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30.An adolescent girl came with complaints of difficulty and pain during sexual intercourse. She has regular menstrual period with abdominal cramps. On pelvic examination: a nurse identified loses of hymen membrane and a membrane like structure with small perforation on middle third of vagina. The nurse suspected that her problem is vaginal congenita l anomalies. What is the most likely manifestation for diagnosis of this condition? (Tikimt 2013/October2020) A. Abdominal . cramp B. Small perforation C. Painful sexual intercourse D. Membrane like structure 31. A 20 weeks pregnant woman came with the complaint of vaginal bleeding for three hours. She had abdominal and back pain. On examination, her hemoglobin level was 9g/dl (NR: 10.5-13.7g/dt) , blood pressure 90/50mmHg and pulse rate 110/min . The woman was diagnosed for inevitable abortion. What is the priority nursing interventior for this woman?(Tikimt 2013/October 2020) A. Provide analgesia B. Reassure the woman C. Prepare for blood transfusion D. Resuscitate with normal saline

13. A 25-year -old woman delivered her baby at a health center . You attempt to deliver the placenta actively with intramuscular oxytocin but it was not successful. She starts to bleed heavily. It has been 40 minute since the delivery of the baby . Despite your attempt, the placenta neither expels out nor it shows sign of separation. What is your best : intervention at this level? ( Hidar 2012/December 2019 ) A. Put her on IV fluid, give ampicilline 2 g IV , refer her B. Change oxytocin with ergometrine and attempt CCT once again C. Wait the placenta for additional 20 minutes, attempt manual removal D. Give sedative agent and prophylactic antibiotics, attempt manual removal

12. A woman has delivered 4000g baby within 3 hours since labor starts.At the initial postpartum assessment fundus is firm and at the level of the umbilicus . But there is heavy brighter red bleeding with occasional small clots Vital signs are unchanged from prenatal value. What is the best next step of you intervention?( Hidar 2012/December 2019) A. Tell the mother it is normal .having vaginal discharge after delivery B. Tell the mother it is okay as long as the bleeding is less than 500ml C. Begin aggressive intravenous fluid and oxytocic administration D. Insert speculum and explore cervix , vagina and perineum for tear 13. A 25-year -old woman delivere d her baby at a healt h center. You attempt to deliver the placenta actively with intramuscular oxytocin but it was not successfu l.She starts to blee d heavily. It has been 40 minute since the delivery of the baby . Despite your attempt , the placenta neithe r expels out nor it shows sign of separation. What is your best intervention I at this level?(Hidar 2012/December 2019) A. Put her on IV fluid give ampicilline 2 g IV, refer her B. Change oxytocir I with ergometrine and attempt CCT once again C. Wait the placenta for additiona 120 minutes,attempt manua l removal D. Give sedative agent and prophylactic antibiotics , attempt manual removal 14. A 37 -year-old woman comes to family planning unit demanding highly effective contraceptiv e method . The doctor told her pregnancy could endange her life because she has advanced heart disease.She does not accept tubal ligation as an option. Which contraceptive method is best to satisfy her need?( Hidar 2012/December 2019) A. IUCD B Implants

26.A mother who uses an Implant contraceptive came with complaints of changed bleeding pattern , headaches , abdominal pain , breast tendernes s and nausea. The mother reported that her menstruation period become sometimes ; absent and little in amount on other time. What is the priority intervention for this woman? (Tikimt 2013/October 2020) A. Switch contraception B. Provide counseling C. Check for pregnancy D. Remove the contraception

38. A mother, who was lactating for seven months, came to family planning clinic to take contraceptive. A nurse assessed for medical eligibility criteria and explained to her about the options, side effects and benefits of contraceptive for her . The mother preferred to take combinec I oral contraceptive. For which category of contraceptive the woman is eligible? A. Category 1 B. Category 2 C. Category 3 D. Category 4 39.A 26-year-old mother used Depo -Provers contraceptive for one year. She discontinued the contraceptive due to irregular bleeding , nausea, headache, and missing period. After three month of discontinuing the contraceptive, she became amenorriC. Her body mass index is 238 and blood pressure is 110/70mmHg What would be the priority side effect of discontinuing this contraceptive? A. Nausea B. Headache C. Amenorrhea D. Irregular bleeding 40. A multi-para woman came to family clinic for the service of contraceptive. She has repeated history of STI The nurse discussed with the woman on family planning option, benefits, side effect and time to initiate the contraceptives. What is the most priority contraceptive to be recommended for this woman? A. Sino-implant B. LNG-lUD C. CU-IUD D. Injectable