Obstetrics and Gynaecology — Labour and Delivery, NMC MBBS licence examination syllabus (Nepal Medical Council).
Labour — NMC-style practice questions
Practice questions written for this chapter. These are not past NMC papers.
📋 About these questions: These are practice questions written to test the reasoning in this chapter. They are NOT reproduced from any past Nepal Medical Council examination, and no verified past NMC questions were supplied for this chapter.
Level 1–2 — recall and understanding
Q1. The third stage of labour is defined as:
A. Full dilatation to delivery of the baby
B. Delivery of the baby to delivery of the placenta
C. Onset of labour to full dilatation
D. The first hour after delivery
ANSWER: B.
Why: it is the shortest stage and the most dangerous, because
this is when postpartum haemorrhage occurs. Active management
— uterotonic, controlled cord traction and uterine massage —
reduces blood loss.
LEARNING POINT: short does not mean safe.
Q2. Which of the three P's is the only one that can be
directly corrected?
A. Passage
B. Passenger
C. POWER
D. All three equally
ANSWER: C — power.
Why: the bony pelvis cannot be changed, and the size and
presentation of the fetus usually cannot either. Inadequate
contractions can be augmented — but only once obstruction has
been excluded.
LEARNING POINT: if the passage or passenger is the problem,
the answer is delivery by another route.
Level 3–4 — application and clinical reasoning
Q3. A primigravida has strong frequent contractions, severe
moulding, a large caput and no descent for several hours.
She is tachycardic with scanty concentrated urine. The
correct action is:
A. Oxytocin augmentation
B. Continued observation for 4 more hours
C. Resuscitate and DELIVER — caesarean section
D. Encourage maternal pushing
ANSWER: C.
Why: strong contractions with severe moulding and no descent
is OBSTRUCTED labour, not inadequate powers. Augmenting an
obstructed labour risks uterine rupture.
LEARNING POINT: exclude obstruction before considering
augmentation — always in that order.
Q4. A woman has had irregular contractions for 14 hours. The
cervix is 3 cm and effacing; mother and fetus are well.
The best management is:
A. Caesarean section for failure to progress
B. Immediate oxytocin augmentation
C. Support, hydration, analgesia and continued monitoring
D. Instrumental delivery
ANSWER: C.
Why: this is the LATENT phase, which is long and variable.
Assessment of progress belongs to established active labour,
and intervening here is a common cause of avoidable caesarean
section.
LEARNING POINT: do not diagnose delay in the latent phase.
Q5. After prolonged obstructed labour a woman develops sudden
severe pain, contractions cease, the fetal heart is lost
and she becomes shocked. The diagnosis is:
A. Placental abruption
B. UTERINE RUPTURE
C. Amniotic fluid embolism
D. Cord prolapse
ANSWER: B — uterine rupture.
Why: cessation of contractions with a receding presenting part
after prolonged obstruction is characteristic. The bleeding is
largely concealed, so shock may precede any visible loss.
LEARNING POINT: immediate resuscitation and laparotomy.
Level 5 — exception-based
Q6. Why does transverse lie carry a particular risk of cord
prolapse?
A. The cord is longer in transverse lie
B. No presenting part fills the pelvis, so the cord can
descend when membranes rupture
C. The placenta is always low
D. Contractions are stronger
ANSWER: B.
Why: an ill-fitting or absent presenting part leaves room for
the cord to descend ahead of the fetus at rupture of
membranes. It is then compressed, and fetal oxygenation fails
within minutes.
LEARNING POINT: relieve pressure on the cord and deliver
immediately.
Q7. Which presentation is NOT deliverable vaginally at term?
A. Occipito-posterior position
B. Face presentation with the chin anterior
C. BROW presentation
D. Frank breech
ANSWER: C — brow presentation.
Why: brow presents the largest diameter of the fetal head to
the pelvis. Occipito-posterior is a malPOSITION and often
delivers vaginally; a chin-anterior face may deliver; brow at
term will not.
LEARNING POINT: distinguish malposition from malpresentation,
and know which malpresentations are simply impossible.
Syllabus points
Recall and understanding questions
Application and clinical reasoning questions
Exception-based questions
Create a free account to tick topics off, take notes as you read, watch the video lessons and get a day-by-day study plan built around your exam date.