MCQ:

1- What is shed every month as a result of the menstrual cycle?

A. Endometrium

2- What is the bluish discoloration of cervix and vagina during pregnancy called?
A. Chadwick's sign

3- Which one of the following conditions is common in pregnant women in the second
trimester of pregnancy?
Quickening reflex

4- Which one of the following is a probably sign of pregnancy?

A. Amnonerrha
B. Goodell’s Sign
C. Fatigue
D. Quickening

5- In the later part of the 3rd trimester the mother may experience shortness of breath.
The complains may be explained as:
A. The woman nay be experiencing a complication of pregnancy
B. The fundus of the uterus is high pushing the diaphragm upwards
C. The woman s having an allergic reaction to the pregnancy and to hormones
D. A normal occurrence in pregnancy because the fetus is using more oxygen
A 63
6-
It
*During an assessment of a pregnant patient who is 20 weeks gestation, she tells
you the following information regarding the pregnancy. She currently has 3
children, all of them were born at 39 and 40 weeks. Gestation, she has been
pregnant 5 times (including this pregnancy ) how would you document her GTPAL?

A. G:5 T:3 P:0 A:1 L:3

B. G:4 T:3 P:0 A 0 L:4
C. G:5 T;2 P:0 A:1 L:4
D. G:4 T:4 P:0 A:0 L:3

feb 28
7- During a prenatal visit, a patient tells you her last menstrual period was May 21,
2021. Based on Naegele's rule, when is the estimated due date of the baby?

A. July 28,2021
B. March 29,2022
 C. January 28, 2021
D. February 28,2022

8- Which one of the following would the nurse most likely expect to find when
assessing client with abruption placenta?

A. Excessive vaginal bleeding

B. Premature rupture of membrane
C. Rigid, like abortion
D. Teac Uterus contractions

9- *A pregnant women is receiving magnesium sulfate to the management of pre-

eclampsia. A nurse determines the client is responding badly from the medication if
which one of the following is noted on assessment?

A. Respirations of. 10 per minute

B. Serum magnesium level of 6
C. Presence of deep tendon reflexes
D. Proteinuria of 3+

10- Four hours after birth, a neonate is transferred to the nursery, where the nurse
intervenes to prevent hypothermia. What is a common source of radiant heat loss?

a. Low room humidity

b. Cold weight scale
c. Cold incubator walls
d. Cool room temperature

11- When a nurse on duty accidentally bumps the bassinet, the neonate throws out its
arms, hands opened, and begins to cry, the nurse interprets this reaction as
indicative of which of the following:
A. Babinski reflex
B. Grasping reflex
C. Moro reflex (startle reflex)
D. Tonic neck reflex

12- One hour after birth, you checked the temperature and recorded 36.3C which one
of the following nursing interventions is a priority
A. Wrap the newborn in a warm blanket and place cap on the head
B. Reassess the temperature in 4 hours
C. Take the new-born to the nursery and observe for 2 hours
 D. Notify the pediatrician immediately

13- The nurse is preparing to administer vitamin k injection to a male newborn shortly
after birth, what statement by the mother indicates that the ----purpose of the
injection
A. My baby is at a high risk for a Partum bleeding this bloods to clot
B. The red blood cells my baby formed during pregnancy are… the
vitamin K
C. My baby
D.
K ‫ ﺑﺷﻛل ﻋﺎم أﺳﺑﺎب اﻋطﺎء اﻟﺣدﯾث اﻟوﻻدة ﻓﯾﺗﺎﻣﯾن‬.‫ﻓﻲ ھذا اﻟﺳوال ﻣو واﺿﺢ اﻟﺧﯾﺎرات ﺑس‬
‫ھو ﻟﻣﻧﻊ اﻟﻧزﯾف‬
"Newborn infants are deficient in vitamin K, and this injection prevents your infant from
abnormal bleeding."

14- A newborns one-minute APGAR score is 8. Which one of the following

interventions will you provide to the newborn
A. Full resection assistance is needed
B. A routine post-birth
C. Continue to monitor and reassess the APGAR score in 12 minutes
D. Some resacuation assistance such as oxygen
Reson: Scoring Interventions are as follows: 7-10: no interventions, baby doing good
just needs routine post-delivery care, 4-6: some resuscitation assistance required like
oxygen, suction.... stimulate the baby, rub baby's back, 0-3: needs full resuscitation
*Remember the APGAR scoring is performed at 1 minute and 5 minutes after birth and
reassessed at 10 minutes (5 minutes later) after birth if the score is 6 or less.

15- Twenty- for hours after c-section birth, a neonate at 30 weeks gestation is
diagnosed with respiratory distress syndrome (RDS) which one of the following
substances secretions are altered?

A- Surfactant = Helps the lungs remain expanded after the initiation of breathing
B- Somatropin
C- Testarone
D- Progestogen

16- All of the following complications can develop in an infant of a diabetic mother except
A. Hypocalcemia
B. Hyperglycemia
C. Hypomagnesmia
D. Hyperbilburima
 17- A primiparous woman who gave birth vaginally four hours ago would like to take a
shower. The nurse anticipates the woman to face which one of the following problems ?
A. Fatigue
B. Hygiene needs
C. Diurests
D. fainting

18- the world health organization recommends that infants should be exclusively
breast-feed for------- while continuing to breastfeed for ------
A. 4 MONTHS, 1 YEAR
B. 5 MONTHS, 1 YEAR
C. 7 MONTHS, 2 YEARS
D. 6 MONTHS, 2 YEARS

19. early sucking at the breast post-partum triggers the production of breast milk and
accelerate lactrogenes this can be achieved through
A. allowing the mother ample time to rest
B. expecting milk as soon as the mother can
C. avoiding bathing the infant after bath
D. initiating breast-feeding one hour after birth

20. the nurse is teaching a primiparous about how often she should breastfeed her
infant. Which one of the following statements made by the mother requires further
education?
A. I will let my son take the lead in the feeding pattern
B. I will schedule feeding every 2 hours
C. I will not limit the duration of the feed in each breast
D. I will feed my baby on demand

21. the nurse is teaching a primiparous about comfortable and effective latch-on
techniques for breast-feeding which one of the following should be included in the
teaching plans
A. align your baby’s nose to the nipple, while baby’s head slightly back , make sure
the mouth is wide open then hep the baby at the breast
B. hold the breast at the nipple then tickle your baby’s cheeks, once the mouth is open
lean larwards help the baby to the breast
C. use your hands to express some breast milk once it touches infant’s mouth it will
stimulate the infant to suck the nipple
D. tickle your baby’s lip, then aim the nipple to the centre of the mouth to achieve an
even latch
22. Lauren gave birth 4 days ago and is experiencing the baby blues. Lauren asks you
when the baby blues will end. Which one of the following statements is correct?
A. the baby blues normally last no longer than 10-14 days post birth
B. the baby blues never excess 5 days post birth
C. the baby blues normally ends 13-14 months after birth
D. the baby blues normally end 3-6 months after birth

23. Fatema gave birth 2 weeks ago. She reported hallucinations, having delusions and
her mood changes quickly. Which one of the following Fatema most likely has based on
her symptoms ?
A. Postpartum anxiety
B. postpartum psychosis
C. bulimia
D. the baby blues

24. a mother has completed the Edinburgh postnatal depression scale ( EPD)
questionnaire and has a score of 3 however, the mother has the thought of harming
herself often, what initial action should the nurse take?
A. the nurse should take the mother vital signs
B. the nurse should quietly observe the mother appearance for any signs of distress
C. the nurse should have an immediate discussion with the mother about her
complained …..
D. the nurse should reassure the mother that a score 4 out of 3 is very low and the
thoughts of harming herself is not a cause of concern

25. Thirty four hours after birth, the nurse is planning for discharge education for a
mother about infant care. By this time the nurse expects that the phase of postpartum is
psychological adaption that the mother would be in termed which of the following?
A. taking hold
B. resolution
C. taking in
D. Letting go

Rationale: Beginning after completion of the taking-in phase, the taking hold phase lasts
about 10 days. During this phase, the client is concerned with her need to resume
control of all facets of her life in a competent manner. At this time, she is ready to learn
self-care and infant care skills.

26. the nurse would use which one of the following descriptions of the fetal position
when explaining the mother the occurrence of frank breech position:
A. Both the hips and the knees are extended
B. The hips are fixed and the knees are extended
C. Both the hips and the knees are fixed
D. The hips are exended and the knees are fixed

27. the nurse anticipates that assessment of normal episiotomy immediately post-
delivery is mostly to reveal which on of the following :
a. Gaps in between the sutures
b. Slight yellow brown bruising
c. Purulent drainage from the suture line
d. Edema at the episiotomy site makes the tissue appear shiny

28. the nurse is teaching a primiparous about early feeding cues ((signs) the
mother is encouraged to instate breastfeeding after when her baby is :
a. Stirring mouth opening turning head and seeking / rooting
b. Smacking lips while sleeping or awake
c. Crying, agitated body movements and colour turning red
d. Stretching, increasing physical movement, and hand in the mouth

29. Rho (D) immune globulin (RhoGAM) is prescribed for a women

following birth of the newborn infant and the nurse provides formation to
women about the purge of the medication. The nurse determines that the
women understand the purpose of the medication if the woman states that
will protect her need baby from at one of the following?
a. Being affected by Rh incompatibility
b. Developing physical under
c. Having R- positive blood
d. Developing a Nutella infection

30. Papanicolaou smear (pap smear) is usually done to determine risk for cancer of
which one of the following organs:
a. Ovaries
b. Breasts
c. Fallopian tubes
d. Cervix
SAQ;
Case analysis question 1

Today is march 28th, 2022. A 36 year old- hanan is GTPAL 42102 presented to anetal l
clinic complaining of missed period, urinary frequency, breast changes and fatigue. You
obtained her vital signs temp 36.9 pulse 70bpm, respiratory rate 18bpm. Bp 125/75
her weight was 80KG urine negative for ketone, albumin and glucose. Her last
menstrual period was on janurary 2nd,2022. She has a history of gestional diabetes
mellitus in her third pregnancy.

1- You understand that Hanan presented with subjective signs of pregnancy.

identify those signs of subjective changes ?

1- Missed period
2- Breast changes
3- Urinary frequency
4- Fatigue

2- List two signs of objective ( probable) changes of pregnancy :

1-Changes in pelvic organs (Goodell’s signs and Chadwick’s sign)

2- Enlargement of the abdomen
3- Braxton Hick’s contractions
4- Skin pigmentation
3_ List two signs of diagnostic ( positive) changes of pregnancy
1) Fetal heart tones detected by ultrasound examination
2) Visualization of the fetus by radiographic study
3) Fetal heart rate detected on doppler

5- You identified that Hanan is in which trimester?

first trimester
 ‫اھﻲ ﺣﺿرت اﻟﻛﻠﯾﻧك ﻻن ﻓﯾﮭﺎ اﻋراض ﺑداﯾﺔ اﻟﺣﻣل‬

6- Hanan is multigravida what does that mean?

a woman who is in her second or any subsequent pregnancy

7- At which week of pregnancy will Hanan start having quickening?

Between 14 and 26 weeks but generally close average of week 18 to week 22
(in the second trimester )
8- What is the medical term for missed period?
Amenorrhea

9- Calculate hanan’s estimated date of birth using Nagele rule showing the
calculation steps

Last period on janurary 2nd 2022

Adding 7 days, janurary 9th 2022(2+7=9)
Subtracting 3 months October 9th
= October 9th 2022.
**** note no need to add one year. In this example

10- Hanan is GTPAL 42102. What do the letters GTPAL stand for?
G = Gravida = Number of pregnancies
T= Term = number of babies born at 37 0/7 weeks gestation or beyond
P = para // perterm = births after 20 weeks gestation but before 37 0/7 weeks
gestation, whether living or stillborn
A = Abortion = number of. The pregnancies ending in either spontaneous or
therapeutic abortion (before 20 weeks gestation)
L= Living = Number of currently living children

11- When is her next Antental visit?

 Every 4-5 weeks until 28 week of pregnancy

12- Hanan was diagnosed with folic acid defiency

What advice could have been given to her while planning to get pregnant to
prevent folic acid deficiency?
* all women could be pregnant should take a multivitamin containing 400
mcg daily before conception and throughout at least the first trimester

*To eat more foods rich in folic acid such as papaya & oranges ,seeads &nets ,
bell peppers, broccoli and leafy greens or take folic acid supplementations

13- The nurse understands that hanan might be at risk for developing gestional
diabetes mellitus for the following reasons
1) She has a history of GDM in previous pregnancy
2) Her weight is 80KG
3) She is 36 years old
 14- what is the foetal/ neonatal implication of folic acid defiency anemia ?

risk for neural tube defect (NTD):

A. Spina bifida
B. Meningomyelocele
C. Anencephaly

Case analysis question 2

2- Amina a 20 year old primigravida at 42werrks gestation presented with moderate
uterine contractions every 2-3 minutes lasting 40 to 60s she is accompanied by her
husband. During pregnancy she was diagnosed with pregnancy induced hypertension.
Amina told you that she broke her water three hours ago and the fluid was colorless.
And has no odor. You obtained her vital signs. Temp37.c. pulse 70bpm,respiratory rate
28bpm. Bp 145/90 mmhg. Urine test albumin + glucose and ketone negative. She
complained of headaches and generalized odema. Vaginal examination findings. Cervix
is 75% effaced, 4cm dilated with a vertex at 0 station in the left occipital anterior foetal
hear rate baseline 140150bpm .

1- Amina is in the first stage of labor, based on the information given above,
which phase in the firsts stage of labor is Amina going through?

Phase : The active phase or the second phase.

2- Amina has moderate contractions every 2-3 hours lasting 40- 60 seconds
define frequency, duration, intensity of contraction?

– Frequency – the time between the beginning of one contraction and

the beginning of the next contraction
– Duration – is measured from the beginning of a contraction to the
completion of that same contraction
– Intensity – the strength of the contraction during acme

3- What is the most appropriate foetal monitoring method that can be used in
amnia’s case? Justify your answer

Internal fetal monitoring using FSE, (foetal scalp electrode), because the cervix is fully
dilated (Cervix is 75% effaced, 4cm dilated ) and membrane is ruptured and this method
is more assuring.

4_ amnia was diagnosed with pre-eclampsia what are the clinical manifestations
found in Amina ?

1- Hypertension
2- Sever headache
3- Generalized edema
4- IV. Magnesium sulphate 6meq was administered to prevent seizures. If
amina has a seizure what is it called?
Eclampsia

5- Amnia has given birth to a baby boy through vaginal delivery. The midwife
is waiting for the delivery of placenta. List three signs that indicate
placenta birth

1- Gush blood
2- Firm and globular uterine
3- Cord lengthening
4- Uterine rises anteriorly.

6- There are two mechanisms for placental separation name them/

Fetal placental = Shiny Schultze

Maternal placental= dirty Duncan

7- List three maternal factors that may lead to IUGR

1- malnutrition, anaemia
2- heart or respiratory disease
3- smoking\substance abuse
4- chronic kidney disuse
5- hypertension/ preeclampsia
6- advanced diabetic mellitus

8- You are providing post-natal care for amnia and assessing bleeding. You
understand that lochia is classified in three stages. Name the types and
duration

1- Lochia rubra : Dark Red 3 – 4 Days

2- Lochia serosa:Pinkish Brown 4 – 10 Days
3- Lochia alba: Whitish Yellow 10 – 28 Days
9- You are providing care for baby ahmed. You noticed that his feet and
hands are blue but the rest of the body is pink. You understand that this
condition is called?
Acrocyanosis

10- How would you manage baby Ahamed’s hypoglycemia?

• Early feeding
• Administer glucose orally or intravenously as prescribed
• Check blood glucose levels as ordered
• Assess for feeding problems
• Monitor for apneic periods
• Evaluate lethargy and poor muscle tone
 11) IUGR new-borns is at high risk of developing hypo-glycemia. List four
complications of un-treated hypothermia in new-borns
a. neonatal sepsis.
b. hypoglycemia
c. metabolic acidosis
d. jaundice
e. Respiratory distress\
f. Pulmonary hemorrhage
g. mortality.

(***Note :I didn’t find it in the lecture so the answer I am not sure from it )

13) How many arteries and vein?

2 arteries and one vein

(remember. The happy face )

14) amina was found to be in true labour , name two differences between true
and false labor?

 True labour – contractions get stronger with ambulation, false labour –

contractions frequently stop with ambulation or position change
 True labour- contractions seem to start in lower back then travel to lower
abdomen, false labour- contractions may be felt in back, but often noticed in the
fundus
 True labour – contractions not stopped by controlled breathing, sedation, false
labour – contractions eventually stop with relaxation intervention
 True labour – cervix softens, effaces and dilates, false labour – cervix may soften
but little or no change in effacement or dilation
 True labour – foetus continues descent into pelvis, false labour – no significant
change in foetal position

