Obstetric and Gynaecology MCQ Set-62
Obstetric and Gynaecology Nursing MCQ Question 576:-
The cause of dysmenorrhoea is…
(a) Ovulation
(b) Decreased progesterone
(c) Increased progesterone
(d) Secretory epithelium
Show Answer
Ans: (b) Decreased progesterone ✔
Rationale for Each Option:
(a) Ovulation:
Ovulation is the process of releasing a mature egg from the ovary. While it is a significant event in the menstrual cycle, it is not directly linked to the uterine pain characteristic of dysmenorrhoea. However, hormonal changes following ovulation can trigger prostaglandin production, indirectly contributing to menstrual pain.
(b) Decreased progesterone:
This is the correct answer. A decrease in progesterone levels at the end of the luteal phase triggers the breakdown of the endometrium and the release of prostaglandins. These prostaglandins cause uterine contractions and reduced blood flow, leading to the pain experienced in dysmenorrhoea.
(c) Increased progesterone:
An increase in progesterone occurs during the luteal phase to prepare the endometrium for implantation. It generally has a relaxing effect on the uterine muscles and does not cause dysmenorrhoea.
(d) Secretory epithelium:
The secretory epithelium is formed in the endometrium during the luteal phase under the influence of progesterone. While it is essential for preparing the uterus for a potential pregnancy, it is not a causative factor in dysmenorrhoea.
This explanation ensures clarity on why each option is correct or incorrect.
Obstetric and Gynaecology Nursing MCQ Question 577:-
Which among the following sequences indicates the correct mechanism behind lactational amenorrhea?
(a) Increased prolactin level → inhibits ovarian response to FSH → less follicular growth → hypo-estrogen state → no menstrual cycle
(b) Increased prolactin level → suppresses the release of LH → no LH surge → anovulation
(c) All the above
(d) None of the above
Show Answer
Ans: (c) All the above ✔
Rationale for Each Option:
(a) Increased prolactin level → inhibits ovarian response to FSH → less follicular growth → hypo-estrogen state → no menstrual cycle:
This sequence is correct. High prolactin levels during lactation inhibit the ovarian response to follicle-stimulating hormone (FSH), leading to reduced follicular growth. This creates a hypo-estrogenic state, which prevents the menstrual cycle from resuming.
(b) Increased prolactin level → suppresses the release of LH → no LH surge → anovulation:
This sequence is also correct. Elevated prolactin suppresses the release of luteinizing hormone (LH) from the pituitary gland. Without the LH surge, ovulation does not occur, contributing to the absence of menstruation.
(c) All the above:
This option is correct because both mechanisms described in (a) and (b) are valid explanations for the physiological process of lactational amenorrhea.
(d) None of the above:
This is incorrect because both (a) and (b) accurately describe mechanisms involved in lactational amenorrhea.
This explanation clarifies the mechanisms behind lactational amenorrhea and validates why both sequences are correct.
Obstetric and Gynaecology Nursing MCQ Question 578:-
Oral contractive pills need to be started on……………
(a) 1st day of menstruation
(b) 3rd day of menstruation
(c) 5th day of menstruation
(d) 7th day of menstruation
Show Answer
Ans: (c) 5th day of menstruation ✔
Rationale for Each Option:
(a) 1st day of menstruation:
Starting oral contraceptive pills on the first day of menstruation ensures immediate protection. However, this is not the standard guideline for most oral contraceptives, which recommend starting by the 5th day for optimal convenience and cycle alignment.
(b) 3rd day of menstruation:
Starting on the third day is acceptable and allows for contraceptive coverage to begin, but it is not the most common recommendation for initiating oral contraceptives.
(c) 5th day of menstruation:
This is the correct answer. Oral contraceptive pills are typically started on the fifth day of menstruation because, by this time, menstruation is usually tapering off, and it aligns well with the hormonal cycle. It provides effective contraception when taken consistently.
(d) 7th day of menstruation:
Starting on the seventh day is not advised as ovulation might occur before the pill takes full effect, increasing the risk of pregnancy.
This explanation aligns with the standard practice of starting oral contraceptive pills on the fifth day of the menstrual cycle.
Obstetric and Gynaecology Nursing MCQ Question 579:-
Primary PPH is….
(a) Haemorrhage occur within 24 hours following the birth of the baby
(b) Haemorrhage occur beyond 24 hours and within puerperium
(c) Bleeding occur after 28 weeks but before the onset of labour pain
(d) Bleeding occur at any time during pregnancy
Show Answer
Ans: (a) Haemorrhage occur within 24 hours following the birth of the baby ✔
Rationale for Each Option:
(a) Haemorrhage occurring within 24 hours following the birth of the baby:
This is the correct answer. Primary postpartum haemorrhage (PPH) is defined as excessive bleeding (more than 500 mL after vaginal delivery or 1000 mL after cesarean delivery) occurring within 24 hours after childbirth. It is most commonly caused by uterine atony, trauma, retained placenta, or coagulopathy.
(b) Haemorrhage occurring beyond 24 hours and within the puerperium:
This describes secondary PPH, not primary PPH. Secondary PPH occurs from 24 hours to 6 weeks postpartum, often due to retained placental fragments or infection.
(c) Bleeding occurring after 28 weeks but before the onset of labour pain:
This describes antepartum haemorrhage (APH), which includes conditions like placenta previa or placental abruption. It is unrelated to postpartum haemorrhage.
(d) Bleeding occurring at any time during pregnancy:
This is a general description of bleeding during pregnancy and could include implantation bleeding, early pregnancy loss, or APH. It does not refer to PPH specifically.
This rationale clarifies the timeframes and definitions of PPH in contrast to other bleeding conditions during pregnancy and postpartum.
Obstetric and Gynaecology Nursing MCQ Question 580:-
Secondary PPH is…..
(a) Haemorrhage occur within 24 hours following the birth of the baby
(b) Haemorrhage occur beyond 24 hours and within puerperium
(c) Bleeding occur after 28 weeks but before the onset of labour pain
(d) Bleeding occur at any time during pregnancy
Show Answer
Ans: (b) Haemorrhage occur beyond 24 hours and within puerperium ✔
Rationale for Each Option:
(a) Haemorrhage occurring within 24 hours following the birth of the baby:
This describes primary PPH, not secondary PPH. Primary PPH occurs within the first 24 hours after childbirth, typically due to uterine atony, trauma, or retained placenta.
(b) Haemorrhage occurring beyond 24 hours and within puerperium:
This is the correct answer. Secondary postpartum haemorrhage (PPH) occurs after the first 24 hours but within the puerperium (the first 6 weeks following childbirth). It is often due to retained placental tissue, infection, or delayed uterine involution.
(c) Bleeding occurring after 28 weeks but before the onset of labour pain:
This describes antepartum haemorrhage (APH), such as placenta previa or placental abruption, and is unrelated to postpartum haemorrhage.
(d) Bleeding occurring at any time during pregnancy:
This is a general description of bleeding during pregnancy and does not refer to secondary PPH specifically.
This explanation highlights the timing and causes of secondary PPH compared to other types of bleeding during and after pregnancy.
Obstetric and Gynaecology Nursing MCQ Question 581:-
Reason for prolonged labour due to fault in passage include….
(a) Contracted pelvis
(b) Cervical dystonia
(c) Pelvic tumor
(d) All of the above
Show Answer
Ans: (d) All of the above ✔
Rationale for Each Option:
(a) Contracted pelvis:
This is a correct reason for prolonged labor. A contracted pelvis, which occurs when the pelvic bones are narrowed or misshapen, can obstruct the passage of the baby during labor, leading to a prolonged delivery.
(b) Cervical dystonia:
This is also correct. Cervical dystonia refers to abnormal muscle tone or spasms in the cervix, which can prevent the cervix from dilating normally, thereby contributing to prolonged labor.
(c) Pelvic tumor:
A pelvic tumor can also cause prolonged labor by obstructing the birth canal or impeding the normal progression of labor. Tumors such as fibroids or other growths can block the passage, leading to labor difficulties.
(d) All of the above:
This is the correct answer. All of the conditions listed (contracted pelvis, cervical dystonia, and pelvic tumor) can cause faults in the passage that contribute to prolonged labor.
This rationale emphasizes how different anatomical and physiological factors affecting the birth passage can lead to extended labor.
Obstetric and Gynaecology Nursing MCQ Question 582:-
The action of spermicidal agent is to
(a) Prevent the motility of the sperm
(b) Kill sperm immediately
(c) Render the sperm inactive
(d) Prevent sperm from sticking to the uterine wall
Show Answer
Ans: (b) Kill sperm immediately ✔
Rationale for Each Option:
(a) Prevent the motility of the sperm:
Spermicidal agents do reduce sperm motility, but their primary action is to kill sperm rather than merely prevent movement.
(b) Kill sperm immediately:
This is the correct answer. Spermicidal agents work by killing sperm upon contact, making them unable to fertilize an egg. The immediate action of these agents ensures that sperm do not survive in the reproductive tract.
(c) Render the sperm inactive:
While spermicidal agents do affect sperm function, their primary mechanism is killing sperm rather than just rendering them inactive.
(d) Prevent sperm from sticking to the uterine wall:
This is incorrect. Spermicidal agents do not specifically prevent sperm from adhering to the uterine wall. Their main role is to kill sperm before they can reach the egg.
This rationale confirms that the correct description of the action of spermicidal agents is to kill sperm immediately upon contact.
Obstetric and Gynaecology Nursing MCQ Question 583:-
The umbilical cord is attached to the placental margin in …
(a) Placenta succenturiata
(b) Battledore placentae
(c) Circumvallate placentae
(d) Placenta accreta
Show Answer
Ans: (b) Battledore placentae ✔
Rationale for Each Option:
(a) Placenta succenturiata:
Placenta succenturiata refers to a placenta with one or more accessory lobes. The umbilical cord is usually attached to the main placental disc, not the margin, in this condition.
(b) Battledore placentae:
This is the correct answer. In battledore placenta, the umbilical cord is attached to the margin of the placenta rather than the center. The term “battledore” refers to the shape of a shuttlecock, with the cord insertion resembling this pattern.
(c) Circumvallate placentae:
Circumvallate placenta involves a thickened, rolled placental edge, where the placental membrane extends beyond the margins of the placenta, but this does not describe the umbilical cord’s attachment. The cord is still inserted centrally, not at the margin.
(d) Placenta accreta:
Placenta accreta is a condition in which the placenta grows too deeply into the uterine wall, leading to difficulty in separation after delivery. It does not describe abnormal umbilical cord attachment.
This explanation distinguishes the conditions and clarifies why battledore placenta is the correct term for marginal cord attachment.
Obstetric and Gynaecology Nursing MCQ Question 584:-
Rh-isoimmunization is given to a Rh negative pregnant woman if
(a) The first baby born is Rh-negative
(b) The husband is Rh-positive
(c) The husband is Rh-negative
(d) All of the above
Show Answer
Ans: (b) The husband is Rh-positive ✔
Rationale for Each Option:
(a) The first baby born is Rh-negative:
Rh-isoimmunization is not given based on the Rh status of the first baby. If the first baby is Rh-negative, there is no risk of Rh incompatibility, and therefore no need for Rh immunoglobulin.
(b) The husband is Rh-positive:
This is the correct answer. If the husband is Rh-positive, there is a possibility that the fetus may inherit the Rh-positive gene, which could lead to Rh incompatibility if the baby is Rh-positive and the mother is Rh-negative. In such cases, Rh-isoimmunization (Rh immunoglobulin) is given to prevent sensitization.
(c) The husband is Rh-negative:
If both the mother and father are Rh-negative, there is no risk of Rh incompatibility, and Rh-isoimmunization is not needed, regardless of the baby’s Rh status.
(d) All of the above:
This is incorrect, as Rh-isoimmunization is not necessary if the baby and husband are both Rh-negative or if the baby is Rh-negative.
This explanation clarifies the conditions under which Rh-isoimmunization is indicated, focusing on the Rh-positive status of the husband and the potential for Rh incompatibility.
Obstetric and Gynaecology Nursing MCQ Question 585:-
The degree of uterine prolapse in which the uterine body descent to lie outside the introitus is….
(a) 1st degree
(b) 2nd degree
(c) 3rd degree
(d) 4th degree
Show Answer
Ans: (c) 3rd degree ✔
Rationale for Each Option:
(a) 1st degree:
In 1st-degree uterine prolapse, the uterus descends into the vaginal canal but does not extend beyond the vaginal introitus. The cervix may be at or near the vaginal opening, but the uterine body remains inside the vagina.
(b) 2nd degree:
In 2nd-degree uterine prolapse, the uterus descends to the level of the vaginal introitus but does not protrude outside. The cervix is at the vaginal opening, but the body of the uterus has not yet moved outside the introitus.
(c) 3rd degree:
This is the correct answer. In 3rd-degree uterine prolapse, the uterus descends to such a degree that the uterine body lies outside the introitus. This is considered a complete prolapse, where both the cervix and the uterine body are external to the vagina.
(d) 4th degree:
4th-degree prolapse is not a standard classification for uterine prolapse. However, some descriptions refer to a complete prolapse where the entire uterus, including the cervix, has descended outside the introitus, and may sometimes include other pelvic organs involved.
This explanation helps differentiate the stages of uterine prolapse and clarifies the extent of descent for each degree.
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