1.

A 44 year old G3P0 presents to your hospital after

unprotected intercourse two days ago, and worried about an
unwanted pregnancy. She has history of chronic
hypertension well controlled on two medications, diabetes
mellitus type II well controlled on insulin, as well as
migraines. Her weight is 113.6 and height is 5ft 2in. Her
last menstrual period was about 12 days ago and she
describes them as light and regular. Which of the under
listed method would you recommend?
A. IUCD
B. Levonorgestrel emergency contraception
C. Combined oral contraceptive pill
2. Miss Esimy Churchil, a 13 year old was diagnosed of
leukemia. She reported with profuse uterine bleeding. You
are consulted to begin urgently therapy. Which of the
following is the best initial therapy the Gynecologist would
recommend?
A. Depomedroxyprogesterone (DMPA)
B. Levonorgestrol intrauterine device (lUD)
C. Combined oral contraceptive pills
3. Maame Ama, a thirty (30) year old nulliparous delivered a
live male infant prematurely. On examination of the new
born, the Midwife did not detect testicles in the scrotum.
She would document her findings as …….
A. Spermatic cord
B. Crytorchism
C. Interstitial cryptorch
4. The testes reached an adult size at ……… years
A. 16
B. 14
C. 12
5. The following are factors involed in the transit if milk from
the secretory cells to the nipples EXCEPT:
A. Bringout reflex
B. Backward flow
C. Neurohormonal reflex
6. The upper expanded portion of the ureter which forms a
collecting area for the urine is referred as
A. Medulla
B. Pelvis
 C. Pyramid
7. Demadar Adade an 18 year old mother who delivered a
premature baby a month ago, reported back to the hospital
that baby easily chokes at feeds and the tongue also falls
back to occlude the airway, upon examination by the
midwife it was detected that baby has central cleft palate.
Which of the under listed describes baby’s condition?
A. Pierre Robin syndrome
B. Pyloric stenosis
C. Meconuim ileus
8. After the delivery of a baby, select the changes that occur
as soon as a baby is born?
A. Foetal circulation changes to adult circulation
B. There is too much air around the ward so baby feels cold
C. Blood floors from the night atrium to the left atrium
9. Which of the following BEST explains the anteversion and
anteflexion positon of the non-pregnant uterus?
I. Leans forward
II. Bends forward on itself
III. Leans backward
IV. Bends towards the side
A. III and IV
B. I and II
C. II and III
10. During the antenatal visit of Mrs. Riverson, the Midwife
that the symphisio-fundal height has become static and
mother has also lost weight. At birth, the baby was
diagnosed of intra uterine growth restriction. Which of the
following factors accounts for this condition?
A. Trauma
B. Chronic hypertension
C. Cervical incompetence
11. Which of the following other pelvic ligaments runs from
the sacrum to the ischial to the ischial tuberosity and the
sacrospinous ligament from the sacrum to the ischial
spine…… ligament
A. Sacroiliac
B. Sacrotuberous
C. Sacrospinous
12. Which of these ligaments arise from the cornua of the
uterus to be inserted into lebia majora?
A. Round ligaments
B. Utero-Sacral ligaments
 C. Broad ligaments
13. As a midwife working in the labour ward. How would you
diagnose a mother with placenta succenturiata?
I. Retained lobe when placenta is expelled
II. Fetal anoxia caused by pressure on extra lobe vessels
III. Two separate areas of placenta tissue develop
IV. There is an abnormality of cord insertion
A. III and IV
B. I and IV
C. I and II
14. A women is less than 1.50cm with a shoe size of less than
3, very short and stout but has previously delivered per
vaginum. Which of the following of pelvis does she have?
A. Roberts
B. Justominor
C. Naegele’s
15. Madam Juliet Antiaye, a 35 year old multiparous woman
reported to your facility for a routine gynecological
examination. She wishes to decrease her risk of developing
ovarian cancer. She does not desire pregnancy now but
does so in the future. You advise her that most appropriate
contraceptive management is
A. Combined oral contraceptives
B. Bilateral tubal ligation
C. Levonorgestrol intrauterine device
16. During a comprehensive sexual education (CSE) class, the
teacher informed the students that puberty is a process that
presents the individual into a state of being reproductive
maturity. The major hormonal event surrounding menarchy
involves the secretion of …….
A. Protein hormones
B. Luteizing hormones
C. Follicle stimulating
17. The midwife in a preconception class presented the
following as internal structures of the urinary system
I. Bladder
II. Cervix
III. Ureters
IV. Urethra
A. I, II and III
B. I, II and IV
C. II, III and IV
18. A typical pelvis with a narrow outlet and a heart shaped
 brim can be said to be
A. Android pelvis
B. Roberts pelvis
C. Anthropoid pelvis
19. Blood from the right atrium and pulmonary artery flow
through the …….. to the descending aorta
A. Foramen ovale
B. Ductus venosus
C. Ductus arteriosus
20. Your patient is a 30 year old G2P1 at week’s gestation.
She had a recent exposure to chickenpox. She reported to
your facility with a pruritic rash consistent with varicella.
While in triage the patient complained at shortness of
breath and cough. On examination, she has bilateral
crackles and rhonchi. Chest X-ray shows bilateral
infiltrates. You suspect varicella pneumonia. Which of the
following is the correct treatment?
A. Oral acyclovir
B. Varicella zoster immune glublin
C. Intravenous acyclovir
21. Mrs. Angela Mann, a 38 year old woman with a
mechanical mitral valve and chronic atrial fibrillation
presents with a complaint of excessive intermenstrual
uterine bleeding. She is not interested in any future
pregnancies and has been using contraception with her
partner without issue. What would be the best treatment for
this patient?
A. Hysterectomy
B. Depo-Provera
C. Endometrial ablation
22. A woman at 12 weeks gestational age presents to the
obstetrician with a hematocrit of 30%. She is diagnosed
with anemia. Which of the following values most likely
indicates iron deficiency anaemia?
A. Decreased iron level
B. Normal iron level
C. Decreased total iron bonding capacity
23. A 25 year old female with a history of Deep Vein
Thrombosis (DVT) discussed with the Midwife about her
plans of getting pregnant. She is currently on Warfarin.
This would be her second child, and she resembles her
obstetric history saying that she cannot be on Warfarin
while pregnant. Before switching her to heparin, which side
 effect well you counsel her about?
A. Fetal hypoplasia of nasal bones
B. Maternal thrombocytopria
C. Fetal blindess
24. The following are true about Braxton Hick’s contraction
EXCEPT
A. Can be stimulated towards the end of pregnancy by
abdominal examination
B. Believed to be progressively strong
C. Commerce in the cornua and are partially initiated be
peristatic action of the fallopian tubes
25. Which of the following human papillomavirus (HPV)
genotypes is most likely to cause a genital wart?
A. 6
B. 10
C. 8
26. A 16 year old girl delivered a baby girl in the labour of
your facility. The baby had an abdominal defect with
extrusion of bowels not covered by peritoneum. The baby’s
condition is likely to be which of the underlisted
conditions?
A. Exomphalos
B. Gastroschisis
C. Gastro malformation
27. A 25 year old woman who is G4P0 at 11 weeks gestation
presents for her initial prenatal visit. Her past obstetrical
history is significant for two early first trimester
termination with one requiring dilation and evacuation. It is
also significant for a subsequent spontaneous vaginal
delivery at 32 weeks two years ago. She denies any
pregnancy complications prior to her premature delivery.
Her greatest risk factor for preterm delivery is which of the
following? History of
A. Abnormal paps
B. Normal delivery
C. Preterm birth
28. During examination to assess a newborn with fractures,
the Midwife confirms fracture by noting which of the
following?
A. A “broken pot” sound is heard on examination
B. Severe reddening of the affected area
C. A “crack” sound is heard during delivery
29. The PH of the prostatic secretion is?
 A. 22
B. 66
C. 44
30. You attending the delivery of a 40 year old week woman.
The pregnancy was uncomplicated and all maternal
laboratory tests are negative. At delivery the infant is not
crying. When placed on the warmer her heart rate us 110
per minute. Her extremities are flexed and her torso is pink
but the hands and feet are dusky. Which of the following is
NOT a recommended technique to simulate spontaneous
respiration?
A. Rubbing her back
B. Spanking the bottom
C. Flicking of the soles
31. The following describes the cervical endometrium
EXCEPT:
A. Does not respond to hormonal stimuli of the menstrual
cycle
B. Epithelial cells are tall and columnar in shape
C. Forms a linning of ciliated epithelium on the base of
connective tissue
32. A baby born at home and was brought to your facility with
a history of inability to suck, but baby looks active.
Immediate action would be to:
A. Educate Mother on importance of breastfeeding
B. Positioning and attachment of baby to the breast
C. Admit baby to the ward
33. Which of the following would you do to initiate
respiration in baby you just delivered?
I. Gently stimulate the body by drying the baby
II. Clear the airway by suctioning mouth and oro pharyx
III. Tum baby with head downwards and rub the back
IV. Give oxygen using the ambu bag
A. I, II and III
B. I, III and IV
C. I, II and IV
34. A 30 year old multiparous woman with a history of
chronic hypertension discontinued her usual medications
when she realized she was pregnant. At her prenatal visit at
22 weeks of gestation, her blood pressure (BP) is 148/90
mmHg. Urine dipstick shows no protein. She reports no
other medical problems. The next best step in her
management is:
 A. Magnesium sulfate
B. Methyldopa
C. Continue with medication
35. Klumpke’s palsy results when mother go through difficult
labour. As a midwife on the ward how would you identify
Klumpke’s Palsy?
I. Paralysis of the shoulder and arm
II. Wrist and hands are paralyzed
III. Wrist drop and no gaps reflect
IV. 7 , 8 cervical and 1 thoracic nerve
th th st

A. I and II
B. I, III and IV
C. II, III and IV
36. Madam Enokaa, a 24 year old G2P1 reported to your
clinic for antenatal care at 10 weeks of gestation. During
history taken, Enokaa claimed she was pregnant when she
went to the emergency department for abdominal pain
about six weeks ago. She received an abdominal/pelvic
computed tomography (CT) scan. Unfortunately, her urine
sample was confused with another patient’s and read as
negative instead of positive. Whiles her urine pregnancy
test was actually positive. She concerned about fetal
radiation exposure. What do you tell her? Her fetus will
likely
A. Have intrauterine growth restriction
B. Experience no effect
C. Have microcephaly
37. A second year student asked the midwife what else the
hormone relaxin does apart from softening the joints of the
pelvis.
A. Ripens the follicle and allows it to rupture
B. Maintains the corpus luteum
C. Prepares the breast for lactation
38. The unique feature that differentiate caput succedaneum
from ceptal hamatoma is that Caput succedaneum
A. Cause by trauma
B. Does not cross suture line
C. Cross suture line
39. A 42 year old G3P3 with the history of bilateral tubal
ligation presents with complaints of irregular heavy
menses. She claims she menstruates every 27 to 60 days.
She has completed childbearing. She wishes to know what
is happening to her. Which of the following statements is
 NOT true?
A. Endometrial sampling should be taken to exclude
endometrial hyperplasia
B. Pregnancy testing should be performed at this visit
C. Endometrial ablation is a first line treatment option
40. Miss Ama Kodjie is in the first stage of labor and wants to
know what she can do to prevent pelvic floor trauma.
Which of the following is she to do?
I. Empty bladder every hour
II. Adopt kneeling position when there is the urge to bear
down
III. Perform pelvic floor exercises
IV. Encourage client to lie on her side with the urge to bear
down
A. I, III and IV
B. I, II and IV
C. I, II and III
41. In labour uterine contractions commence in the …….. of
the uterus
A. Body
B. Fundus
C. Cornua
42. As a newly qualified midwife on the ward, a mother
delivered a baby with severe asphyxia. You detected that
the asphyxia came about as a result of narcotic analgesic
given to the mother to relief pain during labor. What
medication would you administer to the baby to counteract
the effect of the maternal narcotic?
A. Naloxone hydrochloride
B. Adrenaline
C. Sodium bicarbonate
43. A 28 year old G4P4 delivered a 4.15kg live female baby
after pushing for 4 hours. The delivery was complicated by
a 45 second shoulder dystocia that resolved after the use of
McRoberts maneuver. Now that the epidural is wearing off
she is complaining of excruciating suprapubic pain. The
Midwife has already given her oral pain medications and
has emptied her bladder. Despite these efforts she continues
to report agonizing pain in the suprapubic region. Which of
the following is most likely to cause the findings on the
below X-ray?
A. Epidural use
B. Multiparity
 C. Shoulder dystocia
44. The anterior fontatlle is the part labelled
A. “c”
B. “A”

C. “F”
45. Mrs. Rebecca Ayim, is a 25 year old G3P2 with an
intrauterine death at 24 weeks gestation. Her past medical
history is significant for rheumatoid arthritis. Her obstetric
history is significant for one full term spontaneous vaginal
delivery, followed by a cesarean section at term for non-
reassuring fetal heart tones. She has no allergies. Her cervix
is closed, thick and high. What is best management for this
patient?
A. Induction of labour with oxytocin
B. Repeat cesarean section with low transverse
hysterotomy
C. Induction of labor with Misoprostol
46. A 25 year old woman has adjust undergone a gastric by-
pass surgery and presents to your clinic requesting
contraception. Medical history is negative for hypertension
and headache, and notable only for acne and irregular
vaginal bleeding secondary to known submucosal uterine
fibroids. She is mutually monogamous with one male
partner. The BEST contraceptive method for this patient is
A. Copper IUCD
B. Combination oral contraceptive pill
C. Norplant Levonorgestrel
47. Your patient is a 31 year old G1 with an intrauterine
pregnancy at 30 weeks gestation. She has a diagnosis of
pre-eclampsia. Her maximum blood pressure has been 140
systolic and 95 diastolic. She had a 24 hour urine protein of
400mg. her platelets, liver function, uric acid, and lactate
dehydrogenase are within normal limits. She is
asymptomatic, denying headache. If nothing changes with
 clinical picture, when should she be delivered?
A. 36 weeks
B. 35 weeks
C. 37 weeks
48. During Memuan’s third visit to the antenatal clinic her
scan revealed her placenta lies in the lower unterine
segment. This condition is known as…..
A. Placenta Previa
B. Placenta Abruptio
C. Placenta Valamentosa
49. Her lost in baby resulting from the passing of cool air over
the surface of the body is best deined as?
A. Conduction
B. Evaporation
C. Convection
50. Kofi was asked to identify any two hormones that
stimulates sperm maturation. His BEST answer was
I. Testosterone
II. Luteinizing
III. Follicle stimulating
A. I and II
B. II and III
C. I and III
51. The barthollin’s gland
I. Opens on either side of the vaginal orifice
II. Lie 2.5cm posterior to the clitoris
III. Lie in the posterior part of the labia majora
IV. Secret mucus which lubricates the vigina
A. II, III and IV
B. I, II and IV
C. I, II and III
52. The parts of the diagram labelled “D” and “E” are the
A. Frontal bones

B. Temporal bones
C. Parietal bones
53. Which of these muscles help to stabilize the sacroiliac and
sacrococygeal joins?
A. Licococygeus
B. Pubococygeus
C. Ischiococygeus
54. A 26-year-old Madam Aminatu gravidia 2 para 1 with 16
weeks’ gestation reported for routine prenatal visit. She is
interested in getting the CSM Vccination because of the
outbreak in her catment area. However, she is concerned
about recent media warnings she heard on the news about
the vaccination in relation to pregnancy. What is the best
line of action for Madam Aminatu?
A. Vaccination during the third trimester
B. Vaccination after delivery
C. Immediate vaccination
55. When preventing hypothermia in preterm infants the
midwife should focus on:
I. Kangaroo mother care
II. Keeping the room warm (25-28◦C)
III. Ensure adequate breastfeeding
IV. Put fan on low number
A. I, II and IV
B. II, III and IV
C. I, II and III
56. Madam Eno Edutse a 34-year-old nulliparous woman
reported to your facility with the complaint of worsening
dysmenorrhea for the last 8 months. She describes her pain
as beginning three days prior to the onset of menses and
peaks on the second day of bleeding. She reports the pain
as midline cramping persisting chronically at a low level.
She has no past medical or past surgical history. Physical
exam revealed small retroverted uterus and normal adnexa
bilaterally. Which of the following is the next best option
for this patient?
A. Deep Medroxyprogesterone acetate
B. Gonadotropin-releasing hormone therapy
C. Continued use of Oral Contraceptive Pill
57. Excessive (3+++) moulding could occur as a result
……………. the maternal pelvis
A. Reduced maternal inlet
B. Normal pelvic cavity
C. Narrow pelvic outlet
58. The tough fibrous covering he ovary is known as?
 A. Tunica Albuginea
B. Germinal epithelium
C. Medulla
59. The Midwife at the Antenatal clinic palpated the inguinal
region of the abdomen of a woman. During the examination
she told a group of student midwives that she was assessing
this ligament which becomes strained during pregnancy.
She is likely to be examining the …… ligament
A. Broad
B. Round
C. Uterosacral
60. A 20-year-old woman calls you to ask what she should do
after having unprotected intercourse 3 days ago. Her last
period was about 11 days ago and she is worried she might
get pregnant. You tell her the most effective recommended
emergency contraception would be?
A. Oral Syntocinon
B. Oral mifepristone
C. Oral levonorgestrol
61. The following conditions may be suspected in a baby who
fails to pass Meconium within 24hours of delivery
I. Mal rotations and volvulus
II. Meconium Ileus
III. Hirschprung’s disease
A. I and II
B. I and III
C. I, II and III
62. The testes is an oral structure suspended in the scrotum by
the spermatic cord. It measures about ……
A. 6cm long and 2.5cm in diameter
B. 5 cm long and 3 cm in diameter
C. 7.5cm long and 3cm in diameter
63. The term Thelarche in sexual maturation can be explained
as ….
A. The beginning of breast development
B. The beginning of endometrial growth
C. Process of ovarian maturation
64. A teenage girl aged 14, a JHS pupil, asked the big sister to
describe to her the situation of the breast. The breast can be
said to be situated by
A. Internal mammary glands
B. Suspensory ligaments
C. Axillary of space
65. Madam Amasa Adongo a puerperal mother in the lying in
ward drew the attention of the midwife that her baby’s eyes
became Jaundiced on the 3 day Post Natal. The Midwife
rd

will explain to the mother that Jaundice occur as a result of

A. Exposure to morning sun
B. Medication taken by the mother
C. Increase red blood cell breakdown
66. Which of these deep pelvic floor muscles is the most
important?
A. Iliococygeous
B. Pubococygeus
C. Ischiococygeous
67. A 28-year-old Akafia Afedo G2P1 at 39 weeks of
gestation is undergoing a trial of labor after previous
cesarean delivery. Her first child was a breech delivery
weighing 3.5kg at 37 weeks of gestation, and the operative
report confirms that she had a low transverse incision.
During the trial of labor, the most common sign of uterine
rupture is
A. Loss of fetal station
B. Sudden pain between contractions
C. New onset of severe thing pain
68. Intra uterine infections occur due to early rupture of
membranes and pre-existing maternal infections when
untreated, it may result in the following
I. Intra uterine fetal death
II. Premature labor
III. Chromosomal defects
IV. Intra uterine growth retardation
A. I, II and III
B. I and II
C. I, II and IV
69. A nulliparous woman delivered in your maternity unit a
few hours ago. During the initial bath, the Midwife
detected an abnormal physical appearance with low birth
weight of 1.5kg. on interviewing the mother, she stated that
she didn’t know she was pregnant unit nearly 32 weeks and
so had not had prenatal care prior to delivery. She has a
history of hypertension, Epilepsy, and Depression. Which
of the under listed could be a case of the Baby’s condition?
A. Cigarette Smoke
B. Alcohol
C. Phenytoin
70. A 35-year-old breastfeeding mother, Ayishetu Mumbi
reported for post-natal care. During counseling, she showed
interest in family planning and wanted to know when is the
earliest time she can start combined oral contraceptive pills
without any
A. 2 days
B. 7 days
C. 21 days
71. Which of the following types of pelvis has/have one or no
wings?
I. Justominor
II. Robert
III. Naegele
A. I and III
B. I and II
C. II and III

72. A diabetic mother delivered a large for date baby on the

ward and a student midwife asked for the reason behind
large babies?
A. Hyperinsulinism
B. Polycythaemia
C. Depressing of fats
73. The part of the diagram labelled “4” provides surface for
attachment of ……

A. Placenta
B. Ovum
C. Sperm
74. A 23-year-old nulliparous patient presents for
contraceptive counselling. She is about to start medical
school and does not plan on getting pregnant for many
years. Her past medical history is notable for epilepsy, first
diagnosed as a child. She has been on various mediations to
control her symptoms over the years but has been well
controlled on carbamazepine for the last two years. She
prefers oral contraceptive. Given her history of epilepsy
you recommend intrauterine device contraception because
A. The metabolic interaction between antiepileptic and oral
contraception reduces the effectiveness of the oral
 contraception
B. The metabolic interaction between antiepileptic and oral
contraception is harmful to the liver
C. The metabolic interaction between antiepileptic and oral
contraception results in increased seizure activity
75. Which of following are the reasons for exchange blood
transfusion in the new born?
I. Correct anaemia
II. Decrease high serum bilirubin
III. Increase blood volume
IV. Remove foetal antibodies
A. II, III and IV
B. I, II and IV
C. II, III and Iv
76. A postpartum ward nurse calls to tell you that the patient
you delivered at term 12 hours ago has a temperature of
38.30C. She lost an estimated 800mls of blood. You
reviewed her chart and medical history. The best next step
in management is
A. Broad-spectrum antimicrobial coverage
B. Examination of the patient
C. Acetaminophen and observation
77. Madam Adwoa Omuku is a 23-year-old nullipara reported
to your facility to preconception counselling. She has
phenylketonuria
A. 2 months
B. 1 month
C. 3 months
78. In an anatomy class a 2 year student midwife asked why
nd

babies suckle at breast when lactation has not been

established. The tutor answers
A. Suckling at the breast causes prolactin to be released
B. Suckling at breast satisfies both baby and mother
C. When baby does not suckle ovulation occurs early
79. Madam Esi Animah a 29-year-old sexually active woman
reported to the OPD with mild lower abdominal pain and a
temperature of 38.4◦. Physical examination revealed
cervical tenderness, uterine and adnexal tenderness, and
mucopurulent vaginal discharge. Laboratory results
confirmed elevated WBC’s on microscopic exam of the
vaginal discharge, elevated ESR and vaginal culture was
also positive for gram-negative diplococci. What is the
most likely diagnosis?
 A. Cervical dysplasia
B. Tubo-ovarian abscess
C. Acute salpingitis
80. In early Neonatal life, the Gutherine test is done by
obtaining a blood sample from a heel prick. This is a
diagnostic test to determine Neonates which of the
following condition?
A. ABO incompatibility
B. Kernicterus
C. Phenylketonuria
81. Which of the following longitudinal diameter presents
when the head is partly extended?
A. Occipitofrontal
B. Submentovertical
C. Mentrovertical
82. Which of the following is the most common complication
following epidural or spinal anesthesia for obstetric
purposes?
A. Spinal hematoma
B. Transient hypotension
C. Chronic low back pain
83. To prevent traumatic birth injury, consideration of
cesarean delivery is recommended in women with diabetes
with estimated fetal weight of ……...
A. 4kg
B. 3.5kg
C. 4.25kg
84. Auntie Ataa, a 34-year-old G1 at 31 weeks’ gestational
age presents to the labor ward complaining of painful
contraction of every 5 minutes. The pregnancy has been
umcomplicated, she has had good fetal movement. There is
no vaginal discharge, leakage of fluid or vaginal bleeding.
She started feeling unwell for the past week. She has
decreased appetite, but has no nausea, vomiting or diarrhea.
How will you manage Auntie Ataa?
A. Administer Intravenous ampicillin and gentamicin
B. Administer intravenous infusion
C. Refer her to the Gyaenecologist
85. Madam Kamah Abremaa delivered a preterm baby at 37
weeks’ gestation. The obstetrician suspected baby has
Horner’s syndrome. One of the under listed will confirm
the diagnosis EXCEPT
A. Drooling eyelid
 B. Swelling on the affected part
C. Construction of pupil
86. Which of the following is likely the most important
predictor of cerebral injury and infarction in a patient with
hypertensive emergency in pregnancy?
A. Degree of diabetic hypertension
B. Relative increase of mean arterial pressure from baseline
C. Degree of systolic blood hypertension
87. You are at the delivery of a 38-week female infant. The
mother has elected not to receive an epidural. Her pain has
been well controlled with intermittent does of Pethedine. At
delivery the infant is limp and blue. She is placed on the
warming table where she is quickly dried and the mouth
and nose suctioned. At one minute of life she remains limp
with peripheral cyanosis and no respiratory effort. Her
heart rate us auscultated at 55 beats per minute. The infants
still no chest rise or crying. Which of the following is the
next best step?
A. Administer epinephrine 0.01 mg/kg IV
B. Administer normal saline 10ml/kg IV over 5 minutes
C. Administer naloxone 0.1 mg/kg IV
88. Maame Esivi complained of changes in the length of her
menstrual cycle. Which of these phases is likely to cause
the change?
A. Regenerate
B. Secretory
C. ovulation
89. Baby Neequaye was delivered premature has less body
fat, in order to prevent the baby from getting hypothermia
the mother should encouraged to/do
A. Kangaroo care
B. Keep the room warm
C. Ensure adequate breastfeeding
90. Auntie Joe Quayson delivered a 40-week old male infant.
The delivery was complicated by heavy bleeding. After
delivery the infant breathing was normal with pinkish color.
Which of the following routine actions is the most
appropriate intervention of the Midwife?
A. Give rescue breathes using a ambu bag
B. Dry the infant gently and discard the wet linens
C. Start chest compressions at a rate 60 compression per
minute
91. Which of the following is the most common complication
 of circumcision?
a. Removal of excessive skin
b. Injury to the glands of the penis
c. Bleeding

92. Baby Johnson was delivered with severe neonatal

asphyxia. He was later diagnosed with meconium
aspiration syndrome. The midwife odserving her will look
out for which of the following sign?
i. Cyanosis
ii. Barrel snapped chest
iii. Chest retractions
iv. Labour respiration
a. I, ii and iv
b. I, ii and iv
c. I, ii and iii
93. Mrs akama billy a rhesus negative mother, was asked by
the midwife in-charge of the antenatal clinic to buy anti-D
immunoglobulin to be given to her after delivery. As a
midwife in-charge of the labour ward, your Rhesus
negative mother has delivered successfully. Which of the
following sites of injection would you select for the optimal
absorption of the Anti-D.
a. Deltoid muscle
b. Ventro gluteal
c. Dorsogluteal
94. You are at the OPD when a mother reported at the clinic
with her 2 weeks old baby referred from a private clinic.
The referral notes read; ‘’baby is not feeding, too hot to
touch, has convulsions and no movements as well as having
chest in-drawing’’. Upon assessment of the baby, you may
classify these signs and symptoms as……..
a. Danger signs.
b. Epileptic attack
c. Infections in the neonate
95. Which of the ligament extends from the sides of the cervix
and the vagina to the side of the pelvis.
A. Mackenrodst’s
B. Uterosacrat
C. Round
96. Which of the following is not an element of effective
chest compressions during the resuscitation of a newborn?
A. Compressions should be to a depth of about two thirds
 of the anterior-posterior diameter of the chest
B. Compressions should be delivered on the lower third of
the stemum
C. The chest should be allowed to re expand fully between
compressions
97. Infibulation is a type female circumcision in which
……………… is removed.
a. Part or whole of labia minora and clitoris
b. Fold of labia minora.
c. Clitoris labia minora and2/3 of labia majora.
98. You are speaking with expecting parents. They are trying
to decide if they should circumcise their son after birth and
want to know more about the benefits. Which of the
following is the major benefits of circumcision during
infancy?
a. Reduction in urinary tract infection
b. Reduction in sexually transmitted infections
c. Reduction in penile cancer
99. At the back of the uterus the peritoneal membrane dips
low into the pelvic and forms……
a. Vaginocervical pouch
b. Rectovaginal pouch
c. Rectocervical pouch
100. Premature babies lack surfactants in their lungs hence
they develop respiratory distress syndrome. Which of the
medications outlined below would be prescribed to help in
the maturity of the baby’s lungs?
a. Hydrocortisome.
b. Dexamethasone
c. Adrenaline.
101. Which of the following ligaments are another on the
ovary to the pelvic wall
a. Ovarian ligament
b. Suspensory ligament
c. Round ligament
102. In your daily examination of the babies at the nursery,
you noticed a baby presents with moist papular or
vesicular skin rash in the axillae, neck, perineum and
unbilical region. These rashes colud be explained to the
mother as
a. Chlamydia infection
b. Cutaneous candiasis
c. Cutaneous land migrans
103. A 38 year old woman a complaint of excessive
intermenstrual uterine bleeding. She is not interested in any
future pregnancies and has been using barrier contraception
with her partner without issue. What would be the best
treatment for his patient?
a. Depo-provera
b. Tubal ligation
c. Hysterectomy
104. Baby dotty, a 2 weeks old baby after discharge was
brought back to the clinic with moist papular rash at the
axillae, neck, perineum and umbilicus. The baby is likely to
be suffering from ……………………………..
a. Cutaneous candidiasis
b. Systemic candidiasis
c. Staphylococcal infections
105. The following are all features of the post baby
EXCEPT:
I. Dry peeling skin
II. Abundant scalp hair
III. Maximum fat deposit
a. I, ii and iv
b. I, ii, and iii
c. Ii, iii and iv
106. Mother are encouraged to feed babies solely on the
breast for six months because the breast milk contains anti-
infecctive factors. Which of these promotes the growth of
gram positive bacilli in the gut of the baby?
A. bifidus factor
B. lysozyme
C. growth factors
107. ringer’s lactate infusion is useful for which of the
following indication?
a. To reduce risk of fetal distress in mothers with
meconium-strained fluid.
b. To increase risk of caesarean section for ‘’suspected fetal
distress’’ with variable decelerations
c. To increase recurrence of variable accelerations.
108. The following are superficial pelvic floor muscles
EXCEPT
A. External anal sphincter
B. Transverse perinei
C. Ischiococcygeus
109. You are seeing a 3 day newborn. The mother is
 concerned about a rash. The infant has multiple lesions that
look like pustules on the neck and the face and spreading to
other part of the body. You tell the mother that the rash is
a. Pityriasis rosea
b. Pemphigus neonatorum
c. Erythema toxicum
110. You will differentiate the two (2) obstetrical fontanellers
by the following EXCEPT:
A. Time Of Formation
B. Shape identified
C. Size in dimention
111. Madam ama Deborah G2P1, aged 25 report for antenatal
care. The obstertrician requested for an abdominal scan on
suspicion of a developmental. Ultrasound scan revealed an
abnormality on the fetal face. What is the most likely
diagnosis?
a. Facial cleft
b. Anecephaly
c. Micrognathia
112. This single layer of cells forms around the blastocyst?
a. Syncytiotrophoblast
b. Trphoblast
c. Cytotrophoblast
113. After devlivery of a foetal macrosomia, the midwife
realized that the baby has Erb’s palsy. How best would you
explain Erb’s palsy to a junior staff who does not
understand the term?
a. Facial palsy
b. Caput succedaneum
c. Erb’s palsy
114. Mrs. Anokye Avornyo, 32-year-old G2P2 is being
hospitalized with her day old new born after an
uncomplicated vaginal delivery at 39 weeks. She
complained of fever, cough, cold, loss of appetite and
muscle aches. The patient is breastfeeding. Which of the
following will be the best option for mother and child?
a. Send baby to NICU and take care of the mother
b. Carry out laboratory investigation.
c. Conservative management of symptoms.
115. Baby kuma, a 4 week old baby girl is brought to your
clinic by her mother on account of feeding problems. She is
on exclusive breastfeeding and tolerating feeds until about
1 week ago when she became very irritable while feeding
 and started vomiting multiple times a day after her feeds.
The baby is very irritable during the physical examination.
Vitals signs taken and recorded as follows: heart rate:
175bpm, respiration 70bpm. What will be your first line of
action as the midwife?
a. Encourage mother to breastfeed
b. Counsel mother and refer
c. Give ORS
116. Madam Adjoa Mansah, a primigraravida who delivered
two weeks ago want to know where milk is stored in the
breast. The midwife will describe it as
a. A central duct into which the tubules run
b. Smalls duct which connect the aveoli
c. Widened – out portion which lies under the ampulla
117. Hajiah mamata a Rhesus negative mother was by the
midwife in-charge of the antenatal to buy Anti-D
immunoglobulin to be given to her after delivery. The
mother wants to know why the Anti-D immunoglobulin?
a. Will help the new born to survive.
b. Prevent rhesus isoimmunisation
c. Destroys any foetal cells in the mothers blood
118. The foetal membranes which run horizontally at right
angle to the falx cerebri, and shaped as horse shoe which
divides the cerebrum from the cerebellum is known as
……….
a. Felx cerebri
b. Tentorium cerebelli
c. Inferior longitudinal sinus
119. A 27 years old G3P0 underwent left salinggostomy for a
ruptured ectopic pregnancy three weeks ago. The surgery
was uncomplicated and the operative report describe
evacuation of the entire pregnancy through a
salpingostomy. She reported back two weeks post-
opratively and complained of lower abdominal pain and she
claims she still feel signs of pregnancy, you suspect an
ongoing ectopic pregnancy. What is your next best step in
management?
a. Immediate surgical intervention
b. Obtain a pelvic ultrasound
c. Repeat HCG in hours.
120. The two main types of phototherapy commonly used for
neonates are …………………………
a. Conventional and fibre optic mattresses
 b. Fibre optic and turquoise
c. Conventional and fibre optic

121. A 35 year-old mrs. Emilia kowajet, gravida 1, at 38

weeks of gestation requires a caesarean delivery for an
active phrase arrest. Her body mass index (BMI) is 45. She
undergoes the caesarean delivery through a Pfannensteil
incision. The surgical technique or option that is most
likely to prevent would breakdown is
a. Skin closure with staples
b. Placement of a subcutaneous drain
c. Subcutaneous closure
122. Ms adzo lolo reported at your clinic with the complaints
of dull, cramp-like lower abdominal pain that occurs during
ovulation. In assessing her which of the following would
you suspect Ms lolo is having?
a. Mettelschmerz
b. Dysmenorrhoea
c. Spinnbarkheit
123. Midwifery student came on a visit to your ward. They
asked about the primary source of progesterone in the later
stage of pregnancy. Your best response will be.
a. Corpus luteum
b. Endometrium
c. Placenta
124. The amniotic fluid has a lot of properties that helps the
baby. The following are some of the function EXCEPT.
I. Maintains constant intrauterine temperature.
II. Allows the free movement of the fetus.
 III. Fluid is clear and slightly alkaline.
IV. Aids in effacement of cervix
a. I, ii and iv
b. Ii, iii and iv
c. I, ii and iii
125. Which of the following is the most important advice to
reduce mortality in infancy?
a. Infants should be placed on their back to sleep.
b. The rotavirus vaccine series should be administered
between 6-12 weeks of age.
c. Infants should be placed in the prone position.
126. Which of the following hormones forms the basis of
many pregnancy test available as it is excreted in the
mother’s urine.
a. Human chrionic gonadotropin (HCG).
b. Human placenta lactogen (HPL)
c. Progesterone
127. Fetal blood, low in oxygen is pumped by the fetal heart
towards the placenta along the ………….
a. Umbilical veins
b. Umbilical arteries.
c. Chorionic vili
128. Restriction of sacral movement is controlled by the
following ligament EXCEPT
a. Sacrococcygeal
b. Sarospinous
c. Sacrotuberous
129. The following are all types of contracted pelvis EXCEPT
A. Anthropoid
B. Naegele’s
C. Robert
130. Which of the labelled part closes by six (6) weeks after
birth?

a. ‘’A’’
b. ‘’F’’
c. ‘’C’’
131. Mrs. Allottey is worried about the wellbeing of her
foetus, she is 24weeks and thinks the abdomen is too small.
What will be the appropriate response in assessing foetal
wellbeing?
a. Your baby’s heart rate is between 110-160 beats per
minute.
b. Your baby’s movement does not follows a regular pattern
c. You are growing too fat so the foetus is not getting
enough space
132. A placenta with two complete and separate parts each
and a cord leaving it is known as.
a. Valementous insertion of the cord
b. Battledore insertion of the cord
c. Bipartita placenta
133. A 24year old G2P1 reported to the labour ward at 39
weeks of gestation. She recently moved into the area at 37
weeks and tells you her doctor had called her and let her
know that her genital culture was positive for group B
streptococci. She has a history of penicillin allergy with
anaphylaxis. You are unable obtain the culture report. What
is the best antibiotic for her?
a. Clindamycin
b. Erythromycin
c. Vancomycin
134. Which of the following may improve fetal oxygenation
in labour?
a. Maternal lateral positioning
b. Panting
c. Intravenous fluid
135. Your patient is a 14 year old female who has never been
sexually active. She has a recent diagnosis of human
immunodeficiency virus (HIV) which was acquired during
a blood transfusion after a motor vehicle accident. When is
co-testing with cervical cytology and human papilloma
virus (HPV) testing recommended for this patient if the
initial cytology is negative?
a. Age 21
b. Age 25
c. Age 30
136. Which of these structures release a small amount of fluid
prior to ejaculation which lubricates the penis facilitating
its entry into the vagina
a. Prostate gland
 b. Epididymis
c. Bulb0-urthral gland
137. At the labour ward, a baby was born to a 16year old ama
mansah. during head to toe examination of the baby, the
midwife realised that baby had copious amount of mucus,
effect made to pass nasogastric tube could go just 10-12cm.
what condition could this baby be suffering from?
a. Imperforate anus
b. Rectal atresia
c. Oesophageal atrsia
138. Which of these layers of the fallopian tube undergoes a
slight hypertrophy during the menstrual cycle
a. Connective tissue
b. Muscular layer
c. Ciliated epithelium
139. Baby ansah who was delivered 2 weeks ago, failed to
establish spontaneous repiration and was diagnosed as
aspiration neonatorium. The midwife resuscitated the bady
for a few minutes before baby established its spontaneous
respiration. How would you explain the major cause of this
condition in the baby?
a. Blockage of trachea by blood and mucus
b. Tight cord around baby’s neck
c. Utrine contractions during labour.
140. A 34 year old woman is getting ready for infertility
treatment. Part of your counsel involve reducing the risk of
having baby with a nueral tube defect by taking a
supplement containing:
a. Pyridoxine
b. Thiamine
c. Folic acid
141. Which of the following conditions is likely to occur
when normal healthy parent each having cystic fibrosis on
a recessive gene is inherited by a male child?
a. Haemophilia
b. Sterility
c. Achondroplasia
142. When giving education to the newly delivery mothers at
the postnatal clinic on danger signs among the new born,
the midwife would lay emphases on one of the underlisted
a. Jaundice appearing at soles and palms
b. Rashes on the skin including chest
c. Jaundice of the face and eyes
143. Which of the following statement is incorrect?
a. Women diagnosed with acute pelvic inflammatory
disease should be tested for gonorrhoea / chlamydia and
screened for HIV.
b. Outpatient therapy for pelvic inflammatory disease
requires follow-up with a clinician to confirm
improvement of symptoms.
c. Pelvic inflammatory disease should be treated with a
single antibiotic to reduce drug-resistant organisms.
144. Abnormal placentation, in which the placenta grows
through the myometrium and serosa, and sometimes into
adjacent organs, is best described by which of the following
terms
a. Placenta previa
b. Placenta increta
c. Placenta precreta
145. The bregma is the protion that can be used to depict if a
child is dehydrated. As a newly qualified d nurse how can
you determin this?
a. By pressing you fingers against the part to feel for domed
shaped or depression
b. By observing with eyes to see if the part is domed
shaped
c. By placing your fingers slightly over the part to feel for
depression
146. These ligaments link the sacrum and the innominate
bone
i. Sacroiliac
ii. Sacrospinous
iii. Sacrotuberous
a. Ii and iii
b. I and ii
c. I and iii
147. The causes of convulsion in the neonate includes all the
following EXCEPT
A. Worn infestation
B. Kinecterus
C. Congenital abnormalities
148. The preterm baby has a lot of potential problems. Baby
teye is one of the baby’s and the mother is having problems
feeding him. All the responses below are some of the
problems with their feeding EXCEPT
A. Weak urethra
 B. Weak abdominal muscles
C. Strong abdominal muscles
149. The following are characteristics of a woman with
platypelloid pelvis EXCEPT:
A. Engagement of the fetal head may necessitate lateral
tilting, known as asynclitism
B. Woman with this type of pelvis tend to be tall with
narrow sholuders
C. The ischial spines are blunt and aciatic notch and the
sub-public are both wide
150. The primary action of the hormone human chorionic
gonadotropin is………………...
a. Sustaining of fertilized ovum
b. Ripening the endometrium
c. Maturation of graffian follicle.
151. A 58-year-old Mrs. Janet Onukpa has been treated for
several months for chronic candidiasis despite negative
vaginal culture results. The patient has intense valva pruntis
and moderate dyspareunia. On examination, you find the
presence significant adhesions at the clitoris that clitoris
that were not previously documented. Your next step in the
treatment of this patient would be …………
A. Anti-viral
B. Anti-bacterial
C. Anti-fungal
152. When a woman with Rhesus negative (Rh) blood type
deliver a baby with a Rhesus positive (RH) type, what
condition can the baby develop?
A. Physiological jaundice
B. Haemclytic jaundice
C. RHD incompatibility
153. Which of the following would you EXCLUDE in
diagnosing a Justo minor pelvis?
A. Short statured woman
B. Gynaecoid shape
C. Cavity of 12cm dimension
154. Your patient is a 19-year-old female recently diagnosed
with uncomplicated urogenital gonorrhea. She and her
partner were both treated today with ceftriaxone and
Azithromycin. What is the minimum amount of time they
need to wait before resuming intercourse? …….. days
A. 7
B. 5
 C. 9
155. Yaa Basua a 24-year-old has just delivered and you
overhead the grandmother complaining that mothers of
today don’t want her baby’s head to be moulded. What
advice would give the grandmother to prevent her from
using hot water on baby’s head leading to premature
closure of the frontanelles.
I. The frontenelles allows for growth of the brain
II. The frontanelles has to close gradually.
III. It will widened when hot water is applied
IV. It also to diagnose pre and post maturity
A. I, II and IV
B. I, II and III
C. II, III and IV
156. What is a good option for the treatment of pregnant
women with flu-like symptoms with joint pains?
A. Doxycycline for 4-6 weeks
B. Amoxicillin for 4-6 weeks
C. Amoxicillin for 1 week
157. Which of the following layers of the developing embryo
forms the epithelial lining of the digestive, respiratory and
urinary system as well as the liver and pancreas
A. Mesoderm
B. Ectoderm
C. Endoderm
158. The condition found in newborn where the testicles
failed to distend at birth is termed?
A. Hypospadia
B. Cryptorchism
C. Abigious gentialia
159. Which of the following is NOT a landmark of the pelvic
cavity?
I. Hollow of sacrum
II. Lower border of the sacrum
III. Body of the pubic bone
A. I and III
B. I and II
C. II and III
160. Baby Bruwaa, 10 days who was diagnosed of intestinal
volvulus has undergone surgery. Baby is crying due to pain
at the wound site. Which pharmacological measure would
employ to manage her pain?
A. Administer pethidine
 B. Breastfeeding immediately
C. Give sucrose solution
161. The bones of the vault of the fetal skill are the following
EXCEPT
I. Temporal
II. Frontal
III. Occipital
IV. Parietal
A. I, II and IV
B. I, II and III
C. II, III and IV
162. A 36-year-old, nonlactating woman presents with a 2-
montth history of bloody nipple discharge from her left
breast. No mass is palpable on physical examination. What
is the MOST appropriate management?
A. Diagnostic mammography with ultrasound
B. Measure serum prolactin and TRH levels
C. Observation alone
163. Mrs. Arumo Osei, a 53 year old woman with a history of
estrogen dependent breast cancer is experiencing atrophy-
related urinary symptoms and asks your opinion regarding
treatment. Which of the following do you tell her?
A. Non-hormonal treatments are first-line, and vaginal
estrogen should never be used due to increased risk of
cancer
B. Non-hormonal treatments are first-line with vaginal
estrogen reversed for those patients unresponsive to non-
hormonal treatment
C. Vaginal estrogen is first line, with non-hormonal
treatments reserved for those patients unresponsive to
non-hormonal treatment
164. You are attending the delivery of a term male infant. At
delivery he has an irregular cry, a heart rate of 100 beats
per minute, is actively moving all his extremities with
peripheral cyanosis. When placed on the warming table for
dying he sneezes. What is the correct APGAR score at 1
minute?
A. 6
B. 7
C. 8
165. The following principles are recommended during drug
administration in pregnancy to prevent Teratogenic effects
I. Avoid medications where possible during the first
 Trimester
II. Do not stop long term medications abruptly
III. Be informed of possible risk in medications
administration
IV. Choose safe drug options in the first Trimester where
possible
A. I, III and IV
B. I, II and III
C. I, II, III and IV
166. Your patient is an 18-year-old, in whom you, recently
placed an intrauterine device (IUCD) for contraception.
Prior to placement, you performed cervical swabs for
gonorrhea and chlamydia. One week later, her chlamydia
test returned positive. Which of the following is the next
best steps?
A. Leave the IUCD in place and treat the infection
B. Remove the IUCD, but do not treat the infection
C. Remove the IUCD and treat the infection
167. Which of these develop to form the lower uterine
segment?
I. Cavity
II. Isthmus
III. Cervix
IV. Corpus
A. III and IV
B. II and III
C. I and III
168. Which of these would be done when the rooting reflex in
a baby?
A. Place a finger in the baby’s mouth
B. Touch the side of baby’s lips
C. Place a finger in the baby’s palm
169. Which of the following is inappropriate advice for new
parents trying to calm a fussy infant?
A. Carny with the baby
B. Shake the baby
C. Breastfeed the baby
170. The advantages of episiotomy includes
I. Prevention of extensive perineal trauma and protects the
anal sphincter muscles
II. Reduction of compression of fetal skill
III. Causation of more painless delivery
IV. Prevention of post-natal laxity of the pelvic floor
 A. I, II and IV
B. I, II and III
C. II, III and IV
171. A 22-year-old woman presents with a purulent vaginal
discharge 1 week after having sexual intercourse for the
first time with a new boyfriend. She stated that he informed
her in retrospect that he had felt burning sensations with
urination. She is asymptomatic. At the time of pelvic
examination, cervical testing is performed for Neisseria
gonorrhea and Chlamydia trachomatis. The gonorrhea test
is positive. She has no known allergies. What should you
prescribe?
A. Doxycycline
B. Erythromycin
C. Ceftriaxone and Azithromycin
172. During a discussion on the structures of the ovary on the
ward, the midwife explained that the tunica albuginea is
covered by ……...
A. Surface epithelium
B. External epithelium
C. Internal epithelium
173. The intracranial sinus that is likely to bleed more when
there is tear in the tentorium cerebelli is the ……………
A. Superior sagittal sinus
B. Confluence of sinuses
C. Lateral sinus
174. The vesicular follicles which have a fluid cavity called
the antrum is also known as ………… follicles.
A. Tertiary
B. Secondary
C. Primary
175. Which of the following is not a type of episiotomy
incision?
A. Mediolateral
B. Lateral
C. Medial
176. Baby Fusena was delivered at 38 weeks’ gestation and
weighed 1500g at birth. The baby could best be described
as:
A. Very low birth weight
B. Extremely low birth weight
C. Low birth weight
177. Which of the following is an indication for cerclage
 placement in a pregnancy?
A. Current singleton pregnancy, prior spontaneous preterm
birth less than 37 weeks’ gestation and short cervical less
than 2.5cm before 24 weeks’ gestation
B. History of one or more second trimester pregnancy
losses related to painless cervical dilation in the absence
of labour or placental abruption
C. Current singleton pregnancy, prior spontaneous preterm
birth less than 34 weeks’ gestation and short cervical
length lass than 3cm before 24 weeks’ gestation
178. Immediately after delivery of baby Mansah, the Midwife
observes an oedamatous baby a large pale waterlogged
placenta. The baby was diagnosed to have severe
haemolytic disease of the newborn. This type of haemolytic
disease is known as
A. Haemolytic jaundice
B. Erythroblastosis fetalis
C. Hydrops fetalis
179. The following are associated with an increase risk of
malignant change in a woman with molar pregnancy
EXCEPT
A. Partial Hydatidiform mole
B. Maternal age more than 39 years
C. The woman with blood group A and blood group O.
180. During puberty the part labelled “7” produces the hormes
A. Prolactin and oestrogen
B. Prolactin and aldosterone
C. Oestrogen and progesterone