitofrontal

Q56)The sub Occipito Bregmatic (SOB) diameter measures.......cm

A)8.5
B)9.5

C)10.5

D)11.5

Q57)The decidua vera.........................

A)Lies above the embryonic plate

B)Lies below the embryonic plate

C,)Lines the remainder of the uterine cavity

D)Lines the placental site

Q58)Nidation of the fertilized ovum occurs by the ..........day of fertilization.

A)3rd -5th

B)7th -10th

C)12th -14th

D)14th-16th

Q59)Which of the following vessel is mostly affected when cerebral membranes are torn?

A) Inferior sagittal sinus

B) Straight sinus

C) Superior sagittal sinus

D)The great vein of Galen

Q60)The Sub-occipito bregmatic circumference presented in a well flexed head is taken from

A)Below the occiput to the anterior fontanelle

B) Between the two extreme points of the coronal suture

C) Between the chin and the anterior fontanelle

D)From the chin to the vertex

Q61)The name given to the double fold of dura mater which dips down between the cerebrum is...........

A)Falx cerebri
B)Falx cerebelli

C) Tentorium cerebelli

D) Tentorium cerebri

Q62) Which of the underlisted brings about the GIVE OF THE PELVIS?

I.Loosening of the sacro coccygeal joint

II.Softening of symphysis pubis

III.Softening of sacro iliac joint

IV.Tilting back of the coccyx

A)I and IV only✔️

B)II and III only

C)II, III and IV

D)I,II, III and IV

Q63)Which of the statements below is correct about a primigravida patient at 18weeks gestation?

A)Feels Braxton Hicks contraction

B)Fetus can be described as viable

C) Fundus can be palpated just below the umbilicus ✔️

D) Fundus reaches midway between xiphisternum and umbilicus

Q64) During pregnancy,increase blood supply to the uterus is as a result of which one of the following?

A)Decrease diameter of uterine blood vessels

B) Development of new blood vessels

C)Increase cardiac output

D) Influence of estrogen

Q65)At what stage in pregnancy does the corpus luteum atrophie?

A)After 10th weeks

B)After 12th weeks

C)After 20th weeks

D)Before 12th weeks

Q66) Which of the following positions is the most favorable for vaginal delivery?

A)Left Occipito posterior

B)Left sacro anterior

C) Right Occipito anterior

D) Right Occipito transverse

Q67)The second stage of labour is known as a stage of

A) Dilatation

B) Expulsion

C) Placental separation

D) Recovery

Q68)The following are the uterine actions during the first stage of labour EXCEPT.

A) Contraction and retraction

B) Fundal dominance

C)Polarity

D) Rupture of the membrane

Q69)The equal distribution of the pressure exerted by the contracting uterus on the placenta and fetus
while the membranes remain intact is termed.........

A) Contraction and retraction

B) Fundal dominance

C) General fluid force

D) General fluid pressure

Q70) Lightening is also known as........

A) Contraction and retraction

B) Dropping
C) Fundal dominance

D) General fluid pressure

Q71)The length of labour varies widely and is Influenced by the following factors EXCEPT

A) Maternal age

B)Parity and birth interval

C)Size and shape of pelvis

D) Presentation and position

Q72) Which of the following is not a characteristic of normal labour?

A)Lie is transverse

B) Minimal injury to mother and baby

C) Presentation is vertex

D)Term above 37weeks

Q73) During counting the foetal heart rate the following are correct, EXPECT.

A)Locate the position of the shoulder

B)Put the woman in a dorsal position

C)Stand at the left side of the woman and palpate her back

D)Warm the foetal stethoscope and listen to the foetal heart sound.

Q74) Shortening of a muscle fiber in the absence of contraction is known as........

A) Contraction

B) Fundal dominance

C)Polarity

D) Retraction

Q75)At what intervals are uterine contractions monitored during the active phase of Labour?

A)30 minutes

B)40 minutes
C)50 minutes

D)60 minutes

Q76)The most important feature in determining the progress of labour is

A) Cervical dilatation

B) Descent of the head

C) Maternal condition

D) Uterine condition

Q77) Partograph is used to manage a client in labour to

A)Detect fetal abnormality

B) Identify high risk client on admission

C)Manage all clients in labour

D) Prevent prolonged Labour

Q78)The first stage of labour starts with

A) Backache

B) Effacement of the cervix

C) Regular rhythmic uterine contractions

D)show

Q79)The neuromuscular harmony that prevails between the upper and lower uterine segment of the
uterus throughout labour is termed........

A) Contractions

B) Foetal axis pressure

C) General fluid pressure

D) Polarity

Q80)The term labour is the process by which

I.contraction and cervical dilatation occurs

II.Fetus is expelled through the birth canal

III.Fetus, placenta and membranes are expelled

IV.Fetal head reaches the "O" station

A)I and II only

B)I,II and III only

C) I and III only

D)I,II and IV

Q81)The latent phase lasts for

A)8 hours

B)10 hours

C)12 hours

D)15 hours

Q82) Which of the following positions encourages more lacerations or larger lacerations

A)Hands-and-knees

B)Lye on her back

C) Sitting

D) Squatting

Q83)The causes of onset of true labour are not known but many factors can be associated with it,that
is...................

I.Genetic

II.Hormonal

III.Mechanical

IV.Physiological

A)I and II

B)I and III

C)II and III

D) III and IV
Q84) Duration of contraction is from the time the contraction is 1st felt abdominally till the time it
passes off and this is measured in

A)Fifths

B)Hours

C)Minutes

D) seconds

Q85) Vaginal examination on a client during labour should be carried out.

A)Every 2 hours unless otherwise indicated

B) Every 4 hours unless otherwise indicated

C)As frequently as possible to provide continuous assessment of labour

D)Only using sterile gloves whether or not membranes intact.

Q86)The following are premonitory signs of labour EXCEPT

A) Frequency of micturition

B) Lightening

C) Spurious labour

D) Taking up of vagina ✔️

Q87)The average duration of the first stage of labour in both nullipara and multipara should not
exceed............

A)12

B)15

C)18

D)20

Q88)In assessing descent of the foetal head in labour,the level of the presenting part is estimated in
relation to the

A) Iliopectineal line

B) Ischial spines

C) Pelvic brim
D)Sacral promontory

Q89) Immediate postpartum period begins with delivery of the

A) Baby

B) Membranes

C) Placenta

D) Products of Conception

Q90)Which of the following observations will you make on the foetal condition during the 1st stage of
labour?

I.Foetal heart rate

II.Liquor

III.Moulding

IV.Presenting part

A)I,II, and III

B)II, III and IV

C)I,II and IV

D)I,III and IV

Q91)Which of the following conditions would delay the progress of labour?

I.Multiple pregnancies

II.Antepartum Haemorrhage

III.Polyhydramnios

IV.Oligohydramnios

A)I and II only

B)I,II and IV only

C)I,II and III only

D)I and III only

Q92) Which of the following conditions can negatively affect the mother during labour?
A)A short Umbilical cord

B)A long Umbilical cord

C) Excessive amniotic fluid

D)Scanty amniotic fluid

Q93)