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
Rationale: First FHT by fetoscope is universal and it is arbitrarily accepted that it starts at the 4 th month of
gestation. Therefore if you heard the first FHT by fetoscope then the patient is at 4 th month and the EDC
will be around 5 months from now.

2. Which hormone is necessary for a positive pregnancy test?

A. Progesterone
B. HCG
C. Estrogen
D. Placental Lactogen
Rationale: HCG is responsible for positive pregnancy test. But it is not a positive sign of pregnancy. Only
probable purpose of HCG id to maintain the secretion of progesterone by the corpus luteum. It will
deteriorate by 2nd trimester as the placenta resumes its function.

3. With this pregnancy, Aling Julia is a:

A. P3 G3
B. Primigravida
C. P3 G4
D. P0 G3
Rationale: She has 3 children, so para 3. Since she is pregnant, this is her 4 th gravida. If the pregnancy is
beyond the age of viability which is 7 months consider it as para and not gravida as long as the baby is still
inside the uterus.

4. In explaining the development of her baby, you identified in chronological order of growth of the fetus
as it occurs in pregnancy as:
A. Ovum, embryo, zygote, fetus, infant
B. Zygote, ovum, embryo, fetus, infant
C. Ovum, zygote, embryo, fetus, infant
D. Zygote, ovum, fetus, embryo, infant
Rationale: the ovum is the egg cell from the mother, the sperm will fertilize it to form a zygote. This
usually happens in the ampulla or the distal third of the fallopian tube. Hyaluronidase is secreted by the
sperm to dissolve the outer membrane of the ovum. The zygote now contains 46 chromosomes. 23 from
each germ cell. The zygote is now termed as an embryo once it has implanted. When the embryo reached
8th weeks it is now termed as fetus until it has been delivered.
5. 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.
Rationale: Some test can detect hCG even earlier, within a week of conception, but no test is 100%
accurate. Another reason you may receive a false negative on home pregnancy test is that HCG levels vary
from person to person, and your individual HCG level may be too low to be detected on a home
pregnancy test.

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 – are relieved by increasing fluid intake and hot sitz bath
B. Backache – is a common complaint of women with an occiput posterior presentation due to pressure
on the back
C. Facial edema
D. frequent urination – it will disappear as soon as the pressure of the uterus is released against the
bladder and as soon as the client’s blood volume has returned to normal.
Rationale: Facial edema is one sign of mild preeclampsia and prompt professional supervision is needed
to lower down the client’s blood pressure.

7. Which of the following statements would be

appropriate for you to include in Aling Julia's prenatal teaching plan?
A. Exercise is very tiresome, it should be avoided – it should not be avoided
B. Limit your food intake – food is never limited in pregnancy
C. Smoking has no harmful effect on the growth and development of fetus – smoke, alcohol and drugs
should be avoided for the rest of pregnancy
D. Avoid unnecessary fatigue, rest periods should be included in your schedule
Rationale: rest period and avoiding unnecessary fatigue is one of the pillars in health teaching of the
pregnant client.

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 – it will create
pressure on the leg.
B. Lay flat for most hours of the day – lying flat will prevent varicosities but will not be helpful for the
client’s overall health
C. Use garters with nylon stocking – stocking should not have garters because it impedes blood flow, they
should be made of cotton not nylon
D. Wear support hose
Rationale: a thigh high stocking or a support hose worn before getting up in the morning is effective in
prevention of varicosities.

9. In a 32 day menstrual cycle, ovulation usually occurs on the:

A. 14th day after menstruation
B. 18th day after menstruation
C. 20th day after menstruation
D. 24th day after menstruation
Rationale: a diary is made for around 6 months to determine the number of days menstrual cycle and the
average is taken from that cycles. 14 days are subtracted from the total days of menstrual cycle. This
signifies the ovulation day. A couple would abstain having sex 5 days before and 5 days after the ovulation
day. therefore a 32 days cycle minus 14 days is 18.

10. Placenta is the organ that provides exchange of nutrients and waste products between mother and
fetus. This develops by:
A. First month
B. Third month
C. Fifth month
D. Seventh month
Rationale: the placenta is formed at around 3 months. It arises from the trophoblast from the chorionic
vili and decidua basalis.

11. In evaluating the weight gain of Aling Julia, you know the minimum weight gain during pregnancy is:
A. 1 lb/wk
B. 2 lbs/wk
C. 7 lbs/wk
D. 10 lbs/wk
Rationale: weight gain should 1 to 2 lbs per week during the 2 nd and 3rd trimester and 3 to 5 lbs during the
first trimester for a total of 25-35 lbs recommended weight gain during the gravida state.

12. The most accurate method of measuring fundal height among the following is:
A. Millimeter
B. Centimeter
C. Inches
D. Fingerbreadths
Rationale: Fundal height is measured in cm not mm. centimeters is the more accurate method of
measuring fundic height than inches or fingerbreadths.

13. To determine fetal position using Leopold's maneuvers, the first maneuver is to:
A. Determine degree of cephalic flexion and engagement
B. Determine part of fetus presenting into pelvis
C. Locate the back, arms and legs
D. Determine what part of fetus is in the fundus
Rationale: Leopold’s one determines what is it in the fundus. This determines whether the fetal head or
breech is in the fundus. A head is round and hard. Breech is less well defined.

14. Aling Julia has encouraged her husband to attend prenatal classes with her. During the prenatal class,
the couple expressed fear of pain during labor and delivery. The use of touch and soothing voice often
promotes comfort to the laboring patient. This physical intervention is effective because:
A. Pain perception is interrupted – pain is still present
B. Gate control fibers are open – when gate control fibers are open, pain is felt to the gate
C. It distracts the client away from the pain
D. Empathy is communicated by a caring person – although empathy is communicated by the caring
person, this is not the reason why touch and voice promote comfort to a laboring patient.
Rationale: touch and soothing voice promotes pain distraction. Instead of thinking too much of the pain in
labor, the mother is diverted away from the pain sensation by the use of touch and voice.
15. Which of the following could be considered as a positive sign of pregnancy?
A. Amenorrhea, nausea, vomiting - presumptive
B. Frequency of urination - presumptive
C. Braxton hicks contraction - probable
D. Fetal outline by sonography
Rationale: fetal outline sonography or other imaging devices is considered a positive sign of pregnancy
along with the presence of fetal heart rate and movement felt by a qualified examiner. All those signs with
the discoverer’s name on them (chadwick, hegars, Braxton hicks, godell’s) are considered probable and all
the physiologic changes brought about by pregnancy like hyperpigmentation, fatigue, uterine
enlargement, nausea, vomiting, breast changes, frequent urination are considered presumptive.

SITUATION 2: Wide knowledge about different diagnostic tests during pregnancy is an essential arsenal
for a health care provider to be successful.
16. 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 – extends from 0 to 3 cm; it is mild in nature
B. Expulsive phase – begins immediately after the birth and ends with separation and expulsion of the
placenta
C. Transitional phase
D. Active phase – extends from 4 to 7 cm, it is moderate for the patient
Rationale: The transitional phase of labor extends from 8 to 10 cm; it is the shortest but most difficult and
intense for the patient.
17. Quickening is experienced first by Multigravida clients. At what week of gestation do they start to
experience quickening?
A. 14th
B. 20th
C. 24th
D. 28th
Rationale: Multigravida clients experience quickening at around 16 weeks or 4 months. Primigravida
clients experience this 1 month later, at the 5 th month or 20th week.
18. Before the start of a Non-stress test, The FHR is 120 BPM. The mother ate the snack and the
practitioner noticed an increase from 120 BPM to 135 BPM for 15 seconds. How would you read the
result?
A. Abnormal
B. Non-reactive
C. Reactive
D. Inconclusive, needs repeat
Rationale: Normal non stress test result is reactive. Non stress test is a diagnostic procedure in which the
FHR is compared with the child’s movement. A normal result is an increase of 15 BPM sustained for 15
seconds at every fetal movement. The mother is told to eat light snack during the procedure while the
examiner carefully monitors the FHR. The mother will tell the examiner that she felt a movement as soon
as she feels it while the examiner takes note of the time and the FHR of the fetus.
19. When should you expect to hear the FHR using a Fetoscope?
A. 2nd week
B. 8th week
C. 2nd month
D. 4th month
Rationale: The FHR is heard about 4 months using a fetoscope. Fetal heart sounds, typically audible by
ultrasound or through fetoscope at 8 to 14 weeks gestation, are a good indicator of fetal well-being.

20. When should you expect to hear FHR using Doppler Ultrasound?
A. 8-10th week
B. 8th month
C. 2nd week
D. 10-12th week
Rationale: The FHR is heard as early as 8th week using ultrasound. The doctor may use the Doppler often
to listen to your baby’s heartbeat during routine chekups, starting at about 8-10 weeks. Fetal doppler
tests are done can vary, but they may be part of routine second trimester checkups.

21. 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.
Rationale: To calculate the EDD, according to Naegele’s rule, add 7 days to the first day of the LMP and
then subtract three months. Since the client’s LMP is Nov. 6, subtract 11 to 3 and add 7 to 6 then the
answer is august 13.

22. Which of the following mothers needs RHOGAM?

A. RH + mother who delivered an RH - fetus
B. RH - mother who delivered an RH + fetus
C. RH + mother who delivered an RH + fetus
D. RH - mother who delivered an RH – fetus
Rationale: Rhogam is given to RH – Mothers that delivers an RH + Fetus. Rhogam prevents
isoimmunization or the development of maternal antibodies against the fetal blood due to RH
incompatibility. Once the mother already develops an antibody against the fetus, Rhogam will not
anymore be beneficial and the mother is advised not to have anymore pregnancies. Rhogam is given
within 72 hours after delivery.
23. Which family planning method is recommended by the Department of Health more than any other
means of contraception?
A. Fertility Awareness Method
B. Condom
C. Tubal Ligation -
D. Abstinence – is never advocated as a family planning method though it is the best method to prevent
STD and pregnancy, it is inhumane and suppresses the reproductive rights of the people.
Rationale: Fertility awareness method is advocated by the DOH more that any kind of contraception. It is
a combination of symptothermal and billings method.

24. How much booster dose does tetanus toxoid vaccination for pregnant women has?
A. 2
B. 5
C. 3
D. 4
Rationale: TT1 and TT2 are both primary dosages. While TT3 up to TT5 represents the booster dosages.

SITUATION 3: Reproductive Health is the exercise of reproductive right with responsibility. A married
couple has the responsibility to reproduce and procreate.

25. Which of the following is ONE of the goals of the reproductive health concept?
A. To achieve healthy sexual development and maturation
B. To prevent specific RH problem through counseling - strategies
C. Provide care, treatment and rehabilitation - strategies
D. To practice RH as a way of life of every man and woman – vision of the RH program
Rationale: Every achiever avoids receiver, this mnemonic is a guide in differentiating which is which from
the goals, vision and strategies. If a sentence begins with these words, it is automatically a Goal.

26. Which of the following is NOT an element of the reproductive health?

A. Maternal and child health and nutrition
B. Family planning
C. Prevention and management of abortion complication
D. Healthy sexual development and nutrition
Rationale: Achieving healthy sexual development and nutrition is a goal of the RH. Knowledge of the
elements, goals, strategies and vision of RH are important.

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
Rationale: Quality of life is the ultimate goal of the RH in the international framework. Way of life is the
ultimate goal of RH in the local framework.

28. 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.
Rationale: It is important to know what time the client’s last ate because this might be the reason of her
bleeding and abdominal discomfort.
29. 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.
Rationale: Ovary pain may cause pain on one side of your lower abdominal or pelvic area. It can also
sometimes cause pain in the back or thigh. Ovary pain may be a sign that implantation is occurring , or it
could be a response to the change in hormones that you’ll experience in early pregnancy.
30. 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.
Rationale: are common during the first pregnancy and usually present during the third trimester. SG are
atrophic linear scars that represent one of the most common connective tissue changes during pregnancy.
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
Rationale: The best time to achieve pregnancy is during the ovulation period which is about 14 days
before the next period is expected. A menstrual cycle is defined as the number of days from the start of
the menstrual period, up to the start of another menstrual period. To obtain the ovulation day, subtract
14 days from the end of each cycle.
32. 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 2 stage of labor?
nd

A. Uterine contractions about 10 minutes apart, cervical dilatation of 6 cm – first stage of labor (Active
labor)
B. Cervical effacement at 100% dilatation at 10 cm
C. Scant to moderate blood mucus showing, station +2 – labor begins
D. Fetal station at -2 and FHR noted at level of umbilicus – third stage
Rationale: The cervix must be 100% effaced and 10 centimeters dilated before a vaginal delivery. The first
stage of labor and birth occurs when you begin to feel regular contractions, which causes the cervix to
open (dilate) and soften, shorten and thin (effacement). This allows the baby to move into the birth canal.
33. 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.
Rationale: when your baby is breastfeeding, and oxytocin is released, it triggers contractions of the
uterus. These uterine contractions are often called after pains and they feel similar to menstrual cramps.
34. The labor monitor tracing shows repeated, mild, variable decelerations. What complication would the
midwife anticipate is occurring?
A. Cord compression – leads to interruption of the blood and nutrient flow to the fetus, followed by a
heart rate decrease.
B. Fetal hypoxia
C. Placental insufficiency – the fetus may also be moving less than expected.
D. Head compression – during uterine contractions, especially during very strong contractions close to
delivery, the fetal head is squeezed. This may result in a slowing of the fetal heart rate during the middle
of contraction, when the pressure in the uterus is highest.
Rationale: if the decelerations are early or variable, the fetal heart rate pattern warns that there is an
increased risk of fetal distress and therefore, the fetal heart rate must be checked every 15 minutes. If late
decelerations are present, the management will be the same as that for fetal bradycardia.
35. Which test is commonly used to determine the number, motility and activity of sperm is the:
A. Rubin test – test to determine the tubal patency by introducing carbon dioxide gas via a cannula to the
client’s cervix.
B. Huhner test
C. Friedman test – involves a frog to determine pregnancy that is why it is also called a frog test.
D. Papanicolaou test – a cytolgic examination of the epithelial lining of the cervix
Rationale: Huhner test is synonymous to postcoital test. This test evaluates the number, motility and
status of the sperm cells in the cervical mucus.
36. In the female, Evaluation of the pelvic organs of reproduction is accomplished by:
A. Biopsy – is acquiring a sample tissue for cytological examination.
B. Cystoscopy – is the visualization of the bladder using a cystoscopy. This is inserted via the urethra.
C. Culdoscopy – is the insertion of the culdoscope through the posterior vaginal wall between the rectum
and uterus to visualize the douglas cul de sac.
D. Hysterosalpingogram
Rationale: Hysterosalpingogram is the injection of a blue dye, or any radio opaque material through the
cervix under pressure.
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
Rationale: membranes, as a rule, rupture at full dilation unless ruptured by amniotomy or ruptured at an
earlier time. The last of the mucus plug from the cervix is also released during the transition phase of
labor. We call that the operculum as signaled by a heavier show. During the transition phase, cervix is
dilated at around 8 to 10 cm and contractions reaches their peak of intensity occurring every 2 to 3
minutes with a 60 to 90 second duration.
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
Rationale: A woman near labor experiences desire to defecate because of the pressure of the fetal head
that forces the stool out from the anus. She cannot help but bear down with each of the contractions and
as crowning occurs, the perineum bulges. A woman with a 50 second contraction is still at the active
phase labor. Women who are about to give birth experience 60 – 90 seconds contraction occurring at 2-3
minutes interval.
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
A. 2, 4 - breathing techniques is not a method to eliminate pain but a method to reduce anxiety, improve
pushing and prevent rapid expulsion of the fetus during crowning.
B. 2, 3 – imagery is not used in severe pain. This is a labor pain and the mother will never try to imagine a
nice and beautiful scenery because at this point pain is all encompassing and severe during the transition
phase of labor.
C. 1, 4 – breathing techniques is not a method to eliminate pain but a method to reduce anxiety, improve
pushing and prevent rapid expulsion of the fetus during crowning.
D. 1, 2
Rationale: Back pain is so severe during labor in cases of posterior presentation. Mother is asked to pull
her knees towards her chest and rock her back. A tennis ball rubbed at the client’s back can relieve the
pain due to the pressure of the presenting part on the posterior part of the birth canal. Effleurage or a
simple rotational massage on the abdomen simply relieves the client’s pain by opening the large fiber
nerve gate and closing the small fiber nerve gate.
40. 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 – common occurrence of postpartum
B. Moderate amount of dark red lochia - normal
C. Episiotomy area bruised with small amount of dark bloody drainage – the perineum (area surrounding
the vaginal opening) may be bruised, or you may have had some stitches to repair a tear or episiotomy
D. Uterine fundus palpated to the right of the umbilicus.
Rationale: By approximately one hour postdelivery, the fundus is firm and at the level of the umbilicus.
The fundus continues to descend into the pelvis at the rate of approximately 1 cm or fingerbreadth per
day and should be nonpalpable by 14 days postpartum.
SITUATION 6: Belle is admitted to the hospital with the following signs: Contractions coming every 10
minutes, lasting 30 seconds and causing little discomfort. Intact membranes without any bloody shows.
Stable vital signs. FHR = 130bpm. Examination reveals cervix is 3 cm dilated with Vertex presenting at
minus 1 (-1) station.
41. On the basis of the data provided above, you can conclude that Belle is:
A. In false labor
B. In the Active phase of labor – cervical dilation of 4-7 cm and contractions of 40 to 60 seconds.
C. In the Latent phase of labor
D. In the Transitional phase of labor – effacement of 100%
Rationale: The earliest phase of labor is the first stage of labor, latent phase characterized by a cervical
dilation of 0-3 cm, mild contraction lasting for 20 to 40 seconds. This lasts approximately 6 hours in primis
and 4.5 hours in multis.
42. Pitocin drip has been started on Belle. Possible side effects of Pitocin administration include all of the
following, except:
A. Diuresis – side effect of Pitocin
B. Hypertension – side effect
C. Water intoxication – side effect of pitocin
D. Cerebral hemorrhage
Rationale: Oxytocin (Pitocin) is a synthetic form of hormone naturally released by the PPG. It is used to
augment labor and delivery. Dosage is about 1 to 2 milli units per minute and this can be doubled until the
desired contraction is met. Side effects are water intoxication, diuresis, hypertonicity of the uterus,
uterine rupture, precipitated labor, nausea and vomiting and fetal bradycardia.
43. The normal range of FHR is approximately:
A. 90 to 140 bpm
B. 120 to 160 bpm
C. 100 to 140 bpm
D. 140 to 180 bpm
Rationale: normal ranges for FHR are 120 to 160 bpm. Many international guidelines define ranges of 110
to 160 bpm which seem to be safe in daily practice.
44. A negative 1 (-1) station means that:
A. Fetus is crowning
B. Fetus is floating
C. Fetus is engaged
D. Fetus is at the Ischial spine
Rationale: at the negative station, the fetus is not yet engaged and floating. At 0 station, it means that the
fetus is engaged to ischial spine. Crowning occurs when the fetus is at the +3, +4 station. Station signifies
distance of the presenting part below or above ischial spine. + denoted below while – denotes above. The
number after the sign denotes length in cm.
45. Which of the following is the characteristic of False labor:
A. Bloody show – characteristic of a true labor
B. Contraction that are regular and increase in frequency and duration - characteristic of a true labor
C. Contraction are felt in the back and radiates towards the abdomen - characteristic of a true labor
D. None of the above
Rationale: false labor is characterized by irregular contraction that is relieved by walking, pain felt at the
abdomen and confined there and in the groin. The cervix does not achieve dilation and pain that is
relieved by sleep and do not increase in intensity and duration.
46. 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.
Rationale: when timing contractions, start counting from the beginning of one contraction to the
beginning of the next. The easiest way to time contractions is to write down on paper the time each
contraction starts and its duration or count the seconds the actual contraction lasts.
47. Which sign would alert the midwife that Belle is entering the second (2 ) stage of labor?
nd

A. Increase frequency and intensity of contraction – second stage of labor has begun
B. Perineum bulges and anal orifice dilates
C. Effacement of internal OS is 100%
D. Vulva encircles the largest diameter of presenting part
Rationale: When the cervix is 100% effaced, it means that it is completely thinned and shortened. An
alternative is to measure the length in cm. as the cervix effaces, it becomes shorter. The encirclement of
the largest head diameter by the vulvar ring is known as crowning. The second stage of labor begins when
the cervix is completely dilated and ends with the birth of your baby. Contractions push the baby down
the birth canal, and you may feel intense pressure, like an urge to have a bowel movement.
48. Important care during the second stage of labor should include:
A. Careful evaluation of prenatal history
B. Coach breathing bear down with each contraction and encourage patient.
C. Shave the perineum
D. Administer enema to the patient
Rationale: Provide physical and psychological support to the woman in labor and the trusted support
person who is with her. Assist her to adopt different positions, try different breathing patterns, be
massaged on her back and make low sounds during labor, as this help her to relieve pain and manage
contractions.
49. According to the WHO, when should the mother start breastfeeding the infant?
A. Within 30 minutes after birth
B. Within 12 hours after birth
C. Within a day after birth
D. After infant's condition stabilizes
Rationale: WHO and UNICEF recommend that children initiate breastfeeding within the first hour of birth
and be exclusively breastfeed for the first 6 months of life – meaning no other foods or liquids are
provided, including water. Many first-time mothers are surprised when the baby is at their breast, ready
to feed, a soon as 30 minutes after birth.
50. The major cause of maternal mortality in the Philippines is:
A. Infection
B. Hemorrhage
C. Hypertension
D. Other complications related to labor, delivery and puerperium
Rationale: According to data form from the Philippines Department of Health the top 4 causes of
maternal mortality are labor complications, pregnancy-related hypertension, postpartum hemorrhage,
and unsafe abortion. The top 1 is the complications related to pregnancy occurring in the course of labor,
delivery and puerperium which has a 100.0%.
Situation 7: As a midwife, you should be able to respond to certain cases in different settings.

51. A client is in the second (2 ) stage of labor and has been pushing for almost an hour. Which of the
nd

following interventions is the most appropriate for the client as this stage?
A. Offer clear fluids in between contractions
B. Encourage ambulation
C. Instruct the client to push with each contraction
D. Encourage frequent changes in position.
Rationale: The second stage of labor begins when the cervix is completely dilated and ends with the birth
of your baby. Contractions push the baby down the birth canal, and you may feel intense pressure, similar
to an urge to have a bowel movement. Your health care provider may ask you to push with each
contraction
52. Your colleague calls you into a labor room as Sara’s baby is about to be born and she wants a second
midwife. What is the second midwifes role?
1 – To resuscitate baby if needed.
2 – To give oxytocic drug (active mgt of 3 stage)
rd

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
Rationale: perform clinical functions for basic and emergency obstetric and neonatal care, including
administration of parenteral antibiotics, oxytocics and anticonvulsants; manual removal of placenta;
removal of retained products of placenta; assisted vaginal delivery.
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
Rationale: Other early signs of and symptoms of toxicity include nausea, feeling of warmth, flashing,
somnolence, double vision, slurred speech, and weakness. Muscular paralysis and respiratory arrest will
develop at plasma levels of 6.3 to 7.1 mmol/L14.
54. What drug is used as the antidote to Magnesium Sulfate?
A. Potassium chloride – used to prevent or to treat low blood levels of potassium
B. Calcium gluconate
C. Tetracycline – antibiotic that fights infection caused by bacteria
D. Oxycodone – is an opioid medication used for treatment of moderate to severe pain, and common drug
of abuse
Rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity. If ordered, administer calcium
gluconate 10%, IV push, 10 ml over 3 minutes.
55. What is the length of time of the 2 stage of labor in a woman who is a primipara?
nd

A. 20 – 30 minutes
B. 50 – 60 minutes
C. 2 hours
D. 3 hours
Rationale: Primiparous women should not actively push for more than 2 hours.
56. The client complains of severe perineal pain the 1 hour after delivery. What should the midwife assess
st

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
Rationale: The entire perineal area and rectum will be swollen after birth, and you’ll likely feel discomfort
in the area for around three to five weeks.
57. 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.
Rationale: + 3 station is crowning and beginning to emerge from the birth canal. -3 station is when the
head is above the pelvis. 0 station is when the head is at the bottom of the pelvis, also known as being
fully engaged.
58. 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.

Rationale: a mother will feel better by getting more rest, drinking more fluids, and using warm or cold
packs on your painful breast. If your nipples are too cracked and painful to breastfeed, hand express or
use a breast pump to empty the breast of milk.
59. A midwife is assessing a client and her infant one week after delivery. The infants 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
Rationale: The infant seems calm and relaxed during feeds. The baby comes off the breast on their own at
the end of feeds. Their mouth looks moist after feeds. The baby appears content and satisfied after most
feeds. As long as the baby is gaining well, this is normal. Wet diapers expect 5-6+ wet diapers every 24
hours.
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.
Rationale: Most are harmless and need no treatment. They fade or disappear as a child grows older.
Salmon patches, also called stork bites or angel kisses, are flat, pink patches that occur mainly on the back
of the neck, the upper eyelids, the upper lip, or between the eyebrows.
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
Rationale: Common side effects of oxytocin include: Slow heart rate (bradycardia), fast heart rate,
premature ventricular complexes and other irregular heartbeats (arrhythmias), neonatal seizure, neonatal
yellowing of skin or eyes (jaundice) and fetal death.
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.
Rationale: This is when the baby’s head is even with the ischial spines. The baby is said to be engaged
when the largest part of the head has entered the pelvis. If the presenting part lies above the ischial
spines, the station is reported as a negative number from -1 to -5.
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. 2stage of labor
nd

Rationale: A woman is considered to be in the active stage of labor once the cervix dilates to around 5 to
6 cm and contractions begin to get longer, stronger, and closer together. When the contractions every 3
to 4 mins. And they each last about 60 seconds, it often means that your cervix is opening faster.
64. A midwife is monitoring a client with a cervical dilatation of 4 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.
Rationale: The normal fetal heart rate during labor is 120-160 bpm. The idea is that giving you extra
oxygen increases oxygen delivery to your baby. It can change the heart rate sometimes, but this is most
likely due to a combination of interventions.
65. During the 1 stage of labor, the cervix becomes thin and indistinct form the body of the uterus. What is
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the term the midwife would use to describe this observation?

A. Dilation – the process of enlargement or expansion. Also known as dilation
B. Attitude – a posture or position of the body; the relation of the various parts of the fetal body to one
another.
C. Effacement
D. Transition – change from one form, state, style, or place to another
Rationale: Cervical effacement refers to a thinning of the cervix. It is a component of the bishop score. It
can be expressed as a percentage. Prior to effacement, the cervix is like a long bottleneck, usually about
four centimeters in length.
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 2 , 3 and 4fingers to press every part of her breast.
nd rd th

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.
Rationale: When examining your breast, some general tips to keep in mind include: use the pads of your
fingers. Use the pads not the very tips, of your three fingers.
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 client 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.
Rationale: The fundus will decrease by 1 cm per day and you won’t be able to palpate it by day 10 -14
because it has entered back into the pelvic cavity. Therefore, 24 hours after birth the fundus should 1 cm
or one fingerbreadth below the belly button. 48 hours should be 2 cm bellow belly button,
68. 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.
Rationale: UTI symptoms can include a persistent urge to urinate, pain and burning with urination, and
extremely strong-smelling urine. For some people, especially older adults, the only sign of illness might be
microscopic blood in the urine. UTI may lead to preterm labor and low birth weight.
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 – usually sets 1 to 2 days
D. Accept the client’s behavior as an indication that she is in the taking-hold phase – starts 2 to 4 days
Rationale: Most infants are ready to bond immediately. Parents, on the other hand, may have a mixture
of feelings about it. Some parents feel an intense attachment within the first minutes or days after their
baby’s birth.
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 - normal
B. Head circumference = 35 cm - normal
C. Birth weight = 11 pounds
D. Chest circumference is 2 cm less than the head circumference - normal
Rationale: Though the average birth weight is 7 pounds and 11 ounces and more than 10 pounds is
considered fairly large.
71. A client who gave birth to a healthy newborn experience 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 – more serious level of sadness after birth
B. Postpartum blues
C. Postpartum psychosis – is a rare but serious mental health illness that can affect someone soon after
having a baby.
D. A normal behavior during the taking-hold phase – the mother strives for independence and autonomy,
she becomes the initiator.
Rationale: During the postpartal period, as many as 50% of women experience some feelings of
overwhelming sadness. They may burst into tears easily or feel let down or irritable. This temporary
feeling after birth has long been known as the “baby blues”.
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 1 12 hours of life.
st

D. Breastfeed the newborn every 4 to 8 hours.

Rationale: Nursing position called the clutch or football hold. This is also a good position for the mom
who’s had a C- section.
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 hydatidiform 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 Ringers Lactate
C. Administer Metoclopramide
D. Monitor fluid intake and urinary output
Rationale: At first, patients are given nothing by mouth. Initial treatment is IV fluid resuscitation,
beginning with 2 L of Ringer’s lactate infused over 3 hours to maintain a urine output of the client.
Rehydration along with replacement of electrolytes is very important in the treatment of hyperemesis
gravidarum.
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
1trimester. Which of the following is not a benefit of folic acid supplementation before and during
st

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.
Rationale: During early development, folic acid helps form the neural tube. Folic acid is very important
because it can help prevent some major birth defects of the baby’s brain (anencephaly) and spine (spina
bifida). Folic acid supplementation of 400 micrograms or more per day reduced the risk of isolated cleft
lip.
75. A client is in her 18 week of pregnancy. Which of the following psychosocial changes is expected at this
th

time?
A. The client is ambivalent about being pregnant – third trimester
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 is feeling both pleased and not pleased about pregnancy
Rationale: Pregnancy is a time when emotions can change. You may feel more forgetful and disorganized
than before. You may feel lots of emotions about things like the way you look or feeling the baby move.
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 midwifes 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.
Rationale: Cervical cancer: women who have used oral contraceptives for 5 or more years have a higher
risk of cervical cancer that women who have never used oral contraceptive. The longer a woman uses oral
contraceptives, the greater the increase in her risk of cervical cancer.
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.
Rationale: when taking an iron supplement, you should take it with a vit. C source. Taking foods with vit. C
or citric acid helps with absorption of iron into the body making it more effective.
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.
Rationale: Braxton Hicks contractions or false labor occurs normally throughout the pregnancy that
doesn’t increase in intensity and frequency. It is felt in the abdomen, doesn’t result in cervical effacement
and dilation and subside when walking or when changing position.
79.In which portion of the fallopian tube does fertilization normally occur?
A. Infundibulum - c. interstitial segment – Part of the tube that lies within the uterine wall and only
about 1 cm in length
b. ampulla d. isthmus – the portion of the tube that is cut or sealed in a tubal ligation
Rationale: The ampulla is the third and also the longest portion of the tube. It is approximately 5 cm in
length. It is in this portion that fertilization of an ovum usually occurs.
80. The body of the uterus:
a. Corpus
b. cervix – the lower and narrow part of the uterus
c. fundus – the broad curved upper area in which the fallopian tubes connect to the uterus.
d. cornua – horn of the uterus
Rationale: Corpus is the main body of the uterus. The body of uterus is the uppermost part and forms the
bulk of the organ. During pregnancy, the body of the uterus is the portion of the structure that expands to
contain the growing fetus.
81. The primary factor that influences the vaginal pH to be acidic is the?
A. Changes in the cervical mucosa
B. Secretion of Skenes glands
C. The action of Doderleins bacillus
D. Secretions from Bartholin’s glands
Rationale: Bartholin’s glands. The bilateral racemes glands are located at the sides of the vaginal orifice.
These glands secret mucous that helps maintain the acidic pH balance of the vagina and acts as alubricant
during sexual intercourse.
82. When milk from mammary gland is carried to the nipples of the breastfeeding mother, this is known
as:
a. after pains – are contractions that occur after labor and delivery
b. let down reflex
c. rooting reflex – a reflex that is seen in normal newborn babies, who automatically turn the face toward
the stimulus and make sucking (rooting) motions with the mouth when the cheek or lip is touched.
d. sucking reflex – actually happens in two stages. When a nipple – either from a breast or bottle – is
placed in the baby’s mouth, they’ll automatically start sucking. With breastfeeding, the baby will place
their lips over the areola and squeeze the nipple between their tongue and roof of the mouth.
Rationale: The let-down reflex. Infant suckling stimulates the nerve endings in the nipple and areola,
which signal the pituitary gland in the brain to release two hormones, prolactin and oxytocin. Milk
ejection is initiated in the mother’s breast by the act of suckling by the baby.

83. A structure of the male reproductive organ that serves as a conduit of semen:
A. ejaculatory duct C. penis
B. testes D. urethra
Rationale: The urethra is the last part of the urinary tract and traverses the corpus spongiosum. The
urethral opening is called the meatus and lies on the tip of the glans penis. It serves as a passage both for
urine and semen. Sperm are produced in the testes and stored in the attached epididymis.
84. Menstruation is ultimately due to
a. Progesterone withdrawal
b. Progesterone stimulation
c. Estrogen withdrawal
d. Estrogen stimulation
Rationale: The menstrual cycle occurs due to the rise and fall of estrogen. This cycle results in the
thickening of the lining of the uterus, and the growth of an egg.
85. Production of progesterone in the non-pregnant woman is a function of the
a. all of this b. Corpus luteum c. Ovum d. Graafian follicle
86. During which of the following phase of the menstrual cycle is it ideal for implantation of a fertilized
egg to occur?
a. Ischemic phase -
b. Menstrual phase
c. Proliferative phase
d. Secretory phase
Rationale: The final phase of the menstrual cycle is called the luteal phase. During the luteal phase, the
follicle morphs into a mass of cells called the corpus luteum. The corpus luteum releases progesterone,
which will keep the uterine wall thick and ready for a fertilized egg to implant. The luteal phase is also
referred to as the secretory phase.
87. One of the important hormones during the menstrual cycle is the luteinizing hormone (LH). As a
midwife, you should know that this is produced by the:

A. hypothalamus – the hormones produces in the hypothalamus are corticotrophin-releasing hormone,

dopamine, growth hormone-releasing hormone, somatostatin, gonadotropin-releasing hormone and
thyrotropin-releasing hormone.

B. ovaries – produce and releases eggs into the female reproductive tract at the mid-point of each
menstrual cycle.

C. anterior pituitary gland

D. uterus – nurturing the fertilized ovum that develops into the fetus and holding it till the baby is mature
enough for birth.

Rationale: The menstrual cycle is regulated by hormones. Luteinizing hormone and follicle-stimulating
hormone, which are produced by the pituitary gland, promote ovulation and stimulate the ovaries
to produce estrogen and progesterone.

88. When the Graafian follicle ruptures, a female may normally experience pain on right or left lower
quadrant of the abdomen with some spotting. This is called as:
A. menarche – the first occurrence of menstruation
B. ferning – occurs due to the presence of sodium chloride in mucus under estrogen effect.
C. precocious puberty – is when a child’s body begins changing into that of an adult too soon. When
puberty begins before age 8 in girls and before age 9 in boys, it is considered precocious puberty.

D. mittelschmerz

Rationale: Ovulation pain, sometimes called mittelschmerz, can feel like a sharp, or like a dull cramp, and
happens on the side of the abdomen where the ovary is releasing an egg. It generally happens 10 -16 days
before the start of your period, is not dangerous, and is usually mild.

89. The most important estrogen in non-pregnant females who are between the menarche and
menopause stages of life and the major estrogen in humans is?
a. Esbestrol -
b. Estriol – also spelled oestriol, is a steroid, a weak estrogen, and a minor female sex hormone.
c. Estrone – also spelled oestrone, is a steroid, a weak estrogen, and a minor female sex hormone. It is
one of three major endogenous estrogens.
d. Estradiol
Rationale: Estradiol is the most important estrogen in non-pregnant females who are between the
menarche and menopause stages of life.
90. The temperature elevation seen just before or during ovulation is primarily caused by:
a. Intraperitoneal irritation from the released ovum
b. A thermo genic effect of FSH
c. A thermogenic effect of progesterone
d. Thermogenic effect of estrogen
Rationale: During ovulation, your body releases the hormone progesterone, which brings on a slightly
raised temperature a day two later-usually by 0.5 degrees. Your temperature will probably stay high
until your next cycle begin. If you become pregnant during that cycle, your temperature will stay up
beyond that.

91. In the menstrual cycle the secretory phase is under the influence of:

a. Estrogen c. progesterone
b. Human chorionic gonadotropin d. corpus luteum
Rationale: The next phase of the menstrual cycle is the luteal or secretory phase. This phase always occurs
from day 14 to day 28 of the cycle. Progesterone stimulated by LH is the dominant hormone during this
phase to prepare the corpus luteum and the endometrium for possible fertilized ovum implantation.
92. Ovulation usually occurs on the:
a. 14 days before menstruation
b. 14 days after menstruation
c. 14day of menstrual cycle
th

d. 14 days every menstrual cycle

Rationale: Ovulation typically happens around day 1 of a 28-day menstrual cycle. However, not everyone
has a textbook 28-day cycle, so the exact timing can vary. In general, ovulation occurs in the four days
before or four days after your cycle’s midpoint.
93. Menopause means:
a. Change of life b. last menses c. climacteric d. empty nester
Rationale: Menopause is a normal part of ageing for a woman and literally means “last period”. It is
generally considered to be complete when a woman has not had a period for one year. Menopause, often
referred to as the “change of life”, usually occurs between the ages of 45 and 55 years.
94. The correct sequence of human sexual response should be: 1 – orgasm 3 – resolution 2 – excitement
4 – plateau
A. 2,1,4,3 C. 2,4,1,3
B. 1,2,3,4 D. 4,2,3,1
Rationale: Sexual response cycle, pattern of physiologic events occurring during sexual arousal and
intercourse. In both men and women, these events may be identified as occurring in a sequence of four
stages: excitement, plateau, orgasm, and resolution.
95. The cell which results from fertilization of the ovum by spermatozoa is called?
a. blastocyst b. Morula c. Conceptus d. Zygote
Rationale: Fertilization occurs when the nucleus of both a sperm and an egg fuse to form a diploid cell,
known as zygote. The successful fusion of gametes forms a new organism.
96. The number of chromosomes found in each sperm is:
a. 46 c. 22
b. 23 d. 44
Rationale: Haploid describes a cell that contains a single set of chromosomes. The term haploid can also
refer to the number of chromosomes in egg or sperm cells, which are also called gametes. In humans,
gametes are haploid cells that contains 23 chromosomes, each of which a one of a chromosome pait that
exists in diploid cells.
97. The head of a sperm cell contains proteolytic enzymes needed to permeate the egg cell during
fertilization. This is called as:
a. zona pellucida c. corona radiata
b. acrosome d. nucleus
Rationale: Sperm cells go through a process known as the acrosome reaction, which is the reaction that
occurs in the acrosome of the sperm as it approaches the egg. The acrosome is a cap-like structure over
the anterior half of the sperm’s head.
98. An ovum is capable of being fertilized within how many hours after ovulation?
a. 12 c. 24
b. 72 d. 48
Rationale: After the egg is released, it moves into the fallopian tube. It stays there for about 2 hours,
waiting for a single sperm to fertilize it. All this happens, on average, about 2 weeks before your next
period.
99. You are educating a small group of couples about vasectomy. Which of the following should you NOT
include in your teaching?
a. It is fully effective only after 20 ejaculations or 3 months
b. It has no effect on the sexual performance of the male
c. Its common complications include scrotal pain, swelling and bruising
d. It results in decreased semen production
Rationale: Some men report having chronic pain or discomfort in the scrotum or testicles that can last
from 1 to 5 years or more after a vasectomy. Few men with severe pain say that they regret having the
vasectomy. The cause of pain is unknown. It may result from pressure caused by the build-up of sperm
that has leaked from an improperly sealed or tied vas deferens, or from nerve damage.
100.The temperature elevation seen just before or during ovulation is primarily caused by
a. intraperitoneal irritation from the released ovum
b. a thermogenic effect of FSH
c. a thermogenic effect of progesterone
d. a thermogenic effect of estrogen
Rationale: During ovulation, your body releases the hormone progesterone, which brings on a slightly
raised temperature a day two later-usually by 0.5 degrees. Your temperature will probably stay high
until your next cycle begin. If you become pregnant during that cycle, your temperature will stay up
beyond that.