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Test 6: The puerperium and family planning

  1. Normal lochia:
    • Is colourless.
    • Has no smell.
    • Has an offensive smell.
    • Has a non-offensive smell.
  2. On day 7 postpartum the size of a normally involuting uterus should correspond to a gestational age of approximately:
    • 8 weeks.
    • 12 weeks.
    • 16 weeks.
    • 20 weeks.
  3. A normally involuting uterus will be:
    • Soft and tender.
    • Soft and not tender.
    • Firm and tender.
    • Firm and not tender.
  4. 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 days 1, 3, 5 and 7.
    • The patient must be kept in hospital for at least 5 days.
  5. Which of the following indicate that puerperal pyrexia is caused by a genital tract infection?
    • General malaise.
    • Rigors.
    • Offensive lochia.
    • A marked tachycardia.
  6. 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.
  7. How should you manage a patient with superficial vein thrombosis?
    • Hospitalise the patient for heparin treatment.
    • Keep the patient in bed for 5 days.
    • Start her on oral ampicillin and metronidazole (Flagyl).
    • Give analgesia and support the leg with an elastic bandage.
  8. 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).
  9. 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.
  10. 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.
  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. A common side effect of an intramuscular injection of depo progesterone is:
    • 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. An injectable is a suitable contraceptive method for a woman who:
    • Is planning a pregnancy within the next 6 months.
    • Is planning a pregnancy in a year’s time.
    • Has a history of severe depression.
    • Is 23 years old with 2 children and wants no further children.
  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.