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Q1
Which core value is explicitly included in the ICM Code of Ethics for Midwives?
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Q2
A midwife wishes to implement delayed cord clamping for term newborns. Which source of evidence is most appropriate to justify this practice?
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Q3
Under the Nepal Nursing Council Act, the primary legal consequence for a midwife found guilty of professional negligence is:
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Q4
In an anovulatory cycle, which of the following hormonal patterns is most likely observed?
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Q5
Which structure is derived from the allantois and connects the fetus to the placenta?
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Q6
A fundal height that is significantly smaller than expected for the gestational age may be a clinical indicator of which of the following?
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Q7
Eclampsia requires the most urgent response. When should a patient with eclampsia be transferred?
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Q8
A woman with eclampsia is admitted. After the seizure is controlled, the midwife should prioritize which of the following actions during the immediate post-ictal phase?
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Q9
The most effective dietary source of heme iron for pregnant women is
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Q10
During the fourth stage, which maternal vital sign change is most indicative of early postpartum hemorrhage?
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Q11
In the partograph, the 'contractions' line is recorded on which graph?
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Q12
A patient presents with a history of prolonged labor, high fever, and foul-smelling vaginal discharge. The uterus is tender. Which complication should the midwife suspect?
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Q13
Which laboratory test is most useful to assess ongoing blood loss in PPH?
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Q14
In a case of uterine inversion, the first maneuver is?
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Q15
Which of the following findings indicates that a mother is ready for discharge within 24 hours after an uncomplicated vaginal delivery?
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Q16
Which statement about postpartum family-planning counseling is FALSE?
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Q17
In the context of the 'Baby-Friendly Hospital Initiative' (BFHI), what is the correct practice regarding newborn feeding?
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Q18
When performing positive pressure ventilation (PPV), what is the correct rate of breaths per minute to be delivered to the newborn?
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Q19
At what age should a newborn receive the first dose of BCG vaccine according to community immunization schedule?
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Q20
Which of the following is a key indicator used by the Nepal Ministry of Health to evaluate the performance of maternity waiting homes?
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Q21
Which of the following is an essential component of risk-appropriate care for women with gestational diabetes?
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Q22
A 22-year-old woman arrives at a community health center with bruising on her upper arms and reports frequent threats from her partner. Which of the following is the priority nursing action for the midwife in this scenario?
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Q23
Which route of administration is recommended for vitamin K in a low birth weight newborn in Nepal?
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Q24
A pregnant woman with antepartum haemorrhage has a pulse of 112/min, blood pressure 85/50 mmHg, and urine output <30 ml/hr. She is classified as:
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Q25
The inner lining of the fallopian tube that is lined with ciliated cells is known as:
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Q26
At what gestational age should a pregnant woman with a singleton pregnancy and a prior low transverse cesarean scar be transferred for delivery planning, according to Nepal guidelines?
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Q27
In a twin pregnancy at 30 weeks with one twin showing IUGR, what is the threshold gestational age for considering delivery to optimize neonatal outcome?
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Q28
Which adjunct can be added to an epidural anesthetic to prolong the duration of analgesia?
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Q29
A 30-year-old primigravida with prolonged labour receiving oxytocin shows absent fetal heart tones. What is the most appropriate next step?
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Q30
A mother with mild postpartum depression is unable to attend weekly face-to-face counseling. Which non-pharmacological intervention is most appropriate?
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Q31
Which of the following is a hallmark of the 'Holistic' approach within midwifery practice?
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Q32
After controlling a seizure in a woman with eclampsia, which action should the midwife prioritize during the immediate post-ictal phase?
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Q33
Which congenital anomaly is most strongly associated with maternal hyperglycaemia during the first trimester?
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Q34
Which of the following findings in a newborn during the discharge physical examination would be classified as a 'danger sign' requiring immediate referral?
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Q35
What is the priority action for a midwife when assessing a newborn with a heart rate of 80 bpm and poor muscle tone?
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Q36
Under the Aama Suraksha Program, which of the following services is provided free of cost to pregnant women?
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Q37
In the cycle of violence in intimate partner violence, which phase is characterized by increasing tension and minor abusive incidents?
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Q38
According to the International Confederation of Midwives (ICM), what is the primary definition of a midwife's professional autonomy in practice?
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Q39
According to Nepal's National Guidelines for ANC, which investigation is mandatory for all pregnant women to screen for syphilis at the first antenatal visit?
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Q40
A newborn presents with feeding difficulties, vomiting, and abdominal distention. An abdominal X-ray shows multiple air-fluid levels suggesting intestinal obstruction. Which congenital anomaly is most likely and what is the appropriate referral?
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Q41
In appraising a systematic review, the presence of an asymmetric funnel plot most strongly suggests:
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Q42
Which of the following is an absolute contraindication for attempting a trial of labor after cesarean (TOLAC)?
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Q43
Which of the following statements aligns with the ethical principle of beneficence in midwifery practice?
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Q44
A mother reports that her nipples are very sore and she notices small blisters. Upon assessment, the midwife finds the baby's tongue is tied (ankyloglossia). What is the appropriate next step?
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Q45
In a term newborn who is breathing and crying, what is the most appropriate action regarding the umbilical cord before the first clamp is applied?
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Q46
Which of the following is considered the 'gold standard' for the definitive diagnosis of TTTS in a monochorionic pregnancy?
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Q47
The round ligament of the uterus primarily develops from which embryonic structure?
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Q48
What is the most critical risk factor for the development of Necrotizing Enterocolitis (NEC) in a premature newborn?
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Q49
A 20-year-old male presents with a solitary, painless ulcer on the penis and tender inguinal lymphadenopathy. Which laboratory technique is the most appropriate for definitive diagnosis?
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Q50
On the partograph, which element must be recorded for every hourly observation during labour?
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Q51
A 2-week postpartum woman who is lactating but not yet amenorrheic wants a contraceptive method. Which option is suitable under Nepal guidelines?
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Q52
A pregnant woman with gestational diabetes has a random plasma glucose of 210 mg/dL at a prenatal visit. What is the most appropriate immediate action?
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Q53
What is the maximum recommended duration of the second stage of labour for a multiparous woman before operative assistance is considered, according to Nepal guidelines?
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Q54
On transabdominal ultrasound in the second stage, the fetal spine is seen in the maternal left lateral position and the occiput is directed toward the maternal right anterior quadrant. This finding corresponds to which position?
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Q55
According to the World Health Organization, which age range is classified as adolescence?
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Q56
Which musculoskeletal change is commonly seen during pregnancy?
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Q57
A midwife is screening for pre-eclampsia markers. In addition to blood pressure and proteinuria, which of the following is an emerging biochemical marker used to predict the risk of early-onset pre-eclampsia?
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Q58
At the postpartum discharge visit, the midwife counsels a mother who is exclusively breastfeeding on contraceptive choices. Which method should be specifically discouraged within the first 6 weeks postpartum?
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Q59
Which of the following is a recommended strategy to improve maternal nutrition during pregnancy in community settings?
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Q60
Which of the following is the most appropriate counseling point to give a client who chooses the Lactational Amenorrhea Method (LAM) regarding its effectiveness?
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Q61
Under Nepal's MDSR, which of the following scenarios is considered a preventable maternal death?
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Q62
What is the primary purpose of the Maternal Death Surveillance and Response (MDSR) system introduced under Nepal's Safe Motherhood policies?
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Q63
In the management of a patient with a previous low transverse caesarean who is now in active labour, which factor most strongly predicts a successful vaginal birth after caesarean (VBAC) according to Nepalese evidence?
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Q64
Which prenatal screening test is considered the most reliable for detecting neural tube defects in the fetus?
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Q65
Which of the following is the most appropriate action for a midwife when a survivor of GBV expresses suicidal ideation during a visit?
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Q66
A 30-year-old pregnant woman at 28 weeks has blood pressure 155/102 mmHg and proteinuria 3+. Which of the following best defines her condition?
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Q67
What is the target preductal oxygen saturation (SpO2) at 5 minutes after birth for a term newborn?
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Q68
Which of the following is a red flag during a postnatal visit that requires immediate psychiatric intervention?
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Q69
A 27-year-old woman with a triplet pregnancy at 30 weeks presents with blood pressure 158/108 mmHg, proteinuria 2+, and peripheral edema. Which of the following best describes the diagnosis?
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Q70
A newborn exhibits jaundice within the first 12 hours of life. In addition to bilirubin levels, which of the following findings would most strongly support a diagnosis of ABO incompatibility?
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Q71
The increase in plasma volume during pregnancy is most significant between which two periods?
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Q72
When plotting the descent of the fetal head on the partograph, the 'station' is typically measured in relation to which anatomical landmark?
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Q73
In a woman with pre-gestational diabetes, the risk of spontaneous abortion and congenital malformations is most closely linked to which of the following factors?
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Q74
What is the recommended daily vitamin D supplementation for a low birth weight infant in Nepal?
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Q75
A 32-year-old woman at 36 weeks presents with sudden severe abdominal pain, a tense firm uterus, dark vaginal bleeding, and hypotension. What is the most likely diagnosis?
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Q76
What is the primary outcome measure for evaluating the success of a caseload midwifery model in Nepal?
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Q77
According to the risk assessment guidelines, which of the following findings in a pregnant woman with diabetes mellitus would necessitate immediate referral to a tertiary center?
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Q78
Which symptom most strongly suggests impending uterine rupture in a woman with prolonged labor?
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Q79
In Nepal's Mother and Child Health (MCH) Handbook, at what gestational age should iron-folic acid supplementation be started for a pregnant woman?
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Q80
Which hormone predominantly inhibits FSH secretion during the early follicular phase?
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Q81
After the trunk of a frank breech fetus has been delivered down to the level of the umbilicus, which step is essential to safely complete delivery?
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Q82
At which gestational age should low-dose aspirin be initiated for pre-eclampsia prophylaxis?
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Q83
When assessing a pregnant woman for nutritional deficiencies, the presence of glossitis and cheilosis is most strongly associated with the deficiency of which of the following?
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Q84
Which of the following is a priority intervention for reducing maternal mortality among adolescent girls under Nepal's reproductive health policies?
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Q85
A mother of a preterm infant at 32 weeks gestation is concerned about milk supply. Which intervention is most likely to help maintain milk production?
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Q86
According to the syndromic management of STIs in Nepal, a patient presenting with a genital ulcer syndrome and painful ulcers should be empirically treated for which of the following?
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Q87
A 34-year-old woman with a history of classical cesarean section is having a spontaneous vaginal delivery. Which of the following is a contraindication to attempting a vaginal birth after cesarean (VBAC) in this case?
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Q88
What is the most appropriate action for a midwife to take if an MDSR audit reveals a consistent lack of Magnesium Sulfate at the health post?
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Q89
Where is the first clamp preferably placed on the umbilical cord?
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Q90
A term baby is born with a bright red, rapidly enlarging lesion over the oral cavity that interferes with breathing. What is the immediate action a midwife should take before arranging referral?
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Q91
Which nursing intervention is most effective in promoting mother-infant bonding for a mother diagnosed with postpartum depression?
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Q92
Which laboratory parameter is most specific for assessing iron stores in a pregnant woman undergoing antenatal screening?
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Q93
What is the normal range for heart rate in a healthy newborn during the first hour of life?
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Q94
Maternal plasma volume reaches its peak at approximately which gestational week?
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Q95
Immediately after delivery of the baby, the Skilled Birth Attendant should administer the uterotonic within which time frame to achieve optimal prevention of postpartum haemorrhage?
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Q96
A 35-year-old primigravida at 38 weeks reports reduced fetal movements for 6 hours. Cardiotocography is reactive and ultrasound is normal. What is the next step per Nepal guidelines?
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Q97
A 28-year-old woman wants to start combined oral contraceptive pills but has a family history of breast cancer. Her personal history is unremarkable. According to WHO MEC adopted in Nepal, which of the following is the most appropriate recommendation?
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Q98
A midwife assists in a termination of pregnancy outside the legal gestational limit (exceeding 20 weeks without accepted medical indication). According to the Nepal Abortion Law and its amendment under the Child Protection Framework, what is the legally mandated response?
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Q99
In a PICO question assessing whether antenatal yoga reduces back pain in pregnant women, the 'O' component refers to:
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Q100
Which of the following best describes the primary utility of the third Leopold's maneuver (Paalkow's grip)?
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Q101
Which key message should community midwives emphasize during antenatal health education sessions regarding birth preparedness?
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Q102
A midwife identifies a pregnant woman with placenta previa at 30 weeks, asymptomatic. According to Nepal referral guidelines, the appropriate level of facility for planned delivery is:
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Q103
Which of the following stages of fetal lung development is marked by the formation of terminal saccules (alveolar sacs)?
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Q104
A mother who delivered vaginally 12 hours ago reports perineal pain scores of 4/10, has a small (≤2 cm) first-degree tear that is approximated, and her lochia is scant and rubra. Which finding on REEDA scale would indicate adequate healing and support discharge planning?
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Q105
A 30-year-old woman, 2 weeks postpartum, is exclusively breastfeeding but has not yet resumed menses. She wants contraception. Which method is suitable at this stage according to Nepal guidelines?
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Q106
Which of the following is a distinguishing feature of the 'midwifery partnership' model as described in international midwifery literature?
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Q107
In Nepal's STI control programme, what is the primary goal of partner notification and treatment?
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Q108
The Maternal Death Surveillance and Response (MDSR) system was introduced in Nepal to achieve which primary objective?
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Q109
According to Nepal's National Safe Motherhood Programme, which of the following is not an indication for urgent psychiatric referral for a postpartum woman?
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Q110
What is the recommended method for cleaning the breast before feeding?
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Q111
A midwife is counseling a woman with a dichorionic twin pregnancy at 16 weeks. Which of the following is the recommended timing for the first routine growth scan in an uncomplicated dichorionic twin pregnancy?
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Q112
According to WHO guidelines, antenatal corticosteroids (betamethasone or dexamethasone) are recommended for women with antepartum haemorrhage who are at risk of preterm delivery between 24 and 34 weeks gestation when:
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Q113
A 28-year-old multiparous woman at 37 weeks is in the second stage with the fetal spine palpable superiory the maternal umbilicus. The mother is feeling uncomfortable being turned to the supine position. Which management is advised according to NAC-NMC guidelines?
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Q114
Which of the following best describes the typical change in functional residual capacity (FRC) during the second trimester of pregnancy?
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Q115
In communications management, to assimilate through the mind or senses is the process of ______________
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Q116
Maslow's theory is about:
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Q117
According to current newborn care guidelines in Nepal, when should the first bath of a healthy term newborn be given?
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Q118
A midline anterior neck swelling in a 10-day-old infant moves upward with swallowing and tongue protrusion. Ultrasound shows a cystic lesion at the level of the hyoid. What is the appropriate referral?
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Q119
According to Nepal's national protocol, what is the recommended initial dose of oxytocin for augmentation of labour in the active phase when contractions are inadequate?
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Q120
When measuring symphysis-fundal height, from which point should the upper reference be taken?
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Q121
Which symptom most specifically distinguishes postpartum depression from the transient postpartum blues?
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Q122
During the luteal phase, the corpus luteum secretes which hormone that maintains the secretory endometrium?
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Q123
When a midwife acts as an advocate for a woman who is being pressured by her husband to undergo an unwanted sterilization, the midwife is primarily upholding which ethical principle?
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Q124
Which of the following laboratory abnormalities is required for the diagnosis of HELLP syndrome according to the Mississippi classification?
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Q125
Which cardiovascular change most commonly occurs immediately after the placenta is delivered in the third stage?
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Q126
In Nepal's health system, which specific set of resources distinguishes a CEmONC facility from a BEmONC facility in the referral chain?
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Q127
According to the MDSR guidelines, a maternal death that occurs 75 days after delivery is classified as
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Q128
Which of the following is the primary goal of glycemic control during the first trimester in a woman with pre-existing diabetes?
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Q129
According to the WHO, what is the primary goal of 'Adolescent-Friendly Health Services' regarding accessibility?
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Q130
The indirect Coombs (indirect antiglobulin) test performed during ANC is primarily used to detect which maternal condition?
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Q131
Which of the following findings alone does NOT require immediate initiation of PPV in a newborn?
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Q132
According to Nepal's Safe Motherhood Programme, postpartum care should be given to the mother within how many hours after delivery to identify early complications?
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Q133
A mother is concerned that her breast milk is not 'filling' the baby because the baby cries shortly after a feed. What is the most appropriate way for the midwife to assess if the baby is getting enough milk?
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Q134
Which classification best describes a woman who loses approximately 1,200 ml of blood after a vaginal delivery?
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Q135
Which hormonal change in the immediate postpartum period is most implicated in the pathophysiology of postpartum depression?
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Q136
A 31-year-old woman has mild vulvar itching and frothy yellow-green discharge. Which organism is most likely responsible?
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Q137
According to Nepal's post-natal care toolkit, which statement should be included in postpartum family-planning counseling?
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D
Q138
A client with uncontrolled hypertension (BP 170/110 mmHg) seeks contraception. Which method is classified as Category 4 (unacceptable risk) for her?
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Q139
In the context of respectful maternity care, obtaining informed consent before a vaginal examination in a community clinic requires the midwife to:
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Q140
A 30-year-old woman reports that her cervical mucus feels watery and stretchy on day 12 of a 28-day cycle. Which hormone is primarily responsible for this change in mucus consistency?
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Q141
During a caesarean section the surgeon notes a soft, boggy uterus with poor tone. What does this finding most likely indicate?
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Q142
Which laboratory parameter, when combined with hemoglobin, provides the most reliable indication of iron deficiency in a pregnant woman when serum ferritin is not available?
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Q143
In the context of normal puerperium, which of the following changes in the cardiovascular system is expected within the first 48 hours?
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Q144
What is the recommended initial dose of labetalol for treating severe hypertension in pre-eclampsia?
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Q145
According to NNC protocol, which of the following is a prerequisite for a trial of vaginal breech delivery in a term pregnancy with frank breech?
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Q146
In Nepal, a midwife's continuing professional development must be documented for how many years before renewal of registration?
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Q147
Which of the following is a contraindication for performing vigorous stimulation in a newborn with a cracked incisor?
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Q148
Which investigation is mandatory for all pregnant women in Nepal during the first trimester to screen for anemia as per national antenatal care guidelines?
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Q149
When assessing a newborn for discharge readiness, the midwife observes the infant's skin. Which of the following findings is considered a normal physiological variation in the first 48 hours?
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Q150
According to the Nepal National STI Control Program, within how many days should sexual partners be treated after a pregnant woman is diagnosed with syphilis?
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Bachelor of Midwifery Studies (BMS) Licensing Exam preparation SET 2
150 multiple-choice questions · 150 questions · 2h 30m · Mid-level licensing
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