Applications from candidates who wish to sit for the midwifery licensing examinations should solve these past question as this will help them prepare for the exams. The Examination Unit which coordinates the preparation of test items, obtain examination centers, identify invigilators and examiners, assess examination scripts and publish results.
Licensing examinations for the various programmes are held in February/March, June/July, August and November/December every year.
Candidates who pass the licensing examination are issued Professional Identification Number (PIN) and a certificate of registration. Those who pursue Auxiliary programmes are issued with Auxiliary Identification Number (AIN) and a certificate of registration.
The following are past questions for the Anatomy.
Q1. The midwife seeks to take history from a client who has reported in labour. Which of the following history is of relevance to the onset of woman’s labour?
I. Parity and age.
II. Onset of labour.
III. Ruptured of membranes.
IV. Most recent food intake
A. I, II and IV.
B. II, III and IV.
C. I, II and III.
Q2. The Lifeway Maternity home unit received a 35year old woman, G4P3 with the complaint of having been in labour for 5days. She claims her labour pains comes in the morning and subsides later in the day when she starts her daily activities. She further said she has been experiencing lower abdominal pain, dull headache and loss of appetite since since 8 days ago. All the under listed are true signs and symptoms of labour EXCEPT
A. Uterine constractions.
B. Presence of show.
C. Dull headache.
Q 3. Rapturing of membranes during labour is important. The student midwife understands that, early ruptured of membranes may:
I. Expose uterine cavity to infection.
II. Predisposes to cord prolapse.
III. Prevents good fetal axis pressure.
A. I and II.
B. I, II and III.
C. I and III.
Q 4. Abena Mordey a post partum client is ready for discharge. During preparation for discharge the midwife should instruct her to report which of the following to her?
A. Lochia alba at 2 weeks post partum.
B. Episiotomy discomfort.
C. Restlessness, warmth and pain in the breast.
Q5. Madam Awusi Mensah is at the labour ward with 4cm dilatation. During monitoring of contraction, she ruptures the membrane. As the Midwife on duty what would be your immediate action to take?
A. Inform ward In Charge.
B. Perform vaginal examination.
C. Set up IV fluids.
Q 6.Five (5) days after a vaginal delivery, Ekua Bonsah comes to your facility because she has a fever and persistent cramping. The midwife recognizes that the cause of the signs and symptoms may be
A. Dehydration.
B. Hypovolaemic shock.
C. Endometritis.
Q 7.Maame Jane G4P3 with 36weeks gestation was seen at the antenatal clinic, on palpation the midwife noticed two heart beat simultaneously with at least 10bpm difference. The midwife would suspect,
A. Triple gestation.
B. Twin gestation.
C. Single pregnancy.
Q 8.Madam Ama Korantemaa was rushed to your facility with the diagnosis of ruptured ectopic pregnancy. Which of the under-listed sign or symptom is an indication of bleeding into the peritoneal cavity.
A. Shoulder pain.
B. Abdominal distension.
C. Dizziness.
Q 9.A 25-year-old female reports with a history of deep vein thrombosis because she is thinking of getting pregnant. She is currently on Warfarin. This would be her second child, and she remembers her Obstetrician saying that she cannot be on Warfarin while pregnant. Before switching her to unfractionated heparin, which side effect will you counsel her about?
A. Fetal blindness.
B. Maternal thrombocytopenia.
C. Fetal intellectual disability.
Q 10.A midwife is providing instructions to the mother of a newborn with hyperbilirubinemia who is being breastfed. What will be the most appropriate instruction to give to the mother?
A. Continue to breastfeed every 2-4 hourly.
B. Bottle feed the baby for two weeks.
C. Breastfeed baby less frequently.
Q 11.During the demonstration of abdominal palpation to a group of students, the following were observed. The uterus feels tense, shiny and it is difficult to feel the fetal parts. Based on these findings, you are likely to diagnose
A. Twin gestation.
B. Hydatidiform mole.
C. Polyhydraminous.
Q 12.Carcinoma of the cervix is common among women in their reproductive age. Which of the following investigations would you recommend for your clients?
A. Cardiotocography.
B. Cone biopsy.
C. Pylerogram.
Q 13.At the diabetic clinic Mame Bruwa started experiencing sweating, tremors and tachycardia. The consulting room nurse recognized Maame Bruwa was suffering from which of the under listed symptoms.
A. Hyperglycaemia.
B. Hypoglycaemia.
C. Hyperkalaemia.
Q 14.Which of the under listed explains the cause of tingling sensation in the breast during the first trimester of pregnancy?
I. Shrinkage of breast lump
II. Increased vascularization
III. Pigmentation
IV. Hypertrophy of glandular tissue
A. I, III and IV
B. I, II and III.
C. II, III and IV.
Q 15.You are discussing inducing labor in a woman with controlled mild chronic hypertension at 39 weeks. She states that she read online that if the induction fails, she will end up needing a cesarean section and the risk of complications is higher after a prolonged labor than if she had just planned a cesarean section. She asks you to inform the Doctor to schedule an elective cesarean instead. The most appropriate next step is:
A. Tell her that her insurance will not cover a cesarean in the absence of a clear clinical indication.
B. Counsel the patient on the risks and benefits of vaginal delivery as well as cesarean section.
C. Schedule an elective cesarean section at 39 weeks as requested.
Q 16.Fetal distress may be the result of………………………
A. Diminished intake of water.
B. Abnormally short cord.
C. Diminished placental perfusion.
Q 17Mrs. Odenky was referred to the hospital where you work as a midwife. She was referred on account of breach presentation. When you did vagina examination you felt the knees below the buttocks. What type of breech presentation is this?
A. Frank presentation.
B. Incomplete presentation.
C. Complete presentation.
Q 18.After assessing a puerperal client before discharge on the 4th day, it was realized that there was continuous flow of lochia rubra, fever and lower abdominal tenderness. These signs are suggestive of
A. Malaria.
B. Endometritis.
C. Endometriosis.
Q 19.Mrs. Margaret Adom, previous c/s came to the labour ward with 7cm cervical dilatation with contraction 2 in 10 lasting 30 sec. What action would you take?
A. Set up oxytocin infusion.
B. Monitor for another 2 hours.
C. Prepare her for caesarean section.
Q 20.Which of the following will the Midwife recommend to a client who complains of constipation?
A. Take frequent laxatives.
B. Continue taking iron medications.
C. Eat fruits and vegetables.
Q 21.A quick glance at a partograph gives the professional midwife a detailed information about progress of labour fetal condition as well as the maternal condition. The midwife is able to predict outcome of labour from the partograph. If the cervical plotting was in the middle of the two lines that cuts across the cervical plotting aspect of the partograph it will mean…
A. The client must be observed for complications.
B. Preparation for intervention.
C. Manage labour normally.
Q 22.A pregnant client on your maternity suit started fitting with eclampsia whilst on her bed. As the midwife on duty what immediate action would you take before treatment?
A. Remove client from source of danger.
B. Set intravenous line.
C. Administer IV fluids.
Q 23.A midwife is preparing to perform a fundal assessment of a postpartum client. Which of the following would be the initial action that the midwife would take?
A. Ask client to turn on her side.
B. Massage fundus before determining the level.
C. Ask client to empty her bladder.
Q 24. At a polyclinic Mrs. Rose Arthur called the midwife to tell her she feels like bearing down. The last vaginal examination was less than an hour. As a professional midwife which of the following will you include to assume Mrs. Arthur is in the second stage apart from confirmation by vaginal examination.
I. Restlessness and the urge to push.
II.Sweats on the face with nasal flaring.
III. Bulging perineum on inspection.
IV. Gaping of vulva with visible presenting part.
A. I, II, IV.
B. I, II, III.
C. I, III, IV.
Q 25. Mrs. Akins sustained tears during 2nd stage of labour, which involves fourchette, superficial perineal muscles and damage to the anal sphincter. Which of the under-listed would classify the tear?
A. Third degree.
B. Second degree.
C. First degree.
Q 26. A rotation midwife was reading the scan of a pregnant woman and came across oligohydraminous and asked of the effect on the fetus. Your answer would be the effects on the fetus is EXCEPT
Ureteric obstruction.
Cerebral palsy.
Pre term birth.
Q 27. An 18 year old sexually active patient reports that she is 6 days late for her period. She has had regular menstrual cycles for the past 3 years. She used a home pregnancy test that returned positive. She does not want to keep the pregnancy and wishes to discuss her options. She is an Asthmatic. Which of the following statements regarding medical abortion is NOT true?
A. The use of misoprostol is contraindicated in this patient due to her history of asthma.
B. Medical abortion is most effective when used prior to 63 days of gestation.
C. The most common method of medical abortion is vacuum aspiration.
Q 28. You are inducing a patient at 39 weeks with mild hypertension. Her cervix was favorable at the onset and oxytocin infusion was set up. Her membranes ruptured spontaneously with clear liquor and her cervix was 4 cm dilated. She has been in labour for 10 hours and you are becoming concerned about a failed induction. Which of the following statements describes adequate labour?
A. Palpable strong contractions of 5 in 10 minutes.
B. Pain is felt mainly in the abdomen.
C. There is progressive dilatation and effacement of the cervix.
Q 29. A client is bleeding in the fourth stage of labour. The midwife examines her and identifies that the uterus is boggy. The midwife’s first action should be to…………………….
A. Administer oxytocin.
B. Massage the uterus.
C. Reassure the patient.
Q 30. A pregnant client on the ward who is hypertensive started complaining of drowsiness, confusion, visual disturbances and upper abdominal pain. This denotes clear signs of?
A. Severe Eclampsia.
B. Impending Eclampsia.
C. Eclampsia.
Q 31. Madam Yaa Nyarkoa came in labour to the labour ward, on abdominal examination, there was a groove between head and back, the limbs were felt opposite to the occiput and the heart rate felt through the fetal chest. Which of the following BEST describes this?
A. Mentoanterior.
B. Occipito posterior.
C. Face presentation.
Q 32. In which of the phases of labour does the cervix of the uterus undergo a more rapid dilatation?
A. Third phase.
B. Second phase.
C. First phase.
Q 33. In comprehensive abortion care the midwife is to be observe personal beliefs nurses professional responsibilities this statement means.
A. The nurse must hold her personal responsibilities.
B. The nurse must hold up her professional responsibilities against her beliefs.
C. Must not condemn others.
Q 34. Which of these minor disorders in pregnancy would the Midwife recommend limited intake of foods such as soda and encourage intake of cheese?
A. Constipation.
B. Leg cramps.
C. Heartburns.
Q 35. Mrs Gyebi G2PI, who has had one (1) previous caesarean section came to the labour ward with 5cm cervical dilatation, the Obstetrician/ Gynaecologist assessed her and ordered for a trial of labour for her. Which of the under-listed would he consider before giving trial of labour?
I. The effectiveness of uterine contraction.
II. The flexion of the fetal head.
III. The fetal heart rate.
IV. The height of the woman.
A. I and II.
B. I and III.
C. I and IV.
Q 36. A 31 year old G1 at 41 weeks gestation presents for induction of labour. She has a singleton pregnancy with vertex presention. You performed a cervical examination in order to generate a Bishop’s score in order to predict the success of the induction of labor. Which of the following has not been shown to be statistically significant in the prediction of vaginal delivery?
A. Effacement of the cervix.
B. Consistency of the cervix.
C. Dilatation of the cervix.
Q 37. Rhoda Minka’s second partograph plotting of a clients information after assessment presented the following cervical dilatation 6cm, descent 4/5, membranes intact, fetal heart at the last reading 165cpm. What other component on the partograph do you anticipate must be referred to based on the level of the descent?
A. Contraction of the uterus.
B. Drugs given to mother.
C. Mothers urine output.
Q 38. Women express a high desire for the father of the baby to be involved in labour because…………………..
A. He is responsible and father of the baby.
B. He acts as a companion and gives both emotional and moral support.
C. He has to observe labour and delivery.
Q 39. Knowledge of the planes of the pelvis is valuable in midwifery practice during
A. Delivery of the body.
B. Perineal repair.
C. Cervical assessment.
Q 40. Rhoda Minka’s second partograph plotting of a clients information after assessment presented the following cervical dilatation 6cm, descent 4/5, membranes intact, fetal heart at the last reading 165cpm. Your interpretation of this pieces of information will be
A. The progress of labour is normal.
B. There is absolutely no progress of labour.
C. Labour process is slow.
Q 41. Which of the following medications used for treatment of hypertension in pregnancy has the potential side effect of cyanide toxicity?
A. Labetalol.
B. Hydralazine.
C. Sodium nitroprusside.
Q 42. The Midwife examines the perineum of a pregnant client for which of the following observations?
I. Scars
II. Lesions
III. Haematoma
IV. Haemorrhoids
A. I, II and IV.
B. I, II and III.
C. II, III and IV.
Q 43. During pregnancy there is an increase in the requirement of iron. In which of the following trimesters of pregnancy is iron requirement needed MOST.
A. Second trimester.
B. First trimester.
C. Third trimester.
Q 44. After suffering from 3 continuous abortions Madam Esivi Narh has been admitted for management of cervical incompetence. Which of the following would be adopted?
A. Complete bed rest.
B. Cervical cerclage.
C. Administration of corcolytics.
Q 45. Mrs Nancy Annan, a midwife in-charge of the maternity wing of a Regional Hospital decided to assist a Pregnant woman at term on the ward to deliver through a vaccum extraction due to delayed 2nd stage. When should she discontinue the procedure should it failed? After attempts.
A. 5.
B. 3.
C. 4.
Q 46. Rhoda Minka’s second partograph plotting of a clients information after assessment presented the following cervical dilatation 6cm, descent 4/5, membranes intact, fetal heart at the last reading 165cpm. The descent of the foetal head at 4/5 has been repeated, it therefore means, the
A. Biparietals are above mid-cavity but below the brim.
B. Biparietal have negotiated the ischial spines.
C. Head is in mid-cavity.
Q 47. Maame Esi Davis a GIPO was referred from a health facility to the District hospital on account of prolonged labour. She was prepared for an emergency Caesarean section, on arrival at the hospital, unfortunately the baby did not survive. Which of the following measures would the midwife adopt to help Maame Esi suppress lactation?
Wearing a well fitted brest binder
Prescribe bromocriptin
Advice on combine contraceptives
Avoidance of breast stimulation
A. III and IV.
B. I and III.
C. I and II.
Q 48.A client with multiple pregnancy is scheduled for caesarean section and is prepared to the theatre. Which position would be appropriate for the procedure in the operating room?
A. vLateral with left leg elevated.
B. Semi fowlers with hip extended.
C. Supine position with a wedge at the left hip.
Q 49. You are a preceptor in your hospital, you have a group of second year students midwives on your ward. As part of your teaching you will NOT include as a
factor that puts postpartum women at risk.
A. Prolonged labour.
B. Oligohydraminus.
C. Operative procedures.
Q 50. A 28 year old G2P1 presents at 38 weeks for discussion of a trial of labor after previous low transverse cesarean section for fetal distress. She is otherwise healthy and fetal surveillance is reassuring. Estimated fetal weight is 3.6kg. Which of the following statements is NOT true?
A. Induction of labor has a lower success rate if there has been no prior vaginal delivery.
B. Misoprostol 25 micrograms intravaginally every 3-6 hours is appropriate.
C. Vaginal birth after cesarean section associated with induction of labor should take place where staff is immediately available to care for the mother and fetus, and cesarean can take place expeditiously.
