WorksheetsCPPHC 2ND EXAMINATION
Total questions: 50
Worksheet time: 25mins
A 28-year-old woman visits the prenatal clinic for her first check-up. She states her last menstrual period (LMP) started on June 10, 2024. Using Naegele's rule, what is her estimated date of confinement (EDC)?
March 17, 2025
March 10, 2025
September 17, 2025
March 3, 2025
A patient tells you she is pregnant for the fourth time. Her first pregnancy was a full-term boy. Her second pregnancy ended in a miscarriage at 10 weeks. Her third pregnancy was twin girls born at 35 weeks. What is her correct gravida and para?
Gravida 3, Para 3
Gravida 3, Para 2
Gravida 4, Para 2
Gravida 4, Para 3
A 32-year-old woman, currently pregnant, has one living child who was born at 39 weeks. She also had a pregnancy that ended at 15 weeks. How would you document her status using the G/P system?
G3 P1
G3 P2
G2 P2
G2 P1
A woman's LMP was November 20, 2023. What is the most accurate EDC for her?
August 27, 2024
August 13, 2024
February 27, 2024
September 3, 2024
A patient is documented as G5 P3 T2 P1 A1 L3. She is currently pregnant. What does this information indicate?
She is pregnant with her third child.
She has had 5 pregnancies, with 2 term births, 1 preterm birth, 1 abortion, and 3 living children.
She has had 5 pregnancies, 3 of which went to term.
She has had 3 preterm births and 2 term births.
A midwifery student prepares to measure the fundic height of a pregnant woman at 28 weeks gestation. Which landmark should the student use as the starting point when placing the tape measure?
Umbilicus
Symphysis pubis
Xiphoid process
Costal margin
During antenatal care, the fundic height of a woman at 24 weeks AOG measures 20 cm. What does this finding most likely indicate?
The fetus is large for gestational age
The fetus is smaller than expected
The woman has polyhydramnios
The woman is in active labor
A midwife is about to measure the fundic height of a 32-week pregnant woman. The patient has just finished urinating. What should the midwife do next to ensure an accurate reading?
Position the woman standing upright
Place the woman in a supine position with legs bent
Place the woman in a supine position with knees straight
Ask the woman to lie on her left side
During a prenatal exam, the midwife first uses inspection. Which of the following should be noted during abdominal inspection of a pregnant woman?
Fetal heart tone
Fundic height
Abdominal contour and skin changes
Cervical dilation
A 32-week pregnant woman asks why the midwife is pressing on her abdomen during Leopold's maneuver. What should the midwife explain?
To listen to the baby's heart
To feel the baby's position and presentation
To measure uterine contractions
To assess cervical dilation
During physical assessment, percussion is least commonly used in pregnant women. Which finding may be assessed by percussion?
Estimating amniotic fluid
Detecting bladder distension
Checking fetal position
Measuring uterine height
A 24-week pregnant woman asks what the midwife is listening to with a Doppler. What is the best response?
“I am checking your bowel sounds.”
“I am listening to your baby’s heartbeat.”
“I am measuring your blood pressure.”
“I am listening for uterine contractions.”
The midwife notes pitting edema in the ankles of a 34-week pregnant woman. What should the midwife do next?
Document as normal in pregnancy
Assess blood pressure
Reassure the patient only
Ignore unless the patient complains
During Leopold’s maneuver, the midwife palpates a hard, round, ballotable part in the lower abdomen. What does this indicate?
Breech presentation
Cephalic presentation
Transverse lie
Shoulder presentation
At 30 weeks, the fetal heart rate (FHR) is auscultated at 180 bpm. What should the midwife do?
Reassure the mother this is normal
Refer immediately for further evaluation
Record and schedule a recheck after 1 month
Encourage the mother to drink water
In physical assessment, which sequence of techniques is correct for examining the abdomen of a pregnant woman?
Inspection → Palpation → Auscultation → Percussion
Inspection → Auscultation → Palpation → Percussion
Palpation → Auscultation → Inspection → Percussion
Percussion → Palpation → Inspection → Auscultation
The midwife palpates the uterine fundus at the level of the xiphoid process. What does this indicate?
20 weeks AOG
28 weeks AOG
36 weeks AOG
40 weeks AOG
A 26-week pregnant woman presents with abdominal pain. On assessment, the midwife finds: fundic height appropriate, fetal heart tones normal, and no uterine tenderness. What is the most appropriate action?
Reassure the patient and advise rest
Refer immediately for emergency care
Order antibiotics
Induce labor
A midwife interviews a pregnant woman during her first prenatal visit. Which question is MOST important to include in obtaining an obstetric history?
“Do you exercise daily?”
“When was the first day of your last menstrual period?”
“How many meals do you eat per day?”
“Have you experienced colds recently?”
During history-taking, a pregnant woman reports having preeclampsia in her previous pregnancy. What should the midwife consider?
This is irrelevant in the current pregnancy.
This increases her risk in the current pregnancy.
This indicates she will definitely have preeclampsia again.
This means she cannot have a normal delivery.
A patient with a history of hypertension is seeking prenatal care. What should the midwife prioritize during health history-taking?
Family history of allergies
Current medications being taken
Usual sleep patterns
Past surgical history only
A mother brings her 2-year-old child for consultation. The midwife notes that the child has not received measles vaccination and is delayed in walking. What does this suggest?
The child is developing normally
The child may need further evaluation for developmental delay
The child does not need immunization anymore
The child’s history is unimportant since he is only 2 years old
A pregnant woman at 10 weeks reports vaginal bleeding and a history of miscarriage. What is the best action of the midwife?
Reassure her that bleeding is normal in early pregnancy
Refer her immediately for medical evaluation
Advise her to monitor at home for 1 week
Record the history and continue routine care
During a rural health visit, the midwife interviews an adult client with diabetes mellitus. Why is it important to ask about lifestyle habits (diet, exercise, smoking)?
Because lifestyle factors may worsen chronic conditions
Because it is only routine questioning
Because lifestyle is more important than medical history
Because it can replace laboratory results
A 24-year-old pregnant woman in her second trimester attends her first prenatal check-up. Which topic should the midwife emphasize first during health education?
Family planning methods
Importance of regular prenatal checkups
Exercise programs after delivery
Home remedies for labor pain
During a rural health mission, a 40-year-old client asks why the midwife is stressing hygiene and chronic disease prevention. What should the midwife explain?
Because most patients prefer hygiene education over medicines
Preventive care reduces disease burden and improves long-term outcomes
Because laboratory services are unavailable in rural areas
To replace medical treatments with health teaching
A mother of a 6-month-old baby asks what the most important health practice is at this stage. Which should the midwife recommend?
Exclusive breastfeeding and timely immunization
Early toilet training
Regular solid meals with family food
Use of vitamins only
A pregnant woman at 32 weeks reports severe headache and blurred vision. What is the most appropriate health education the midwife should provide?
“This is normal in late pregnancy; just rest.”
“Drink more fluids and avoid bright lights.”
“These are danger signs; you must seek immediate medical attention.”
“Ignore unless abdominal pain develops.”
A 22-year-old pregnant woman in her 2nd trimester visits the RHU for regular antenatal care. She is stable, with normal vital signs, and no complications are noted. What is the appropriate action?
Refer her to the nearest tertiary hospital
Admit her in the RHU for close monitoring
Provide antenatal check-up and routine health education
Send her home without documentation
What does admission of patients in an RHU primarily mean?
Transferring patients to higher facilities for advanced care
Formally accepting patients for treatment within the RHU
Recording patients’ names in the barangay health registry
Discharging patients after consultation
A midwife assesses a child with high-grade fever, convulsions, and difficulty breathing. The RHU lacks oxygen and IV medication. What is the MOST appropriate next step?
Manage the patient with paracetamol only
Refer the patient immediately to a higher-level facility
Ask the parents to bring the child back tomorrow
Keep the child under observation until fever subsides
Why is standardizing admission and referral procedures important in rural health practice?
To save time and reduce paperwork
To ensure continuity of care and patient safety
To avoid midwives’ accountability in patient care
To limit referrals to tertiary hospitals
During admission of a patient with suspected pneumonia in the RHU, what is the FIRST step the midwife should perform?
Prescribe antibiotics immediately
Register the patient and conduct initial assessment
Refer the patient without assessment
Request the patient to buy medications from the pharmacy
A midwife decides to refer a patient in labor with eclampsia. What should be included in the referral slip?
Only the patient’s name and age
The patient’s medical findings, management done, and reason for referral
The midwife’s name and address only
The receiving hospital’s bed availability
Which of the following is NOT an indication for referral from RHU to a higher-level facility?
Normal spontaneous delivery without complications
Obstructed labor
Severe preeclampsia
Severe trauma from an accident
While preparing to transfer a patient with postpartum hemorrhage, what is the priority action of the midwife?
Wait for the ambulance without providing care
Stabilize the patient as much as possible before transfer
Ask the family to arrange transport without informing the hospital
Transfer the patient without medical records
Which statement BEST describes the role of documentation in admission and referral?
It is optional and only for legal purposes
It ensures patient data is available for continuity of care
It replaces verbal communication with the patient’s family
It is only required in hospital settings
A patient arrives at the RHU with a deep laceration from a motorcycle accident. The wound is bleeding heavily, and the RHU has no surgical facility. What should the midwife do?
Clean and dress the wound, then refer the patient immediately
Ask the patient to wait until the doctor arrives the next day
Provide pain medication and send the patient home
Attempt to suture the wound despite lack of facility
What is the main purpose of monitoring admitted patients in the RHU?
To document patient names in the logbook
To adjust care plans and ensure timely interventions
To reduce the workload of the midwife
To prepare for early discharge regardless of condition
A midwife is monitoring a postpartum patient admitted in the RHU. The patient suddenly develops a fever and abdominal pain. What should the midwife do FIRST?
Document and wait for the fever to subside
Adjust the care plan and provide immediate intervention
Discharge the patient since she can be managed at home
Refer without initial management
Why is it important to follow up with the referral facility after transferring a patient?
To confirm bed availability in the hospital
To ensure care was transferred successfully and get updates
To lessen RHU workload
To discharge the patient earlier
A 5-year-old child with severe pneumonia was referred to the provincial hospital. Two days later, the midwife calls the hospital to check on the outcome of the referral. What principle is being demonstrated?a. Patient debriefing
Patient debriefing
Referral follow-up
Admission monitoring
Discharge planning
Which of the following BEST describes the role of documentation in monitoring admitted patients?
It is optional and can be skipped if the patient is stable
It ensures that patient progress and discharge plans are recorded
It replaces the need for verbal handover
It is only required for complicated cases
A patient was referred to a higher facility for emergency care. The family is anxious and confused about the next steps. What should the midwife do?
Ignore the family to focus on paperwork
Debrief the family, explain the plan of care, and answer questions
Ask the family to talk to the hospital instead
Give written instructions only
What is the PRIMARY purpose of closure after admission or referral?
To finish paperwork quickly
To reassure the family and provide clear instructions
To prepare for patient billing
To reduce patient visits to the RHU
After a referral, the patient’s husband asks what treatment will be given in the hospital. The midwife is unsure of the specific details. What is the BEST response?
“I don’t know, just wait and see.”
“I am not sure, but the hospital has the resources to provide advanced care. I will also follow up with them.”
“You should not ask too many questions.”
d. “Go to the hospital immediately without explanation.”
“Go to the hospital immediately without explanation.”
Why should community health workers be involved in post-discharge follow-up?
To reduce the responsibility of the RHU midwife
To ensure continuity of care at the community level
To replace hospital care completely
To limit patient access to services
A patient treated for tuberculosis at the RHU has been discharged. What is the BEST way to ensure adherence to treatment?
Stop monitoring once the patient leaves the RHU
Coordinate with community health workers to track medication compliance
Tell the patient to visit only when symptoms worsen
Leave the responsibility entirely to the family.
Which statement BEST reflects the importance of integrating follow-up and closure in patient care?
It reduces the need for RHU midwives
It improves outcomes and builds patient-family trust
It avoids unnecessary referrals
It prevents midwives from making errors
A midwife notices that a hypertensive patient referred for follow-up at the hospital has not returned to the RHU. What is the MOST appropriate action?
Ignore the case since referral was already made
Document the case only without follow-up
Contact the hospital or community health worker to check on the patient
Wait until the patient voluntarily returns
