Quiz 1: Monitoring the condition of the mother during the first stage of labour

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

1. What is a partogram?
   • A chart for recording cervical dilatation only
   • An observation chart to record the clinical findings during the antenatal period
   • A machine to record the fetal heart rate
   • A chart to record the progress of labour together with the maternal and fetal condition
2. During the first stage of labour a partogram must be used:
   • On all patients
   • Only on high-risk patients
   • Only in level 1 clinics
   • Only in level 2 and 3 hospitals
3. Which of the following indicates that the general condition of a patient in the first stage of labour is normal?
   • The patient’s temperature, pulse rate, and blood pressure are normal
   • The patient is at ease and relaxed between contractions and does not appear pale
   • The urine output is normal and ketonuria is not present
   • The patient’s blood pressure is normal and proteinuria is not present
4. The correct management of a 17-year-old primigravida patient who appears very anxious and complains of painful contractions in early labour is:
   • The patient must immediately receive analgesics.
   • A Caesarean section must be done.
   • The patient must be comforted and reassured and receive appropriate analgesia. If possible, someone she knows should stay with her.
   • The membranes must be ruptured to ensure a rapid progress of labour.
5. What is the normal maternal temperature during labour?
   • 35.5–36.0 °C
   • 36.0–37.0 °C
   • 36.5–37.5 °C
   • 37.0–38.0 °C
6. Why is maternal pyrexia an important complication during the first stage of labour?
   • Maternal pyrexia may cause maternal exhaustion and oliguria.
   • Maternal pyrexia may cause convulsions.
   • Maternal pyrexia may cause hypertension during labour.
   • Maternal pyrexia may be caused by an infection which could be dangerous to the patient.
7. What is the normal maternal pulse rate during labour?
   • 60–80
   • 80–100
   • 100–120
   • 120–140
8. What causes a rapid maternal pulse during labour?
   • Fetal distress
   • Hypertension
   • Pyrexia
   • Ketonuria
9. How often should the blood pressure be monitored in a low-risk patient during the latent phase of labour?
   • Every 15 minutes
   • Every 30 minutes
   • Hourly
   • 2-hourly
10. Which of the following may cause hypertension during labour?
    • Anxiety
    • Fetal distress
    • Chorioamnionitis
    • Anaemia
11. Which of the following would be the best management if a patient’s blood pressure was 90/50 mm Hg while she was lying on her back?
    • The patient must change into the lateral position and the blood pressure measurement should be repeated after a further 1 to 2 minutes.
    • As maternal hypotension may cause fetal distress, the fetal heart rate must be checked immediately.
    • The patient should be reassured that some patients normally have a low blood pressure and, therefore, there is no need for concern.
    • As blood loss is the most likely cause for hypotension, active resuscitation must be started immediately.
12. A common clinical sign of shock is:
    • Pyrexia
    • Bradycardia
    • Hypertension
    • A cold and sweaty skin
13. The definition of oliguria is a urine output of less than:
    • 10 ml per hour
    • 20 ml per hour
    • 50 ml per hour
    • 100 ml per hour
14. Oliguria is an important sign of:
    • Dehydration
    • Pyelonephritis
    • Anxiety
    • Heart failure
15. Which of the following statements is correct?
    • All patients should receive an intravenous infusion from the time of admission to the labour ward.
    • Oral fluids must be given to all patients until full cervical dilatation is reached.
    • All patients to be delivered vaginally must be encouraged to take oral fluids while in the active phase of labour.
    • A 50 ml ampoule of 50% dextrose should be given intravenously as soon as ketonuria develops during labour.
16. Infection of the urinary tract may cause:
    • 1+ proteinuria
    • 2+ proteinuria
    • 3+ proteinuria
    • 4+ proteinuria
17. Ketonuria during labour:
    • Is always abnormal and must be treated
    • Is an important sign of fetal distress
    • May be seen in normal patients
    • Is a sign of renal disease
18. Which of the following is a sign of maternal exhaustion during labour?
    • Bradycardia
    • Proteinuria
    • A dry mouth and oliguria
    • Pallor and hypotension
19. What may cause maternal exhaustion during labour?
    • Chorioamnionitis
    • Preterm labour
    • Placenta praevia
    • Prolonged labour
20. How should you treat a patient with maternal exhaustion?
    • Stop the contractions with nifedipine (Adalat).
    • Give oxygen by face mask.
    • Give 2 litres of Ringer’s lactate with 5% dextrose by intravenous infusion.
    • Deliver the infant by Caesarean section.