CA MCHN Prelim

1. What is the average age of menarche?
   A. 10 years
   B. 12.4 years
   C. 14 years
   D. 16 years

B. 12.4 years

2. Average length of a normal menstrual cycle is:
   A. 14 days
   B. 21 days
   C. 28 days
   D. 35 days

C. 28 days

3. The average length of menstrual flow is:
   A. 1–2 days
   B. 2–9 days
   C. 10–12 days
   D. 14 days

B. 2–9 days

4. Which hormone is responsible for the development of the Graafian follicle?
   A. LH
   B. FSH
   C. Progesterone
   D. Estrogen

B. FSH

5. Ovulation occurs around which day of a 28-day cycle?
   A. Day 7
   B. Day 10
   C. Day 14
   D. Day 21

C. Day 14

6. Mittelschmerz is a sign of:
   A. Menstruation
   B. Ovulation
   C. Implantation
   D. Fertilization

B. Ovulation

7. The uterine cycle phase associated with estrogen dominance and endometrial thickening is:
   A. Secretory phase
   B. Proliferative phase
   C. Ischemic phase
   D. Menstrual phase

B. Proliferative phase

8. The ischemic phase of the endometrium occurs if:
   A. Estrogen rises
   B. Fertilization occurs
   C. Fertilization does not occur
   D. FSH rises

C. Fertilization does not occur

9. The hormone primarily responsible for maintaining pregnancy in early stages is:
   A. Estrogen
   B. Progesterone
   C. FSH
   D. LH

B. Progesterone

10. The corpus luteum degenerates into:
    A. Corpus cavernosum
    B. Corpus albicans
    C. Corpus callosum
    D. Corpus medulla

B. Corpus albicans

11. Breast tenderness and amenorrhea are considered:
    A. Probable signs
    B. Presumptive signs
    C. Positive signs
    D. Diagnostic signs

B. Presumptive signs

12. Chadwick’s sign refers to:
    A. Softening of the cervix
    B. Bluish discoloration of the vaginal mucosa
    C. Uterine contractions
    D. Quickening

B. Bluish discoloration of the vaginal mucosa

13. Hegar’s sign is:
    A. Softening of the cervix
    B. Softening of the uterine isthmus
    C. Palpable fetal outline
    D. Audible fetal heart tone

B. Softening of the uterine isthmus

14. Positive signs of pregnancy include:
    A. Amenorrhea and quickening
    B. Uterine enlargement and Chadwick’s sign
    C. Fetal heartbeat on Doppler and ultrasound visualization
    D. Nausea and vomiting

C. Fetal heartbeat on Doppler and ultrasound visualization

15. Quickening usually occurs at:
    A. 8 weeks
    B. 12 weeks
    C. 16–20 weeks
    D. 28 weeks

C. 16–20 weeks

16. Which of the following is a probable sign of pregnancy?
    A. Fetal heart tones
    B. Braxton Hicks contractions
    C. Breast fullness
    D. Fatigue

B. Braxton Hicks contractions

17. Melasma during pregnancy is also called:
    A. Linea nigra
    B. Striae gravidarum
    C. Chloasma
    D. Goodell’s sign

C. Chloasma

18. The earliest laboratory test to detect pregnancy is:
    A. Blood test
    B. Urine test
    C. Ultrasound
    D. Progesterone withdrawal test

A. Blood test

19. The fetal heart can be heard by Doppler as early as:
    A. 6–8 weeks
    B. 10–12 weeks
    C. 14–16 weeks
    D. 20 weeks

B. 10–12 weeks

20. The mucus plug formed during pregnancy is also known as:
    A. Operculum
    B. Nidation
    C. Vernix
    D. Chorion

A. Operculum

21. A pregnant woman at 20 weeks has the fundus at:
    A. Symphysis pubis
    B. Umbilicus
    C. Xiphoid process
    D. Pubic arch

B. Umbilicus

22. Colostrum may be expressed as early as:
    A. 8 weeks
    B. 12 weeks
    C. 16 weeks
    D. 20 weeks

C. 16 weeks

23. Supine hypotension syndrome occurs due to:
    A. Compression of the aorta by uterus
    B. Compression of the inferior vena cava
    C. Reduced hemoglobin levels
    D. Increased BP

B. Compression of the inferior vena cava

24. The best nursing intervention for supine hypotension is:
    A. Place in right lateral position
    B. Place in left lateral position
    C. Encourage ambulation
    D. Increase oral fluids

B. Place in left lateral position

25. A pregnant woman complains of leg cramps. The best advice is:
    A. Increase potassium intake
    B. Take more protein
    C. Increase calcium and phosphorus intake
    D. Lie flat in bed

C. Increase calcium and phosphorus intake

26. Heartburn in pregnancy is called:
    A. Hyperemesis
    B. Pyrosis
    C. Varicosity
    D. Supine syndrome

B. Pyrosis

27. Management for hemorrhoids in pregnancy includes:
    A. Bed rest only
    B. Cold compress, sitz bath, high fiber diet
    C. High protein diet
    D. Avoid fluid intake

B. Cold compress, sitz bath, high fiber diet

28. Ambivalence in pregnancy is most common during:
    A. First trimester
    B. Second trimester
    C. Third trimester
    D. Postpartum

A. First trimester

29. Accepting the fetus as separate from self occurs during:
    A. First trimester
    B. Second trimester
    C. Third trimester
    D. Postpartum

B. Second trimester

30. Preparing for baby’s arrival and end of pregnancy occurs during:
    A. First trimester
    B. Second trimester
    C. Third trimester
    D. Labor

C. Third trimester

31. A 24-week pregnant woman reports shortness of breath. The nurse explains this is due to:
    A. Fetal movement
    B. Increased progesterone
    C. Diaphragm displacement upward
    D. Uterine enlargement only

C. Diaphragm displacement upward

32. A 30-week pregnant client is advised to wear elastic stockings. This is for management of:
    A. Hemorrhoids
    B. Varicosities
    C. Pyrosis
    D. Linea nigra

B. Varicosities

33. During pregnancy, cardiac output increases by:
    A. 10–20%
    B. 20–30%
    C. 25–50%
    D. 50–70%

C. 25–50%

34. During pregnancy, blood pressure normally:
    A. Decreases during 2nd trimester
    B. Increases during 2nd trimester
    C. Remains stable
    D. Decreases during labor only

A. Decreases during 2nd trimester

35. The hormone that stimulates uterine contractions is:
    A. Estrogen
    B. Oxytocin
    C. Progesterone
    D. Relaxin

B. Oxytocin

$36. The most reliable indicator of fetal well-being is:
A. Fetal movement
B. Fetal heart tones
C. Fundal height
D. Weight gain

B. Fetal heart tones

37. A non-stress test (NST) is considered reactive if there are:
    A. No accelerations
    B. At least 2 accelerations in 20 minutes
    C. Decelerations present
    D. Irregular baseline FHR

B. At least 2 accelerations in 20 minutes

38. Which test evaluates fetal lung maturity?
    A. Amniocentesis for L/S ratio
    B. Non-stress test
    C. Ultrasound biometry
    D. Contraction stress test

A. Amniocentesis for L/S ratio

39. A pregnant woman at 16 weeks is scheduled for AFP screening. This test is used to detect:
    A. Down syndrome and neural tube defects
    B. Diabetes mellitus
    C. Rh incompatibility
    D. Amniotic infection

A. Down syndrome and neural tube defects

40. A contraction stress test (CST) is positive when:
    A. There are no decelerations
    B. Late decelerations appear with contractions
    C. Accelerations occur with contractions
    D. Fetal heart rate increases by 15 bpm

B. Late decelerations appear with contractions

41. At what weeks of gestation should fundal height equal the number of weeks of pregnancy?
    A. 12–16 weeks
    B. 18–20 weeks
    C. 22–24 weeks
    D. 20–36 weeks

D. 20–36 weeks

42. Leopold’s maneuvers are used to determine:
    A. Fetal sex
    B. Fetal position and presentation
    C. Fetal heart rate
    D. Fetal age

B. Fetal position and presentation

43. The most accurate method to determine gestational age is:
    A. Fundal height
    B. Ultrasound in the first trimester
    C. Quickening
    D. LMP calculation

B. Ultrasound in the first trimester

44. A primigravida asks why she needs prenatal checkups monthly until 28 weeks. The best response is:
    A. “It is required by law.”
    B. “To detect complications early and ensure fetal growth.”
    C. “Because it helps you prepare psychologically.”
    D. “To know your baby’s gender.”

B. “To detect complications early and ensure fetal growth.”

45. A nurse is assessing a 24-week pregnant woman. Which finding is expected?
    A. Fundus at symphysis pubis
    B. Fundus at umbilicus
    C. Fundus above xiphoid
    D. No fundal growth yet

B. Fundus at umbilicus

46. The fetal heartbeat is first detected by ultrasound at:
    A. 2–3 weeks
    B. 6–7 weeks
    C. 10–12 weeks
    D. 16 weeks

B. 6–7 weeks

47. Quickening is first felt by multiparas around:
    A. 8 weeks
    B. 12–16 weeks
    C. 16–18 weeks
    D. 20–22 weeks

C. 16–18 weeks

48. Vernix caseosa is usually present from:
    A. 12 weeks
    B. 16 weeks
    C. 20 weeks
    D. 24 weeks

D. 24 weeks

49. Surfactant production begins at:
    A. 20 weeks
    B. 24 weeks
    C. 28 weeks
    D. 32 weeks

B. 24 weeks

50. Fetal viability is generally considered after:
    A. 12 weeks
    B. 16 weeks
    C. 20 weeks
    D. 24 weeks

D. 24 weeks

51. The fetus assumes the fetal position by:
    A. 8 weeks
    B. 12 weeks
    C. 20 weeks
    D. 28 weeks

C. 20 weeks

52. Lanugo appears at:
    A. 16 weeks
    B. 20 weeks
    C. 24 weeks
    D. 28 weeks

A. 16 weeks

53. The average fetal heart rate at 10 weeks is:
    A. 100 bpm
    B. 120 bpm
    C. 160 bpm
    D. 200 bpm

C. 160 bpm

54. The placenta is fully developed and functioning by:
    A. 8 weeks
    B. 12 weeks
    C. 16 weeks
    D. 20 weeks

C. 16 weeks

55. Brown fat deposits begin to appear at:
    A. 12 weeks
    B. 16 weeks
    C. 20 weeks
    D. 28 weeks

D. 28 weeks

56. True labor contractions are characterized by:
    A. Irregular, relieved by rest
    B. Regular, increasing in intensity, not relieved by rest
    C. Felt only in abdomen
    D. Weak and irregular

B. Regular, increasing in intensity, not relieved by rest

57. The first stage of labor begins with:
    A. Delivery of placenta
    B. Onset of regular contractions
    C. Full cervical dilation
    D. Expulsion of fetus

B. Onset of regular contractions

58. The latent phase of labor ends at cervical dilation of:
    A. 3 cm
    B. 4 cm
    C. 5 cm
    D. 6 cm

D. 6 cm

59. Transition phase of labor occurs between:
    A. 2–4 cm dilation
    B. 4–6 cm dilation
    C. 7–10 cm dilation
    D. After 10 cm dilation

C. 7–10 cm dilation

60. The second stage of labor is characterized by:
    A. Onset of contractions
    B. Cervical dilation complete to delivery of fetus
    C. Delivery of placenta
    D. Uterine involution

B. Cervical dilation complete to delivery of fetus

61. The third stage of labor involves:
    A. Placental separation and expulsion
    B. Full cervical dilation
    C. Expulsive pushing
    D. Transition phase

A. Placental separation and expulsion

62. Duration of third stage of labor should not exceed:
    A. 10 minutes
    B. 20 minutes
    C. 30 minutes
    D. 60 minutes

C. 30 minutes

63. The mechanism of labor where the fetal head moves to the pelvic outlet is:
    A. Flexion
    B. Descent
    C. Engagement
    D. External rotation

B. Descent

64. Which cardinal movement occurs when the chin is brought into contact with the chest?
    A. Flexion
    B. Internal rotation
    C. Extension
    D. Expulsion

A. Flexion

65. Crowning refers to:
    A. Head visible between contractions
    B. Head visible only at peak contraction
    C. Head has retracted after pushing
    D. Delivery of shoulders

A. Head visible between contractions

66. Which presentation is most common in labor?
    A. Breech
    B. Cephalic (vertex)
    C. Transverse lie
    D. Face presentation

B. Cephalic (vertex)

67. A nurse performs Leopold’s maneuvers and notes the fetal back is on the left side. Where should she place the Doppler?
    A. Left lower abdomen
    B. Right lower abdomen
    C. Left upper abdomen
    D. Right upper abdomen

A. Left lower abdomen

68. A patient in labor requests pain relief. Which method is safest for both mother and fetus?
    A. General anesthesia
    B. Epidural anesthesia
    C. Systemic opioids
    D. Spinal block

B. Epidural anesthesia

69. Uterine contractions every 2 minutes, lasting 90 seconds, are concerning because:
    A. They are normal in transition
    B. They may cause fetal hypoxia
    C. They shorten labor safely
    D. They prevent descent

B. They may cause fetal hypoxia

70. Meconium-stained amniotic fluid may indicate:
    A. Normal maturity
    B. Fetal distress
    C. Placenta previa
    D. Prematurity

B. Fetal distress

71. A nurse is monitoring FHR and observes variable decelerations. This indicates:
    A. Cord compression
    B. Uteroplacental insufficiency
    C. Head compression
    D. Normal pattern

A. Cord compression

72. Late decelerations on FHR tracing indicate:
    A. Cord compression
    B. Uteroplacental insufficiency
    C. Normal variability
    D. Head compression

B. Uteroplacental insufficiency

73. The best intervention for late decelerations is:
    A. Increase oxytocin infusion
    B. Place in left lateral position and give oxygen
    C. Perform fundal pressure
    D. Administer sedatives

B. Place in left lateral position and give oxygen

74. Prolonged labor is most likely when:
    A. Pelvis is adequate
    B. Fetus is cephalic
    C. Contractions are irregular and weak
    D. Cervix dilates steadily

C. Contractions are irregular and weak

75. In shoulder dystocia, the priority action is:
    A. McRoberts maneuver
    B. Cesarean delivery
    C. Fundal pressure
    D. Stop pushing

A. McRoberts maneuver

76. The most critical immediate need of the newborn is:
    A. Thermoregulation
    B. Airway clearance
    C. Bonding
    D. Breastfeeding

B. Airway clearance

77. Apgar score is taken at:
    A. 1 and 3 minutes
    B. 1 and 5 minutes
    C. 3 and 10 minutes
    D. 5 and 15 minutes

B. 1 and 5 minutes

78. A newborn with Apgar score of 7 at 1 minute means:
    A. Severe distress
    B. Mild distress, requires suction and stimulation
    C. Normal, routine care
    D. Immediate resuscitation

C. Normal, routine care

79. The umbilical cord normally contains:
    A. 1 vein and 2 arteries
    B. 2 veins and 1 artery
    C. 2 veins and 2 arteries
    D. 1 vein only

A. 1 vein and 2 arteries

80. Vernix caseosa protects the newborn by:
    A. Preventing hypothermia
    B. Preventing infection and fluid loss
    C. Increasing skin elasticity
    D. Enhancing bonding

B. Preventing infection and fluid loss

81. Physiologic jaundice typically appears after:
    A. 12 hours
    B. 24 hours
    C. 48 hours
    D. Immediately after birth

B. 24 hours

82. The best site for IM injection in a newborn is:
    A. Gluteus maximus
    B. Deltoid
    C. Vastus lateralis
    D. Ventrogluteal

C. Vastus lateralis

83. The first stool of the newborn is called:
    A. Vernix
    B. Meconium
    C. Colostrum
    D. Transitional stool

B. Meconium

84. Normal newborn weight loss in the first week is up to:
    A. 2%
    B. 5%
    C. 10%
    D. 15%

C. 10%

85. Which reflex is elicited when the newborn is startled by a loud noise?
    A. Rooting reflex
    B. Moro reflex
    C. Babinski reflex
    D. Grasp reflex

B. Moro reflex

86. Uterine involution means:
    A. Shrinking of the uterus after delivery
    B. Cervical dilation after delivery
    C. Placental expulsion
    D. Lochia discharge

A. Shrinking of the uterus after delivery

87. Normal uterine descent postpartum is about:
    A. 1 cm per day
    B. 2 cm per day
    C. 5 cm per day
    D. 10 cm per day

A. 1 cm per day

88. Lochia rubra is expected during:
    A. 1–3 days postpartum
    B. 4–10 days postpartum
    C. 10–14 days postpartum
    D. 2–4 weeks postpartum

A. 1–3 days postpartum

89. Lochia serosa is expected during:
    A. 1–3 days
    B. 4–10 days
    C. 2–3 weeks
    D. 4 weeks

B. 4–10 days

90. Lochia alba is expected during:
    A. 1–3 days
    B. 4–10 days
    C. 2–6 weeks
    D. After 8 weeks

C. 2–6 weeks

91. Which hormone is responsible for milk letdown reflex?
    A. Progesterone
    B. Estrogen
    C. Oxytocin
    D. Prolactin

C. Oxytocin

92. Which hormone stimulates milk production?
    A. Progesterone
    B. Estrogen
    C. Oxytocin
    D. Prolactin

D. Prolactin

93. Postpartum blues usually resolve within:
    A. 1–3 days
    B. 1–2 weeks
    C. 1 month
    D. 2 months

B. 1–2 weeks

94. The best position for breastfeeding to prevent nipple trauma is:
    A. Football hold
    B. Cradle hold with proper latch
    C. Side-lying
    D. Upright

B. Cradle hold with proper latch

95. A postpartum mother reports foul-smelling lochia. The nurse suspects:
    A. Normal healing
    B. Infection
    C. Retained placenta
    D. Endometritis only

B. Infection

96. A G2P1 woman at 30 weeks reports sudden painless vaginal bleeding. The nurse suspects:
    A. Placenta previa
    B. Placental abruption
    C. Threatened abortion
    D. Ruptured uterus

A. Placenta previa

97. A laboring woman has painful vaginal bleeding, rigid abdomen, and late decelerations. This indicates:
    A. Placenta previa
    B. Placental abruption
    C. Cord prolapse
    D. Uterine rupture

B. Placental abruption

98. During delivery, the umbilical cord is seen protruding from the vagina. Priority action is:
    A. Push cord back manually
    B. Place mother in knee-chest position and call for help
    C. Deliver immediately
    D. Clamp cord and wait

B. Place mother in knee-chest position and call for help

99. A newborn is apneic and limp with HR 80 bpm. The nurse’s first action is:
    A. Start chest compressions
    B. Begin positive pressure ventilation (PPV)
    C. Give IV epinephrine
    D. Provide blow-by oxygen

B. Begin positive pressure ventilation (PPV)

100. A mother asks why exclusive breastfeeding is recommended for the first 6 months. The best response is:
     A. “It saves money and is convenient.”
     B. “It prevents anemia and infection, and provides complete nutrition.”
     C. “It will help you lose weight faster.”
     D. “It ensures stronger bonding.”

B. “It prevents anemia and infection, and provides complete nutrition.”