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48. A 48-year-old diabetic patient diagnosed as first degree uterine prolapsed, was admitted for an elective surgery. She has complaints of urinary frequency , urgency and incontinence . Physical examinatior result shows that she has skin rash at the area of perineum and upper part of her thigh. What is the priority intervention for the woman? A. Catheterization B. Kegel exercises C. Restriction of fluid intake D. Use skin protection product 49. You see a 20-year-old G1PO with a diagnosis of genital herpes in pregnancy . What is the gestational age at which a primary infection occurs that the risk of transmission 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 emergency CS that she refuses. How will you manage this patient? A. Administer herpes immunoglobulin to the mother 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 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 maternal blood 30-45 min after (ICC) infusion

52.What is the recommended regimen for anti-D prophylaxis for a 26-year-olc I 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 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 associatec I with pain D. The bleeding is small and painless

13. A 25-year-old woman delivered her baby at a health center. You attempt to deliver the placenta actively with intramusculal 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

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