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Test 6: The puerperium and family planning

Please choose the one most correct answer to each question or statement.

  1. Normal lochia:
    • Is colourless.
    • Has no smell.
    • Has an offensive smell.
    • Has a non-offensive smell.
  2. In the puerperium stress incontinence:
    • Is common
    • Is uncommon
    • Requires referral to the doctor
    • Is a sign of a urinary tract infection
  3. On day seven postpartum the size of a normally involuting uterus should correspond to a gestational age of approximately:
    • 8 weeks.
    • 12 weeks.
    • 16 weeks.
    • 20 weeks.
  4. A normal involuting uterus will be:
    • Soft and tender.
    • Soft and not tender.
    • Firm and tender.
    • Firm and not tender.
  5. How frequently should a primipara visit the clinic for postpartum care in the puerperium?
    • At least daily for 7 days.
    • At least daily for 5 days and again on day 7.
    • At least on day 3 and 7.
    • The patient must be kept in hospital for at least 5 days.
  6. Which of the following indicate that puerperal pyrexia is caused by a genital tract infection?
    • General malaise.
    • Rigors.
    • Offensive lochia.
    • A marked tachycardia.
  7. Observations of the presence or absence of offensive lochia in the patient or jaundice in her infant in the puerperium:
    • Can be made by the patient as well as the midwife.
    • Should not be expected from patients as they are too unreliable.
    • Should only be made by a midwife or doctor.
    • Should only be made by a doctor.
  8. How must a patient with a urinary tract infection causing puerperal pyrexia be treated?
    • Admission to hospital for intravenous broad-spectrum antibiotics.
    • Tepid sponging and paracetamol to bring down the temperature at a clinic.
    • Oral broad-spectrum antibiotics given to the patient at home.
    • Oral broad-spectrum antibiotics and paracetamol given to the patient at home.
  9. A patient who develops the ‘puerperal blues’ needs to be:
    • Referred to a psychiatrist.
    • Isolated together with her infant.
    • Comforted and given an explanation of her feelings.
    • Treated with a benzodiazepine (e.g. Ativan).
  10. What is a secondary postpartum haemorrhage?
    • Any vaginal bleeding that appears excessive, after the first hour following delivery of the placenta.
    • Any vaginal bleeding that appears excessive, after the first 24 hours following delivery of the placenta.
    • Any vaginal bleeding that appears excessive, between the 5th and 15th days of the puerperium.
    • Any vaginal bleeding in the puerperium which is severe enough to cause the patient to become shocked.
  11. The most important aim of family planning is to:
    • Save money.
    • Improve the quality of life for everyone.
    • Prevent sexually transmitted diseases.
    • Ensure that each family has one child only.
  12. The correct way to advise a woman regarding a suitable contraceptive method is to:
    • Ask her which method she would like and then consider if it is a suitable choice.
    • Prescribe the method that you think would be the best.
    • Suggest that she use Ovral as a postcoital contraceptive.
    • Allow her to use whatever method she chooses.
  13. One of the very effective contraceptive methods is:
    • The condom.
    • Breastfeeding.
    • An intra-uterine contraceptive device.
    • Spermicides.
  14. Postcoital contraception with Norlevo, E-Gen-C or Ovral should be offered to a woman who has had a single episode of unprotected sexual intercourse:
    • Five days ago.
    • Seven days ago.
    • Ten days ago.
    • When she misses her next expected period.
  15. Lactation is reduced by:
    • The progestogen-only pill (minipill).
    • An intra-uterine contraceptive device.
    • An injectable, e.g. depot progestogen.
    • A combined oral contraceptive pill.
  16. The side effects of injectable contraceptives (depot progestogens) include:
    • Fluid retention and breast tenderness.
    • Reduction in lactation.
    • Chloasma (a brown mark on the face).
    • Amenorrhoea.
  17. Tubal ligation causes:
    • Menstrual abnormalities.
    • Weight gain.
    • Headaches.
    • None of the above.
  18. An advantage of the condom as a method of contraception is that it:
    • Is very effective.
    • Decreases the risk of sexually transmitted disease.
    • Increases sensation during intercourse.
    • Is socially acceptable to everyone.
  19. Which contraceptive method is most appropriate for a teenager who has had an unplanned pregnancy?
    • An intra-uterine contraceptive device.
    • An implant.
    • A combined oral contraceptive pill.
    • Postcoital contraception.
  20. When would be the most appropriate time to insert an intra-uterine contraceptive device after delivery?
    • Immediately after delivery.
    • 2 weeks postpartum.
    • 6 weeks postpartum.
    • Not earlier than 3 months postpartum.