Question 1

A female client asks the nurse about the use of a cervical cap. Which statement is correct regarding the use of the cervical cap?

Accepted Answer

Answer reason: Because the device covers the cervix, it can interfere with adequate cervical cell sampling and may cause local irritation or inflammation that can alter cytology interpretation. The other statements are incorrect: a cervical cap must be fitted by a clinician, it is typically used with spermicide for better effectiveness, and it can generally be left in place longer than 24 hours (commonly up to about 48 hours) while still following manufacturer and clinician guidance.
Category reason: This question tests contraceptive method knowledge and correct use/limitations of a cervical barrier device, which is primarily content from the reproductive system rather than a nursing-priority decision scenario.

Question 2

Most common site of ectopic pregnancy is?

Accepted Answer

Answer reason: Most ectopic pregnancies implant in the fallopian tube, particularly in the ampullary portion, because fertilization normally occurs there and tubal transport can be impaired. Tubal damage or dysfunction (e.g., from pelvic inflammatory disease, prior tubal surgery, or endometriosis) increases the likelihood of implantation before the embryo reaches the uterine cavity. Cervical, ovarian, and abdominal implantations are much less common but carry high risk of hemorrhage.
Category reason: This is a foundational obstetrics/anatomy fact about where implantation most commonly occurs outside the uterus, fitting the Reproductive System subject rather than nursing-process decision-making.

Question 3

Which contraceptive is contraindicated in breastfeeding mothers?

Accepted Answer

Answer reason: C. Combined oral contraceptive pill Estrogen-containing combined oral contraceptives can reduce breast milk production, especially when initiated early postpartum, and may negatively affect lactation success. In addition, the early postpartum period carries an increased risk of venous thromboembolism, and estrogen further increases this risk. Progestin-only methods and nonhormonal methods (IUDs, condoms) are generally compatible with breastfeeding.
Category reason: This question tests knowledge of contraception choices in lactation and postpartum physiology, which is a foundational concept within reproductive health rather than a nursing-prioritization/intervention scenario.

Question 4

The painful phenomenon known as "back labor" occurs in a client whose fetus in what position?

Accepted Answer

Answer reason: D. Left Occipito-Posterior Position Back labor is classically associated with an occiput posterior fetal position because the fetal occiput presses against the maternal sacrum. This increases maternal back pain and can be more intense and persistent than typical labor discomfort. In contrast, occiput anterior positions usually produce more anterior abdominal labor pain and generally smoother descent and rotation.
Category reason: This question tests understanding of fetal positions and their effects on labor pain patterns, which is obstetric anatomy/physiology within the Reproductive System rather than a nursing intervention or prioritization task.

Question 5

Susan tells you she is worried because she develops breast later than most of her friends. Breast development is termed as?

Accepted Answer

Answer reason: This refers to the onset of breast budding, typically the first visible sign of puberty in most girls, driven largely by rising estrogen levels. Adrenarche is the maturation of the adrenal glands leading to pubic/axillary hair and body odor. Menarche is the first menstrual period, and “mamarche” is a less commonly used term that can be used for breast development but the standard term tested is thelarche.
Category reason: This question tests terminology and normal pubertal development in females, which is foundational knowledge of the reproductive system rather than a nursing care decision.

Question 6

Kevin, Susan's husband tells you that he is considering vasectomy. After the left of their new child. Vasectomy involves the incision of which organ?

Accepted Answer

Answer reason: A vasectomy is a male sterilization procedure in which the vas deferens is cut and sealed to prevent sperm from traveling from the epididymis to the urethra for ejaculation. This interrupts sperm transport without removing the testes, so testosterone production and secondary sex characteristics are typically maintained. The epididymis and prostate are not the target structures that are incised and occluded in standard vasectomy techniques.
Category reason: This question tests knowledge of male reproductive anatomy and which structure is surgically interrupted in vasectomy, making it foundational biomedical content within the Reproductive System.

Question 7

On examination, Susan has been found of having a cystocele. A cystocele is?

Accepted Answer

Answer reason: A cystocele is an anterior vaginal wall prolapse caused by weakened pelvic floor support, allowing the bladder to bulge into the vagina. Intestine protrusion into the vagina describes an enterocele, and uterine prolapse refers to descent of the uterus/cervix. A sebaceous cyst is a benign skin gland lesion and is unrelated to pelvic organ prolapse.
Category reason: This question tests the definition of a gynecologic pelvic organ prolapse condition (cystocele) and distinguishes it from related anatomic entities, which is foundational reproductive system knowledge rather than a nursing management decision.

Question 8

Susan typically has menstrual cycle of 34 days. She told you she had coitus on days 8, 10, 15 and 20 of her menstrual cycle. Which is the day on which she is most likely to conceive?

Accepted Answer

Answer reason: Ovulation usually occurs about 14 days before the next menstrual period. In a 34-day cycle, this places ovulation around day 20, and the highest fertility is in the 5 days before ovulation and the day of ovulation due to sperm survival. Among the listed intercourse days (8, 10, 15, 20), day 15 is closest to this fertile window and most likely to result in conception compared with earlier days that are too far from ovulation.
Category reason: This question tests timing of ovulation and the fertile window in relation to menstrual cycle length, which is core reproductive physiology rather than a nursing intervention or prioritization decision.

Question 9

Supposed that Dana, 17 years old, tells you she wants to use fertility awareness method of contraception. How will she determine her fertile days?

Accepted Answer

Answer reason: B. She should assess whether her cervical mucus is thin, copious, clear and watery. Around ovulation, rising estrogen causes cervical mucus to become clear, stretchy, and more abundant, which supports sperm survival and transport; this is a key marker used in fertility awareness methods. This “egg-white” mucus pattern correlates with the fertile window and helps identify days with highest pregnancy risk. Feeling hot, mood changes, or breast sensitivity are non-specific and do not reliably pinpoint ovulation compared with cervical mucus characteristics.
Category reason: This question tests understanding of physiologic changes across the menstrual cycle and fertility indicators, which is core content of the Reproductive System.

Question 10

While talking with Susan, 2 new patients arrived and they are covered with large towels and the nurse noticed that there are many cameras and news people outside of the OPD. Upon assessment the nurse noticed that both of them are silent and the male client’s penis is still inside the female client and the nurse said that “I can’t pull it”. Vaginismus has two possible cause you know that the most psychological cause of vaginismus is related to?

Accepted Answer

Answer reason: Vaginismus is commonly associated with fear, anxiety, and conditioned protective pelvic-floor contraction in anticipation of penetration. Learned negative beliefs about sex (e.g., viewing it as shameful or sinful) can contribute to this anxiety-driven response and reinforce avoidance and involuntary muscle tightening. The other options describe mechanical factors (size/depth) or an anthropomorphic explanation rather than a psychological etiology.
Category reason: This question tests etiologic understanding of vaginismus as a sexual pain disorder related to reproductive/sexual function rather than nursing care prioritization or interventions, so it fits the Reproductive System subject.

Question 11

Which sign confirms pregnancy?

Accepted Answer

Answer reason: This is a positive (diagnostic) sign because it directly demonstrates a fetal presence and viability. Nausea and amenorrhea are presumptive signs that can occur with many nonpregnancy conditions. A home urine test is a probable sign because hCG can be elevated in other situations and the test can yield false results, so it does not definitively confirm pregnancy.
Category reason: This question tests classification of pregnancy signs and what constitutes diagnostic confirmation, which is foundational obstetric knowledge within the Reproductive System.

Question 12

Which prenatal test screens for neural tube defects?

Accepted Answer

Answer reason: This maternal serum screening panel includes alpha-fetoprotein (AFP), which is used to estimate risk for open neural tube defects such as spina bifida and anencephaly. Elevated AFP levels are associated with defects that allow fetal proteins to leak into amniotic fluid and maternal circulation. The other options assess fetal well-being later in pregnancy (BPP, NST) or screen for maternal colonization with group B streptococcus rather than congenital structural defects.
Category reason: This item tests knowledge of prenatal screening tests and what fetal conditions they detect, which is foundational obstetric science content within the Reproductive System rather than a nursing care decision.

Question 13

A woman with type 1 diabetes is at 38 weeks. The fetus is estimated to weigh 4.5 kg. What complication is most likely?

Accepted Answer

Answer reason: A fetal weight of 4.5 kg indicates macrosomia, which is a classic risk in pregnancies complicated by pregestational diabetes due to fetal hyperinsulinemia and accelerated growth. Macrosomia increases the likelihood of cephalopelvic disproportion at the shoulders, leading to impaction of the anterior shoulder behind the maternal pubic symphysis. The other options are less directly linked to macrosomia at term: preterm labor is not suggested at 38 weeks, neonatal hypoglycemia is a neonatal complication rather than an intrapartum mechanical complication, and diabetes more commonly associates with polyhydramnios than oligohydramnios.
Category reason: This item tests an obstetric complication (macrosomia leading to labor/delivery mechanical risk) related to pregnancy physiology and fetal growth in diabetes, which fits best under the Reproductive System rather than nursing task prioritization or intervention selection.

Question 14

A woman at 34 weeks has vaginal bleeding and severe abdominal pain. The uterus is firm and tender. What is the likely diagnosis?

Accepted Answer

Answer reason: Painful third-trimester bleeding with a firm, tender, hypertonic uterus is classic for premature placental separation. The abdominal pain and uterine tenderness reflect blood dissecting into the decidua and myometrium, sometimes with concealed hemorrhage. This presentation contrasts with placenta previa, which typically causes painless bleeding with a soft, non-tender uterus. Uterine atony is primarily a postpartum cause of hemorrhage with a boggy uterus, not a firm tender uterus during pregnancy.
Category reason: This item tests recognition of an obstetric pathology based on hallmark clinical features (painful bleeding with a firm, tender uterus), which is foundational medical knowledge of pregnancy complications within the Reproductive System.

Question 15

Which fetal condition may occur due to isoimmunization (Rh incompatibility)?

Accepted Answer

Answer reason: Rh isoimmunization causes maternal IgG antibodies to cross the placenta and hemolyze fetal red blood cells, producing severe fetal anemia. The resulting high-output cardiac failure and decreased oncotic pressure lead to generalized edema, effusions, and ascites—features of hydrops. This is classically part of hemolytic disease of the fetus/newborn and may be accompanied by hyperbilirubinemia after birth. The other options are congenital malformations not caused by immune-mediated hemolysis.
Category reason: This question tests the fetal consequence of Rh (maternal-fetal) blood group incompatibility, a concept centered on pregnancy and fetal effects within the reproductive system rather than nursing interventions or prioritization.

Question 16

A 36-week patient with intrahepatic cholestasis of pregnancy reports intense itching. What test is priority?

Accepted Answer

Answer reason: B. Serum bile acids Intrahepatic cholestasis of pregnancy is defined and risk-stratified primarily by elevated total bile acids, which correlate with fetal risks (e.g., preterm birth and stillbirth at higher levels). In a symptomatic late-term patient with intense pruritus, measuring bile acids is the most direct test to confirm the diagnosis and guide urgency of management and delivery planning. Platelets and coagulation studies can be relevant in other hepatic/preeclampsia-related disorders, but they are not the key diagnostic/priority marker for this condition. Blood glucose does not address the pathophysiology or fetal risk associated with cholestasis.
Category reason: This question tests the key diagnostic laboratory marker for an obstetric liver disorder (intrahepatic cholestasis of pregnancy), which is foundational biomedical knowledge within the Reproductive System.

Question 17

Rubella infection during the first trimester of pregnancy is most likely to result in?

Accepted Answer

Answer reason: First-trimester maternal infection can transmit transplacentally and disrupt organogenesis, producing the classic triad of congenital defects. Key manifestations include sensorineural deafness, cataracts, and congenital heart disease (especially PDA), with possible microcephaly and “blueberry muffin” rash. The risk of severe fetal malformations is highest early in pregnancy, making this outcome the most characteristic. The other choices are not the typical primary consequence of maternal rubella in early gestation.
Category reason: This tests a foundational obstetric infectious-disease outcome (teratogenic effects of maternal rubella on the fetus), which is biomedical knowledge within the Reproductive System rather than a nursing intervention/prioritization scenario.

Question 18

Dana has asked about GIFT procedure. What makes her a good candidate for GIFT?

Accepted Answer

Answer reason: A. She has patent fallopian tubes, so fertilized ova can be implanted on them GIFT (gamete intrafallopian transfer) requires at least one functioning, patent fallopian tube because gametes are placed into the tube and fertilization occurs in vivo. If the tubes are blocked or severely damaged, the procedure cannot achieve fertilization/transport. Rh status and sildenafil use are unrelated to candidacy, and sperm injection through the cervix describes intrauterine/intracervical insemination rather than GIFT.
Category reason: This question tests understanding of assisted reproductive technology and the anatomic requirement (patent fallopian tubes) for GIFT, which fits the Reproductive System subject rather than nursing care prioritization.

Question 19

Dina, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be the best answer?

Accepted Answer

Answer reason: Tubal ligation works by interrupting the fallopian tubes so that sperm and egg cannot meet for fertilization. Ovulation usually continues normally, and ova are released but cannot travel through the blocked tube to the uterus. The cervix is not occluded by this procedure, and prostaglandin release is not the contraceptive mechanism. Therefore, prevention of pregnancy is due to mechanical blockage of sperm-egg contact.
Category reason: This question tests the physiologic mechanism of a sterilization procedure in the female reproductive tract, which is foundational knowledge about reproductive anatomy and function rather than nursing management or interventions.

Question 20

The Dators are a couple undergoing testing for infertility. Infertility is said to exist when?

Accepted Answer

Answer reason: Infertility is classically defined as failure to achieve pregnancy after 12 months of regular, unprotected intercourse. The other choices describe circumstances that may be associated with infertility but are not the diagnostic time-based definition. In some situations (e.g., advanced maternal age), evaluation may start earlier, but the standard definition remains 1 year.
Category reason: This question tests the standard clinical definition and timing criteria for infertility, which is foundational knowledge within the Reproductive System rather than a nursing intervention/prioritization scenario.

Question 21

Another client named Lina is diagnosed as having endometriosis. This condition interferes with fertility because?

Accepted Answer

Answer reason: A. Endometrial implants can block the fallopian tubes Endometriosis involves ectopic endometrial tissue that causes chronic inflammation, scarring, and adhesions in the pelvis. These adhesions can distort pelvic anatomy and obstruct or impair tubal patency and motility, preventing sperm from reaching the ovum or the fertilized egg from reaching the uterus. Cervical inflammation is not the primary infertility mechanism in endometriosis, and the disorder does not typically cause infertility by suppressing ovarian estrogen production or pituitary FSH.
Category reason: This item tests the pathophysiologic mechanism by which endometriosis impairs conception within the female reproductive tract, which best fits the Reproductive System subject area.

Question 22

Lilia’s cousin on the other hand, knowing nurse Lorena’s specialization asks what artificial insemination by donor entails. Which would be your best answer if you were Nurse Lorena?

Accepted Answer

Answer reason: Artificial insemination by donor (AID) involves placing processed donor semen into the female reproductive tract, most commonly intracervically or intrauterine, timed around ovulation to facilitate fertilization. Injecting sperm into the abdomen or ovaries is not a standard or safe method for achieving conception. Testing tubal patency is done with procedures such as hysterosalpingography or sonohysterography, not by placing “artificial sperm.” Intravenous administration of sperm has no reproductive function and would be unsafe.
Category reason: This question tests knowledge of a reproductive procedure (artificial insemination) and where donor sperm are placed anatomically, which aligns with foundational reproductive system concepts rather than nursing care prioritization or safety interventions.

Question 23

In a newborn with cleft lip and palate, feeding difficulty occurs due to:

Accepted Answer

Answer reason: A cleft palate prevents the infant from creating an adequate seal between the oral and nasal cavities, which is required to build negative pressure for effective sucking. Milk can escape into the nasal cavity and the infant tires quickly due to inefficient feeding. Coordination of suck–swallow may be intact, but without suction the transfer of milk is poor. Airway obstruction and esophageal atresia are separate problems and are not the typical primary mechanism of feeding difficulty in cleft lip/palate.
Category reason: This question tests the physiologic mechanism behind feeding impairment in a congenital craniofacial anomaly rather than nursing prioritization or interventions, so it fits foundational biomedical understanding of newborn feeding anatomy/physiology within the Reproductive System subject area.

Question 24

A pregnant client at 30 weeks presents with painless bright red vaginal bleeding. What condition is most likely?

Accepted Answer

Answer reason: Painless, bright red bleeding in the third trimester is classic for placenta previa due to placental implantation over or near the cervical os, which bleeds as the lower uterine segment thins. Placental abruption typically causes painful bleeding with uterine tenderness and hypertonicity. Preterm labor is characterized by contractions and cervical change rather than isolated painless bleeding. Uterine rupture usually presents with sudden severe abdominal pain, fetal distress, and signs of maternal shock, often in the setting of prior uterine surgery.
Category reason: This item tests recognition of a classic obstetric presentation and its underlying condition (a pregnancy complication) rather than a nursing intervention or prioritization decision, fitting the Reproductive System subject in Nursing Science.

Question 25

Which fetal presentation is considered ideal for vaginal delivery?

Accepted Answer

Answer reason: D) Left occiput anterior LOA is an occiput-anterior vertex position, which aligns the smallest fetal head diameter with the maternal pelvis and promotes efficient descent and flexion during labor. Breech and transverse lies are malpresentations associated with higher risk of obstructed labor and typically require operative delivery. Occiput posterior positions can still deliver vaginally but are associated with longer labor, more pain, and increased likelihood of assisted delivery compared with occiput anterior.
Category reason: This tests obstetric fetal position/presentation knowledge and which is most favorable for vaginal birth, a foundational topic in the Reproductive System rather than a nursing intervention/prioritization scenario.

Question 26

A nurse is managing a client with postpartum hemorrhage (PPH). Which condition is the most common cause?

Accepted Answer

Answer reason: B) Uterine atony Failure of the uterus to contract effectively after delivery leaves uterine blood vessels at the placental site open, leading to heavy bleeding. This is the leading etiology of postpartum hemorrhage and is addressed first with fundal massage and uterotonic medications. Other causes (retained tissue, genital tract trauma, uterine rupture) are important but occur less frequently than inadequate uterine tone.
Category reason: This question tests the underlying obstetric pathophysiology and epidemiology of postpartum hemorrhage causes rather than prioritization or nursing interventions, fitting the Reproductive System foundation.

Question 27

A nurse administers betamethasone to a 32-week pregnant client. What is the goal?

Accepted Answer

Answer reason: Antenatal corticosteroids given between about 24 and 34 weeks’ gestation accelerate fetal pulmonary surfactant production and structural lung maturation. This lowers the risk and severity of neonatal respiratory distress syndrome and also reduces complications such as intraventricular hemorrhage and necrotizing enterocolitis. Betamethasone is not primarily used to stop contractions (tocolysis), alter fetal heart rate, or treat maternal glucose disorders.
Category reason: This item tests the purpose of an antenatal corticosteroid in preterm pregnancy, a foundational obstetric concept about fetal development and physiologic preparation for extrauterine life, fitting best under the Reproductive System.

Question 28

A Rh-negative mother delivers an Rh-positive baby. When should Rh immunoglobulin (Rhogam) be given?

Accepted Answer

Answer reason: B) Within 72 hours postpartum Rh immune globulin is administered after delivery to prevent maternal sensitization to fetal Rh(D)-positive red blood cells that may have entered maternal circulation during childbirth. Giving it within 72 hours maximizes its ability to bind and clear fetal cells before the mother mounts an immune response and forms anti-D antibodies. Preventing sensitization reduces the risk of hemolytic disease of the fetus/newborn in future Rh-positive pregnancies. Jaundice in the newborn is managed separately and is not an indication for timing of prophylaxis.
Category reason: This tests the biologic rationale and standard prophylactic timing of anti-D immunoglobulin in Rh incompatibility, which is a core concept in obstetrics within the Reproductive System.

Question 29

A client with suspected molar pregnancy is being assessed. Which finding confirms the diagnosis?

Accepted Answer

Answer reason: A molar pregnancy (gestational trophoblastic disease) involves abnormal trophoblastic proliferation that can cause a uterus larger than expected for gestational age while no viable fetus is present, so fetal heart tones are absent. Hyperemesis can occur due to very high hCG but is not confirmatory because it is nonspecific. Blood glucose is not a defining feature, and hypotension is not expected; if anything, early-onset hypertension/preeclampsia may occur.
Category reason: This question tests recognition of a characteristic diagnostic finding of gestational trophoblastic disease, which is foundational knowledge about pregnancy pathology within the Reproductive System rather than a nursing intervention or prioritization decision.

Question 30

A woman at 30 weeks with oligohydramnios is being monitored. Which is the most concerning complication?

Accepted Answer

Answer reason: With oligohydramnios, reduced amniotic fluid decreases the cushioning around the umbilical cord, increasing the risk of cord compression. This can cause variable fetal heart rate decelerations and reduced fetal oxygenation, which is an immediate threat to fetal well-being. Preterm labor can occur with several pregnancy complications but is less directly tied to low fluid volume than cord compression. Macrosomia is typically associated with maternal diabetes and polyhydramnios rather than oligohydramnios.
Category reason: This question tests an obstetric complication and its pathophysiologic consequence (low amniotic fluid leading to fetal compromise), which aligns best with foundational reproductive-system science rather than a nursing intervention or prioritization decision.

Question 31

What finding suggests ectopic pregnancy?

Accepted Answer

Answer reason: Unilateral pelvic pain is a classic presenting symptom of a tubal implantation and possible tubal distension or rupture. Referred shoulder pain suggests diaphragmatic irritation from intra-abdominal bleeding (hemoperitoneum), which is a concerning complication of ectopic pregnancy. The other findings are common in normal early intrauterine pregnancy or nonspecific and do not strongly indicate an ectopic location.
Category reason: This question tests recognition of a characteristic symptom pattern of an obstetric condition (ectopic pregnancy), which is primarily reproductive-system knowledge rather than a nursing management/priority task.

Question 32

A 34-week pregnant client has BP 150/95 mmHg, no proteinuria, and mild headaches. What is the likely diagnosis?

Accepted Answer

Answer reason: New-onset hypertension after 20 weeks’ gestation without proteinuria or other end-organ dysfunction is most consistent with gestational hypertension. Preeclampsia requires proteinuria and/or severe features (e.g., thrombocytopenia, elevated creatinine, elevated liver enzymes, pulmonary edema, or persistent severe neurologic symptoms). Eclampsia involves seizures in the setting of preeclampsia. Chronic hypertension is typically present before pregnancy or before 20 weeks’ gestation (or persists beyond 12 weeks postpartum).
Category reason: This question tests obstetric diagnostic criteria distinguishing gestational hypertension, preeclampsia, eclampsia, and chronic hypertension, which is foundational knowledge of pregnancy-related disorders within the Reproductive System.

Question 33

What is the most common cause of late decelerations on a fetal heart monitor?

Accepted Answer

Answer reason: Late decelerations occur when fetal heart rate decreases after the peak of a contraction, reflecting impaired fetal oxygenation during uterine contractions. The most common underlying mechanism is reduced placental perfusion and gas exchange, which leads to fetal hypoxemia and myocardial depression. This pattern is classically associated with conditions that diminish uteroplacental blood flow (e.g., placental dysfunction, uterine tachysystole). In contrast, umbilical cord compression causes variable decelerations, and fetal movement typically causes accelerations.
Category reason: This question tests interpretation of fetal heart rate deceleration patterns and their underlying obstetric physiology/pathophysiology, which is foundational knowledge within the Reproductive System rather than a nursing intervention/prioritization scenario.

Question 34

After ovulation has occurred, the ovum remains viable for

Accepted Answer

Answer reason: The core principle is that the human oocyte has a short post-ovulation lifespan, limiting the fertile window to roughly one day after release. Once ovulated, the ovum rapidly loses the capacity to be fertilized, so fertility peaks around the time of ovulation and declines quickly thereafter. This aligns with the common clinical teaching that the ovum is viable for about 12–24 hours. Longer durations such as 48–72 hours more closely reflect sperm survival in the female reproductive tract rather than ovum viability.

Question 35

Abnormal proliferation of uterine endometrial tissue outside the uterus is known as?

Accepted Answer

Answer reason: This condition is defined by ectopic implantation and growth of endometrial glands and stroma outside the uterine cavity, most commonly on ovaries, pelvic peritoneum, and uterosacral ligaments. Ectopic endometrial tissue remains hormonally responsive, leading to cyclic bleeding, inflammation, and fibrosis/adhesions, which explains typical symptoms like dysmenorrhea, dyspareunia, and infertility. Metrorrhagia and menorrhagia describe patterns of abnormal uterine bleeding rather than a diagnosis of tissue growth outside the uterus. Cystic fibrosis is an inherited exocrine gland disorder and is unrelated to endometrial tissue location.

Question 36

In post term pregnancy usually liquor amnii:

Accepted Answer

Answer reason: Post-term pregnancy is associated with placental aging and reduced uteroplacental perfusion, which decreases fetal urine production and therefore amniotic fluid volume. Oligohydramnios becomes more likely as gestational age extends beyond term, increasing risk of cord compression and fetal distress. This physiologic trend makes a decrease in liquor amnii the most consistent expected finding. Options implying no change or adequacy do not match the typical post-term pattern.

Question 37

The transmission of infection from the mother to the fetus through placenta is termed as?

Accepted Answer

Answer reason: Infections or other harmful maternal exposures that cross the placenta and adversely affect fetal development are classified as teratogenic influences (congenital/perinatal transmission with fetal effects). Placental transfer is a defining feature of these vertically transmitted hazards during pregnancy. Iatrogenic refers to harm caused by medical treatment, nosocomial refers to hospital-acquired infection, and fomites are contaminated inanimate objects that transmit pathogens, none of which specifically denote transplacental mother-to-fetus transmission.

Question 38

Which is the commonest cause of maternal mortality?

Accepted Answer

Answer reason: Maternal mortality worldwide is most commonly driven by obstetric hemorrhage, especially postpartum hemorrhage, because it can cause rapid hypovolemic shock and death without immediate recognition and intervention. Bleeding can occur from uterine atony, retained placenta, genital tract trauma, or coagulation disorders, making it both frequent and acutely life-threatening. While sepsis, eclampsia, and obstructed labor are important contributors, they generally account for a smaller proportion of deaths compared with hemorrhage in most epidemiologic summaries. The key exam principle is that the leading global cause is the one with the fastest lethal trajectory and highest incidence in childbirth-related complications.

Question 39

Which vitamin prevents neural tube defect?

Accepted Answer

Answer reason: Neural tube closure occurs very early in embryogenesis, and adequate folate is required for DNA synthesis and methylation during rapid cell division. Periconceptional folic acid supplementation significantly reduces the risk of neural tube defects such as spina bifida and anencephaly. This is why folate is recommended before conception and through early pregnancy, since the defect can occur before a person knows they are pregnant. While vitamin B12 deficiency can contribute to megaloblastic anemia and may worsen folate metabolism, folate itself is the key preventive nutrient for neural tube defects.

Question 40

Primary power of labor –

Accepted Answer

Answer reason: The primary power in labor is generated by involuntary myometrial activity that causes cervical effacement and dilation and drives fetal descent. These contractions originate in the uterine fundus and create coordinated, progressive increases in intrauterine pressure. Maternal abdominal muscles provide secondary (auxiliary) power mainly during the second stage as pushing efforts. The pelvic floor and diaphragm influence fetal rotation/expulsion mechanics but do not constitute the main propulsive force initiating and sustaining labor progress.

Question 41

Most common presentation in labor —

Accepted Answer

Answer reason: The most common fetal presentation at term is cephalic with a flexed head, producing a vertex presentation. This alignment allows the smallest diameters of the fetal head to negotiate the maternal pelvis, making it the most frequent and most favorable for vaginal delivery. Malpresentations such as breech, face, and brow are comparatively uncommon and are associated with higher rates of labor dystocia and operative delivery. Therefore, the typical presentation encountered in labor is vertex.

Question 42

Which vaccine used for prevention of cervical cancer is?

Accepted Answer

Answer reason: Prophylactic HPV vaccines generate neutralizing antibodies that prevent initial HPV infection and thereby reduce cervical dysplasia and cancer risk. BCG is for tuberculosis, not cervical cancer prevention. IgG is an antibody class rather than a vaccine, and Hep B vaccination prevents hepatitis B–related liver disease rather than cervical malignancy.

Question 43

Involution of uterus is completed by?

Accepted Answer

Answer reason: The expected completion time for this process is about 6 weeks postpartum, which aligns with routine postpartum follow-up timing and normal regression of uterine size and lochia. Longer time frames suggest delayed involution, commonly associated with subinvolution causes such as retained products of conception or uterine infection. Therefore, the best single answer for completion of involution is 6 weeks.

Question 44

The uterine blood flow at term

Accepted Answer

Answer reason: By term, uterine blood flow increases dramatically from the nonpregnant state to roughly 500–750 mL/min, reflecting low-resistance placental circulation. The smaller values would be inconsistent with the high-flow requirements of the placenta and fetus near term. This magnitude also explains why postpartum uterine atony can lead to rapid, severe hemorrhage due to the high baseline uterine perfusion.

Question 45

Normal pH of vagina during pregnancy?

Accepted Answer

Answer reason: In pregnancy, estrogen increases glycogen in vaginal epithelium, supporting lactobacilli and preserving (often slightly enhancing) this acidic environment. An acidic pH around 4–5 helps inhibit overgrowth of pathogenic organisms; markedly higher values are more consistent with conditions like bacterial vaginosis. Therefore, the range 4–5 best matches normal vaginal pH during pregnancy among the given choices.

Question 46

Most common cause of low birth wt baby is?

Accepted Answer

Answer reason: Preterm infants have had less time for normal accretion of fat and lean mass, making prematurity the leading driver of low birth weight prevalence. While infection and maternal anemia can contribute via placental dysfunction and fetal growth restriction, they are less common as the single most frequent overall cause. Maternal diabetes more often leads to macrosomia, with low birth weight mainly in the setting of severe vascular disease causing growth restriction.

Question 47

The length of cervix is ?

Accepted Answer

Answer reason: 3.5 cm Normal adult cervical length is typically about 3–4 cm, reflecting standard gross anatomy of the female reproductive tract. This value is commonly taught as approximately 3.5 cm in nonpregnant anatomy descriptions. The other numeric choices deviate from the usual anatomic range (2.5 cm is more suggestive of a shortened cervix in certain contexts; 4.5 cm is longer than typical). Therefore the best single value among the options is the one that matches the accepted average.

Question 48

The normal duration of spermatogenesis :-

Accepted Answer

Answer reason: The commonly tested standard duration is about 74 days for a spermatogonium to develop into a mature spermatozoon. This matches the physiologic timeline used in reproductive biology and explains why changes in temperature, toxins, or hormones may take months to reflect in semen parameters. Options like 30 days are too short for completion of meiosis and differentiation, while 100 days overestimates the core intratesticular process (even though full maturation including epididymal transit adds additional time).

Question 49

The life span of a sperm is?

Accepted Answer

Answer reason: Under typical teaching used in nursing and reproductive health, motile sperm can remain capable of fertilization for about 2–3 days. This timeframe best matches the window during which intercourse can lead to conception before ovulation. Shorter ranges underestimate sperm survival in fertile cervical mucus, while longer survival is not the standard expectation in most exam settings.

Question 50

Average age of menarche is ?

Accepted Answer

Answer reason: The population average is around 12–13 years, with a normal range roughly 10–16 years depending on genetics, nutrition, and overall health. An age like 19 years is well beyond the expected window and would suggest delayed puberty or underlying pathology. Ten years can be within the early end of normal, but it is below the average, while 16 years is at the upper end rather than the mean.

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