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44. A woman came to a clinic with her husband with complaint of inability to conceive for one year after unprotected intercourse 2. They couples are highly concerned about conception and their health status. The laboratory investigation results show normal semen analysis and hormonal section . Unexplained infertility is diagnosed for the couple. What is the priority nursing intervention for this couple? A. Provide medication to resume fertility B. Advise to reduce alcohol consumption C. Suggest alternative sources of childbearing D. Reassure the couple for psychological upset 45. A nurse provides post abortion care for a pregnant woman who has vaginal bleeding for two days. She has lower abdomina I pain and small uterus for dates. Her blood pressure is 100/60 mmHg and pulse rate is 110/min . the woman is diagnosed with incomplete abortion. What is the priority nursing intervention for this woman? A. Give appointment : after two weeks B. Provide clear instruction on self-care C. Counsel on consumption of abortion D. Resuscitate the woman with normal saline 46. An adolescent girl with complaint of excessive menstrual bleeding for more than a week came to a health center. She also has fainting, breast tenderness and loss of appetite. She uses more than five pads per day. Her blood pressure is 80/60mmHg pulse rate is 120/min , temperature is 37.5^circ C and her hemoglobir level is 10.0gm/dL What is the priority nursing intervention for this girl? A. Administer iron-sulfate B. Administer IV fluid C. Administer antipyretics D. Administer oral contraceptive

49. You see a 20-year-old G 1PO with a diagnosis of genital herpes in pregnancy . What is the gestational age at which a primary infection occurs that the risk of transmis sion to the baby is greatest? A. First trimester 8-13 weeks) B. Second trimester 14-22 weeks) C.Third trimester (29-34 weeks) D.Third trimester (34-40 weeks) 50. You admit a woman at 40 weeks of gestation in labour with confirmed genital herpes This is thought to be a primary infection.She is offered an emergenc), CS that she refuses. How will you manage this patient? A. Administel herpes immunoglobulin to the mothe r and baby after birth B. Administer herpes immunoglobulin to the baby after birth C. Allow vaginal delivery and offer baby prophylactic aciclovir D. Commence her on intravenous aciclovir and also offer the neonate intravenous aciclovir 51. An elective caesarear section is being performed on a 30-year-old Rhesus D negative pregnant woman at 37 weeks of gestation for placenta praevia (major)Arrangements were made and she is receiving intraoperative cell salvage (ICS) transfusion . What would be the plan with regard to Rhesus D prophylaxis in this woman assuming the baby's blood group is unknown? A. Administer 500 IU anti -D Ig and then take a sample of materna l blood 30-45 min after intraoperative cell salvage (ICS) infusion B. Administer 750 IU anti-D Ig and then take a sample of maternal blood 30-45 min after ICS C. Administe r 1500 IU anti-D Ig and then take a sample of maternal blood 30-45 min after ICS infusion D. Administe r 2000 IU anti-D Ig and then take a sample of maternal blood 30-45 -45 min after ICS infusion 52.What is the recommende d regimen for anti-D prophylaxis for a 26-year -old Rhesus D negativ e woman who is not sensitized? A. 500 IU Ig at 28 weeks of gestation B. 500 IU lg anti-D at 34 weeks of gestation C. 1000 IU Ig anti -D at 28 weeks gestation D. 1500 Il J Ig anti -D at 28 weeks gestation

51. An elective caesarean section is being performed on a 30-year-old Rhesus D negative pregnant woman at 37 weeks of gestation for placenta praevia (major). Arrangements were made and she is receiving intraoperative cell salvage (ICS)transfusion. What would be the plan with regard to Rhesus D prophylaxis in this woman assuming the baby's blood group is unknown? A. Administer 500 IU anti-D Ig and then take a sample of materna blood 30-45 min after intraoperative cell salvage (ICS) infusion B. Administer 750 IU anti-D Ig and then take a sample of maternal blood 30-45 min after ICS C. Administer 1500 IU anti -D Ig and then take a sample of materna blood 30-45 min after ICS infusion D. Administer 2000 IU anti-D Ig and then take a sample of maternal blood 30-45 min after ICS infusion 52.What is the recommended regimen for anti-D prophylaxis for a 26-year-old Rhesus D negative woman who is not sensitized? A. 500 IU Ig at 28 weeks of gestation B. 500 IU lg anti-D at 34 weeks of gestation C. 1000 IU lg anti-D at 28 weeks gestation D. 1500 IU Ig anti-D at 28 weeks gestation 53. A 20-year-old RhD negative woman presents with bleeding at 11 weeks of gestation. When will you consider administering anti-D lg prophylaxis to this woman? A. She goes on to have a complete miscarriage B. The bleeding is heavy but is stopping C. The bleeding is repetitive or associated with pain D. The bleeding is small and painless

55. You have been called to the delivery of a 30-year-old primigravida who is pushing. The baby is in the breech position. The midwife is conducting the breech delivery and the head of the baby is trapped behind the cervix, which is only 8 cm dilated. What action will you take to deliver the head? A. Apply a forceps B. Apply Burns-Marshall technique C. Apply Mauriceau -Smellie-Veit manoeuvre D. Incise the cervix at 3 and 70' clock positions 56.You have counselled a 30-year-old primigravida at 35 weeks of gestation with a breech presentation, and she agrees to an external cephalic version. You have scheduled this procedure at 36 weeks of gestation. What success rate will you give this woman? A 30% -37% B 38% -45% C 46% -55% D 56% -64% 57. In the conduct of a breech vaginal delivery, what manoeuvre should be used in delivering the arms? A. Bracht manoeuvre B. Burns-Marshall technique C. Gentle traction on the arms D. Lovset's manoevre

52.What is the recommended regimen for anti-D prophylaxis for a 26-year-old Rhesus D negative woman who is not sensitized? A. 500 IU Ig at 28 weeks of gestation B. 500 IU lg anti-D at 34 weeks of gestation C. 1000 IU Ig anti-D at 28 weeks gestation D. 1500 IU Ig anti-D at 28 weeks gestation