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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

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