SNLE Maternal and Child Health 1 — Questions and Answers
Question 1: What is the normal fetal heart rate range?
- 110–160 beats per minute (Correct answer)
- 60–100 beats per minute
- 160–200 beats per minute
- 80–110 beats per minute
Correct answer: 110–160 beats per minute
Normal fetal heart rate is 110–160 bpm. Bradycardia (<110 bpm) may indicate fetal hypoxia or cord compression. Tachycardia (>160 bpm) may suggest maternal fever, fetal infection, or fetal distress.
Question 2: Which sign differentiates true labor from false labor (Braxton Hicks contractions)?
- Contractions that increase in frequency, duration, and intensity with cervical change (Correct answer)
- Irregular contractions that stop with walking
- Contractions felt only in the lower abdomen
- Contractions that ease with a warm bath
Correct answer: Contractions that increase in frequency, duration, and intensity with cervical change
True labor is characterized by regular contractions that progressively increase in frequency, duration, and intensity, accompanied by cervical effacement and dilation. Braxton Hicks contractions are irregular, do not increase in intensity, and do not cause cervical change.
Question 3: What does the APGAR score assess in the newborn?
- Appearance, Pulse, Grimace, Activity, Respiration (Correct answer)
- Alertness, Pulse, Growth, Activity, Reflexes
- Airway, Pulse, Grunting, Arousal, Respiration
- Appearance, Pain, Growth, Alertness, Respirations
Correct answer: Appearance, Pulse, Grimace, Activity, Respiration
The APGAR score assesses five criteria at 1 and 5 minutes of life: Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration. Each is scored 0–2; total 7–10 is normal.
Question 4: A pregnant patient is 38 weeks gestation and has a blood pressure of 158/105 mmHg with 3+ proteinuria. What condition does this indicate?
- Severe preeclampsia (Correct answer)
- Gestational hypertension
- Chronic hypertension
- HELLP syndrome
Correct answer: Severe preeclampsia
Severe preeclampsia is diagnosed when BP ≥160/110 mmHg with significant proteinuria after 20 weeks gestation. Gestational hypertension has no proteinuria; HELLP syndrome includes hemolysis, elevated liver enzymes, and low platelets.
Question 5: What is the recommended position for a laboring patient with umbilical cord prolapse?
- Trendelenburg or knee-chest position (Correct answer)
- High Fowler's position
- Left lateral position
- Supine position
Correct answer: Trendelenburg or knee-chest position
Cord prolapse is an obstetric emergency. The knee-chest or Trendelenburg position uses gravity to shift the presenting part away from the cord, relieving compression. The nurse manually holds the presenting part off the cord while preparing for emergency cesarean section.
Question 6: Which vaccine is recommended for all newborns within 24 hours of birth according to the Saudi immunization schedule?
- Hepatitis B vaccine (Correct answer)
- BCG vaccine
- MMR vaccine
- Varicella vaccine
Correct answer: Hepatitis B vaccine
The Hepatitis B vaccine is given at birth (within 24 hours) to prevent vertical transmission from infected mothers and to establish early immunity. BCG is also given at birth in Saudi Arabia for tuberculosis prevention.
SNLE Maternal and Child Health 1
What is the normal fetal heart rate range?