A healthy woman at 30 weeks has a haemoglobin of 10.6 g/dL, down from 12 g/dL before pregnancy. The main physiological reason for this fall is that:

Plasma volume rises more than red cell mass

Red cell production is suppressed by oestrogen

Red cells are destroyed faster in pregnancy

Iron is diverted to the placenta before the fetus

Antenatal care, physiology and assessment

26 AIIMS NORCET (Nursing Officer) practice questions on Antenatal care, physiology and assessment, part of Obstetric and Gynaecological Nursing. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Easy
During a pelvic examination at 8 weeks, the nurse notes a bluish-purple discolouration of the vagina and cervix. This finding is called:
1. AHegar's sign
2. BOsiander's sign
3. CChadwick's sign
4. DGoodell's sign
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Answer: C · Chadwick's sign
Chadwick's (Jacquemier's) sign is the dusky bluish colour of the vaginal and cervical mucosa caused by pelvic venous congestion. It appears from about 8 weeks. It is a probable sign, since any pelvic congestion can produce it. Goodell's, Hegar's and Osiander's signs describe softening or pulsation, not colour.
- A: Hegar's sign is softening of the isthmus felt on bimanual examination.
- B: Osiander's sign is increased pulsation felt in the lateral vaginal fornices.
- D: Goodell's sign is softening of the cervix.
Question 2 · Easy
A primigravida usually first feels fetal movements (quickening) at about:
1. A24-26 weeks of gestation
2. B18-20 weeks of gestation
3. C8-10 weeks of gestation
4. D12-14 weeks of gestation
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Answer: B · 18-20 weeks of gestation
Quickening is first felt at about 18-20 weeks in a primigravida and about 2 weeks earlier, at 16-18 weeks, in a multigravida who recognises the sensation. It is a presumptive sign, as intestinal gas can feel similar. The date of quickening was used to support gestational dating before ultrasound. Absent movements beyond 20-22 weeks need assessment of fetal life.
- A: By 24-26 weeks movements are well established, not first felt.
- C: At 8-10 weeks movements are seen only on ultrasound.
- D: At 12-14 weeks the fetus moves but the mother cannot yet feel it.
Question 3 · Medium
A healthy woman at 30 weeks has a haemoglobin of 10.6 g/dL, down from 12 g/dL before pregnancy. The main physiological reason for this fall is that:
1. APlasma volume rises more than red cell mass
2. BRed cell production is suppressed by oestrogen
3. CRed cells are destroyed faster in pregnancy
4. DIron is diverted to the placenta before the fetus
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Answer: A · Plasma volume rises more than red cell mass
Plasma volume rises by about 40-50% while red cell mass rises by only 20-30%, so the blood is diluted (physiological haemodilution). The lower viscosity eases placental blood flow. The fall is greatest at 30-34 weeks. Even so, an Hb below 11 g/dL in pregnancy is treated as anaemia, so this woman still needs assessment and IFA.
- B: Red cell mass actually increases in pregnancy, driven by erythropoietin.
- C: Red cell survival is not shortened in normal pregnancy.
- D: Iron goes to the fetus and expanding red cell mass; the fall is from dilution.
Question 4 · Medium
Under MoHFW guidelines, a single dose of albendazole 400 mg is given to pregnant women for deworming:
1. AOnly after delivery
2. BAt every antenatal visit
3. CIn the second trimester
4. DIn the first trimester
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Answer: C · In the second trimester
Worm infestation, especially hookworm, adds to iron-deficiency anaemia in India. Albendazole 400 mg as a single dose is given once in the second trimester, after organogenesis is complete, to avoid any risk to the embryo. It is given along with IFA. It is not given in the first trimester.
- A: Waiting until after delivery leaves the anaemia-causing worms untreated in pregnancy.
- B: One dose is enough; repeated dosing at every visit is not advised.
- D: The first trimester is avoided because of the theoretical risk during organogenesis.
Question 5 · Hard
A woman with regular 35-day cycles had her last menstrual period on 4 February 2026. What is her corrected expected date of delivery?
1. A11 November 2026
2. B4 November 2026
3. C25 November 2026
4. D18 November 2026
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Answer: D · 18 November 2026
Naegele's rule assumes a 28-day cycle. Standard rule: 4 Feb + 7 days = 11 Feb; minus 3 months and plus 1 year = 11 November 2026. Her cycle is 7 days longer, so ovulation is about 7 days later and 7 days are added: 18 November 2026. An early ultrasound (CRL) is the most reliable way to confirm dating in irregular or long cycles.
- A: 11 November is the uncorrected date for a 28-day cycle.
- B: 4 November forgets the first 7 days of Naegele's rule.
- C: 25 November adds 14 days for the long cycle instead of 7.
Question 6 · Medium
During a 20-minute non-stress test at 36 weeks, the baseline is 140 bpm with two accelerations of 15 bpm, each lasting 15 seconds, linked to fetal movements. The nurse should record the test as:
1. AEquivocal, needing a repeat test after 40 minutes
2. BNon-reactive, needing a contraction stress test
3. CReactive, suggesting good fetal oxygenation
4. DAbnormal, needing immediate delivery
Answer and explanation in LearnFree account
Question 7 · Hard
A woman with regular cycles is 10 weeks 0 days by LMP. Her scan shows a crown-rump length matching 8 weeks 0 days. The unit redates when a CRL differs from LMP dates by more than 7 days. The nurse should expect the obstetrician to:
1. AKeep the LMP-based EDD as she has regular cycles
2. BChange the EDD to the one given by the CRL
3. CKeep both dates until the 20-week anomaly scan
4. DTake the average of the LMP and CRL dates
Answer and explanation in LearnFree account
Question 8 · Medium
Two weeks after starting IFA tablets, a pregnant woman says her stools have turned black, with no pain or other symptoms. The most appropriate response is:
1. ASend her stool sample for occult blood testing first
2. BAdvise her to stop the tablets until she sees a doctor
3. CAsk her to take the tablet with milk to avoid this
4. DExplain this is expected with iron and continue the tablets
Answer and explanation in LearnFree account
Question 9 · Hard
A biophysical profile shows: non-stress test non-reactive; fetal breathing for 40 seconds; three body movements; limb extension and flexion; deepest vertical pool of liquor 1.5 cm. What is the BPP score?
1. A8/10
2. B6/10
3. C4/10
4. D10/10
Answer and explanation in LearnFree account
Question 10 · Easy
Under the Anaemia Mukt Bharat programme, each prophylactic IFA tablet given daily to a pregnant woman contains:
1. A60 mg elemental iron and 400 µg folic acid
2. B45 mg elemental iron and 400 µg folic acid
3. C60 mg elemental iron and 500 µg folic acid
4. D100 mg elemental iron and 500 µg folic acid
Answer and explanation in LearnFree account
Question 11 · Medium
A woman at 34 weeks lying flat on her back for an ultrasound becomes pale, sweaty and dizzy; her BP falls to 88/52 mmHg. The nurse's first action is to:
1. ATurn her onto her left side
2. BRaise the foot end of the bed
3. CStart oxygen by face mask
4. DGive her a glass of glucose water
Answer and explanation in LearnFree account
Question 12 · Medium
On palpation at 36 weeks, the head is in the pelvis and the fetal back lies on the mother's left side, towards the front. The nurse will hear the fetal heart most clearly:
1. AAbove the umbilicus on the left side
2. BBelow the umbilicus on the right side
3. CBelow the umbilicus on the left side
4. DDirectly over the umbilicus in midline
Answer and explanation in LearnFree account
Question 13 · Medium
Nuchal translucency is measured on ultrasound as a screen for Down syndrome. The right time for this scan is:
1. A28 to 32 weeks
2. B6 to 8 weeks
3. C11 to 13 weeks 6 days
4. D18 to 20 weeks
Answer and explanation in LearnFree account
Question 14 · Easy
According to MoHFW guidelines for India, the minimum number of antenatal visits for a normal pregnancy is:
1. AFour visits
2. BSix visits
3. CEight visits
4. DTwo visits
Answer and explanation in LearnFree account
Question 15 · Easy
By current FIGO criteria, the normal baseline fetal heart rate at term is:
1. A100-140 beats per minute
2. B110-160 beats per minute
3. C90-130 beats per minute
4. D120-180 beats per minute
Answer and explanation in LearnFree account
Question 16 · Easy
The first Leopold's manoeuvre (fundal grip) helps the nurse identify:
1. AThe degree of flexion of the fetal head
2. BThe fetal part that lies in the fundus
3. CThe side on which the fetal back lies
4. DWhether the presenting part is engaged
Answer and explanation in LearnFree account
Question 17 · Medium
On a CTG, decelerations begin after the peak of each contraction and return to baseline only after the contraction has ended. These decelerations most likely indicate:
1. AUteroplacental insufficiency
2. BFetal sleep cycle
3. CFetal head compression
4. DUmbilical cord compression
Answer and explanation in LearnFree account
Question 18 · Hard
A woman is now 20 weeks pregnant. She has had live twins at 36 weeks (both living), a stillbirth at 30 weeks and a miscarriage at 12 weeks. Her GTPAL score is:
1. AG4 T0 P3 A1 L2
2. BG4 T0 P2 A1 L2
3. CG4 T1 P1 A1 L2
4. DG3 T0 P2 A1 L2
Answer and explanation in LearnFree account
Question 19 · Easy
Folic acid 400 µg daily, started before conception and taken through the first trimester, mainly prevents:
1. ACleft lip and palate
2. BDown syndrome
3. CCongenital heart block
4. DNeural tube defects
Answer and explanation in LearnFree account
Question 20 · Medium
A woman at 30 weeks has one living child born at 39 weeks, one living child born at 34 weeks, and had a miscarriage at 8 weeks. Her obstetric score in GTPAL format is:
1. AG4 T1 P1 A0 L2
2. BG3 T1 P1 A1 L2
3. CG4 T1 P1 A1 L2
4. DG4 T2 P0 A1 L2
Answer and explanation in LearnFree account
Question 21 · Hard
A woman at 10 weeks has vomited many times a day for a week. She has lost 4 kg (7% of body weight), her urine shows 3+ ketones, and her pulse is 112/min. Before dextrose-containing IV fluids are started, she should receive:
1. APyridoxine
2. BOndansetron
3. CThiamine
4. DPotassium chloride
Answer and explanation in LearnFree account
Question 22 · Hard
At 32 weeks, a hand-held Doppler records a heart rate of 96-100 bpm from the left lower abdomen. The mother is anxious, and her radial pulse is 98/min. What should the nurse do first?
1. AGive oxygen and recheck the rate after one hour
2. BCall for an emergency caesarean for fetal bradycardia
3. CRecord a normal fetal rate and finish the visit
4. DReposition the probe while feeling the mother's pulse
Answer and explanation in LearnFree account
Question 23 · Easy
Which finding is a positive (certain) sign of pregnancy?
1. ASoftening of the uterine isthmus
2. BBluish colour of the vaginal mucosa
3. CFluttering felt by the mother
4. DFetal heart sounds heard with a Doppler
Answer and explanation in LearnFree account
Question 24 · Medium
A woman's last menstrual period began on 12 March 2026; her cycles are regular, 28 days. By Naegele's rule, her expected date of delivery is:
1. A19 December 2026
2. B19 June 2027
3. C5 December 2026
4. D12 December 2026
Answer and explanation in LearnFree account
Question 25 · Medium
A woman at 33 weeks uses the Cardiff 'count to ten' chart. She should be told to report to the hospital the same day if she feels:
1. AFewer than 10 movements in 24 hours
2. BFewer than 10 movements in 1 hour
3. CFewer than 10 movements in 12 hours
4. DFewer than 3 movements in 12 hours
Answer and explanation in LearnFree account

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Antenatal care, physiology and assessment

During a pelvic examination at 8 weeks, the nurse notes a bluish-purple discolouration of the vagina and cervix. This finding is called:

A primigravida usually first feels fetal movements (quickening) at about:

A healthy woman at 30 weeks has a haemoglobin of 10.6 g/dL, down from 12 g/dL before pregnancy. The main physiological reason for this fall is that:

Under MoHFW guidelines, a single dose of albendazole 400 mg is given to pregnant women for deworming:

A woman with regular 35-day cycles had her last menstrual period on 4 February 2026. What is her corrected expected date of delivery?

During a 20-minute non-stress test at 36 weeks, the baseline is 140 bpm with two accelerations of 15 bpm, each lasting 15 seconds, linked to fetal movements. The nurse should record the test as:

A woman with regular cycles is 10 weeks 0 days by LMP. Her scan shows a crown-rump length matching 8 weeks 0 days. The unit redates when a CRL differs from LMP dates by more than 7 days. The nurse should expect the obstetrician to:

Two weeks after starting IFA tablets, a pregnant woman says her stools have turned black, with no pain or other symptoms. The most appropriate response is:

A biophysical profile shows: non-stress test non-reactive; fetal breathing for 40 seconds; three body movements; limb extension and flexion; deepest vertical pool of liquor 1.5 cm. What is the BPP score?

Under the Anaemia Mukt Bharat programme, each prophylactic IFA tablet given daily to a pregnant woman contains:

A woman at 34 weeks lying flat on her back for an ultrasound becomes pale, sweaty and dizzy; her BP falls to 88/52 mmHg. The nurse's first action is to:

On palpation at 36 weeks, the head is in the pelvis and the fetal back lies on the mother's left side, towards the front. The nurse will hear the fetal heart most clearly:

Nuchal translucency is measured on ultrasound as a screen for Down syndrome. The right time for this scan is:

According to MoHFW guidelines for India, the minimum number of antenatal visits for a normal pregnancy is:

By current FIGO criteria, the normal baseline fetal heart rate at term is:

The first Leopold's manoeuvre (fundal grip) helps the nurse identify:

On a CTG, decelerations begin after the peak of each contraction and return to baseline only after the contraction has ended. These decelerations most likely indicate:

A woman is now 20 weeks pregnant. She has had live twins at 36 weeks (both living), a stillbirth at 30 weeks and a miscarriage at 12 weeks. Her GTPAL score is:

Folic acid 400 µg daily, started before conception and taken through the first trimester, mainly prevents:

A woman at 30 weeks has one living child born at 39 weeks, one living child born at 34 weeks, and had a miscarriage at 8 weeks. Her obstetric score in GTPAL format is:

A woman at 10 weeks has vomited many times a day for a week. She has lost 4 kg (7% of body weight), her urine shows 3+ ketones, and her pulse is 112/min. Before dextrose-containing IV fluids are started, she should receive:

At 32 weeks, a hand-held Doppler records a heart rate of 96-100 bpm from the left lower abdomen. The mother is anxious, and her radial pulse is 98/min. What should the nurse do first?

Which finding is a positive (certain) sign of pregnancy?

A woman's last menstrual period began on 12 March 2026; her cycles are regular, 28 days. By Naegele's rule, her expected date of delivery is:

A woman at 33 weeks uses the Cardiff 'count to ten' chart. She should be told to report to the hospital the same day if she feels: