Obstetrics and Gynaecology — Postnatal Care, NMC MBBS licence examination syllabus (Nepal Medical Council).
Postnatal care — 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. Durations, intervals and visit schedules come from current national guidance.
Level 1–2 — recall and understanding
Q1. Secondary postpartum haemorrhage is bleeding occurring:
A. Within the first 24 hours of delivery
B. From 24 HOURS up to several weeks after delivery
C. Only during labour
D. Only after caesarean section
ANSWER: B.
Why: it is usually caused by retained products of conception,
endometritis, or both together — which is why it is often
managed as an infection and a retained-products problem
simultaneously.
LEARNING POINT: fever after delivery is sepsis until proven
otherwise.
Q2. In mastitis, the mother should be advised to:
A. Stop feeding from the affected breast
B. CONTINUE feeding or expressing from that breast
C. Stop breastfeeding entirely
D. Bind the breasts
ANSWER: B.
Why: milk stasis worsens mastitis. Continuing to drain the
breast, alongside treatment per local guidance, is part of
management.
LEARNING POINT: this is counterintuitive and therefore
examined.
Level 3–4 — application and clinical reasoning
Q3. A woman returns 12 days after delivery with heavy
bleeding, offensive lochia, fever and a tender bulky
uterus. The correct approach is:
A. Oral antibiotics as an outpatient
B. Assess circulation, take cultures, give antibiotics
early and ASSESS FOR RETAINED PRODUCTS
C. Reassure — this is normal lochia
D. Iron tablets and review in two weeks
ANSWER: B.
Why: this is secondary PPH with endometritis, and puerperal
sepsis is a leading direct cause of maternal death. A young
woman compensates until she decompensates abruptly.
LEARNING POINT: source control applies — retained products
may need evacuation.
Q4. A first-time mother reports insufficient milk with
cracked painful nipples and frequent brief feeds. The
best first step is:
A. Start formula supplementation
B. WATCH A FEED and correct positioning and attachment
C. Prescribe a galactagogue
D. Advise stopping breastfeeding
ANSWER: B.
Why: cracked nipples with poor transfer is the signature of
poor attachment. Formula reduces stimulation and genuinely
reduces supply, making the perceived problem real.
LEARNING POINT: assess the baby's weight and output
objectively before concluding supply is inadequate.
Q5. Eight days after delivery a woman is confused, agitated,
not sleeping, and believes her baby has been swapped.
This is:
A. Baby blues
B. PUERPERAL PSYCHOSIS — a psychiatric emergency
C. Normal exhaustion
D. Postnatal depression only
ANSWER: B.
Why: rapid onset with delusions and confusion distinguishes
puerperal psychosis from baby blues, which is mild and
self-limiting. It carries real risk to mother and baby.
LEARNING POINT: also exclude organic causes — sepsis and
eclampsia can cause postnatal confusion.
Level 5 — exception-based
Q6. Why should contraception be discussed BEFORE postnatal
discharge rather than at the first period?
A. Because periods never return while breastfeeding
B. Because OVULATION PRECEDES the first period — waiting
is waiting too long
C. Because contraception is only effective early
D. Because breastfeeding is fully protective
ANSWER: B.
Why: fertility returns before menstruation resumes.
Breastfeeding gives conditional and unreliable protection, and
a woman who lives far away may not return.
LEARNING POINT: short birth intervals harm both mother and
child.
Q7. A woman has a fit three days AFTER delivery. This
should be regarded as:
A. Impossible — pre-eclampsia ends at delivery
B. ECLAMPSIA until proven otherwise
C. Certainly epilepsy
D. Baby blues
ANSWER: B.
Why: pre-eclampsia and eclampsia can present or worsen in the
postnatal period. A seizure after delivery must be treated as
eclampsia until excluded, per obstetric protocol.
LEARNING POINT: delivery is not the end of pre-eclampsia
risk.
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.