PGIMER Nursing Officer OBG Quiz
Practice 30 high-yield OBG MCQs on APH and PPH for PGIMER Nursing Officer Exam 2026. Test your preparation with instant answers, clinical rationales & score tracker.
PGIMER Nursing Officer Bharti 2026
OBG Mock Test: Antepartum (APH) & Postpartum Hemorrhage (PPH) – 30 MCQs
1. By clinical definition, Antepartum Hemorrhage (APH) is bleeding from or into the genital tract occurring after:
Right Answer: B
Rationale: In Indian guidelines, APH is defined as bleeding from the genital tract occurring after the period of fetal viability (28 weeks in India) until the birth of the baby.
Rationale: In Indian guidelines, APH is defined as bleeding from the genital tract occurring after the period of fetal viability (28 weeks in India) until the birth of the baby.
2. A pregnant woman at 34 weeks presents with sudden onset, painless, causeless, recurrent, bright red vaginal bleeding. This classic presentation points towards:
Right Answer: B
Rationale: Painless, causeless, recurrent, bright red vaginal bleeding with a soft, non-tender uterus is the hallmark of Placenta Previa.
Rationale: Painless, causeless, recurrent, bright red vaginal bleeding with a soft, non-tender uterus is the hallmark of Placenta Previa.
3. Which essential obstetric procedure is STRICTLY CONTRAINDICATED in a patient presenting with suspected Placenta Previa until ultrasound confirmation?
Right Answer: B
Rationale: Digital vaginal examination may detach the low-lying placenta and precipitate massive, life-threatening hemorrhage.
Rationale: Digital vaginal examination may detach the low-lying placenta and precipitate massive, life-threatening hemorrhage.
4. Which degree of placenta previa is known as “Dangerous Placenta Previa” due to high risk of massive bleeding and fetal head non-engagement?
Right Answer: B
Rationale: Type II Posterior placenta previa compresses against the sacral promontory, preventing head engagement and causing severe cord compression (Stallworthy’s sign).
Rationale: Type II Posterior placenta previa compresses against the sacral promontory, preventing head engagement and causing severe cord compression (Stallworthy’s sign).
5. A 32-week pregnant woman with severe pre-eclampsia presents with continuous severe abdominal pain, dark port-wine vaginal bleeding, and a tense, woody/hard uterus. The most probable diagnosis is:
Right Answer: B
Rationale: Painful, dark vaginal bleeding with a board-like, rigid, tender uterus (woody uterus) is characteristic of Abruptio Placentae (accidental hemorrhage).
Rationale: Painful, dark vaginal bleeding with a board-like, rigid, tender uterus (woody uterus) is characteristic of Abruptio Placentae (accidental hemorrhage).
6. What is “Couvelaire Uterus” (Uteroplacental Apoplexy) commonly seen in severe concealed abruptio placentae?
Right Answer: C
Rationale: In severe abruptio placentae, blood infiltrates into the myometrium and beneath the peritoneal coat, giving the uterus a mottled, dark purple/copper-colored appearance known as Couvelaire uterus.
Rationale: In severe abruptio placentae, blood infiltrates into the myometrium and beneath the peritoneal coat, giving the uterus a mottled, dark purple/copper-colored appearance known as Couvelaire uterus.
7. Which hematological complication is most commonly associated with severe concealed abruptio placentae?
Right Answer: A
Rationale: Release of high quantities of tissue thromboplastin from the retroplacental clot into the maternal circulation leads to consumption coagulopathy and DIC.
Rationale: Release of high quantities of tissue thromboplastin from the retroplacental clot into the maternal circulation leads to consumption coagulopathy and DIC.
8. In a bedside clinical test for DIC in concealed abruption, normal blood collected in a clean glass test tube fails to form a clot or forms an unstable clot within:
Right Answer: B
Rationale: In Weiner’s bedside clot observation test, normal blood clots within 6-10 minutes. Clot failure or lysis within an hour indicates severe hypofibrinogenemia (<150 mg/dL).
Rationale: In Weiner’s bedside clot observation test, normal blood clots within 6-10 minutes. Clot failure or lysis within an hour indicates severe hypofibrinogenemia (<150 mg/dL).
9. Macafee and Johnson regimen is an expectant conservative management protocol practiced for which condition?
Right Answer: B
Rationale: Macafee regimen aims to prolong pregnancy up to 37 weeks in preterm placenta previa with maternal and fetal stability to enhance fetal lung maturity.
Rationale: Macafee regimen aims to prolong pregnancy up to 37 weeks in preterm placenta previa with maternal and fetal stability to enhance fetal lung maturity.
10. By definition, Primary Postpartum Hemorrhage (PPH) is blood loss from the genital tract exceeding:
Right Answer: B
Rationale: Primary PPH is defined as blood loss >= 500 mL after vaginal delivery or >= 1000 mL following Cesarean section occurring within 24 hours of delivery.
Rationale: Primary PPH is defined as blood loss >= 500 mL after vaginal delivery or >= 1000 mL following Cesarean section occurring within 24 hours of delivery.
11. Secondary Postpartum Hemorrhage (Late PPH) is defined as excessive bleeding occurring:
Right Answer: C
Rationale: Secondary PPH occurs after 24 hours up to 12 weeks (conventionally 6 weeks) postpartum, most commonly caused by retained placental cotyledons and infection (subinvolution).
Rationale: Secondary PPH occurs after 24 hours up to 12 weeks (conventionally 6 weeks) postpartum, most commonly caused by retained placental cotyledons and infection (subinvolution).
12. The most common underlying etiology for Primary Postpartum Hemorrhage (accounting for ~80% of cases) is:
Right Answer: B
Rationale: The 4 T’s of PPH are Tone, Trauma, Tissue, and Thrombin. Atonic uterus (Tone) is by far the leading cause (~80%).
Rationale: The 4 T’s of PPH are Tone, Trauma, Tissue, and Thrombin. Atonic uterus (Tone) is by far the leading cause (~80%).
13. The anatomical physiological mechanism that controls postpartum bleeding at the placental site is famously termed:
Right Answer: B
Rationale: The middle layer of uterine myometrium consists of interlacing figure-of-8 muscle fibers that clamp down on traversing blood vessels when contracted, acting as “living ligatures”.
Rationale: The middle layer of uterine myometrium consists of interlacing figure-of-8 muscle fibers that clamp down on traversing blood vessels when contracted, acting as “living ligatures”.
14. What is the FIRST step a nursing officer must perform immediately upon diagnosing an atonic uterus postpartum?
Right Answer: B
Rationale: Immediate vigorous fundal massage stimulates uterine muscle contraction, expresses pooled blood clots, and buys critical time while calling the resuscitation team.
Rationale: Immediate vigorous fundal massage stimulates uterine muscle contraction, expresses pooled blood clots, and buys critical time while calling the resuscitation team.
15. The standard intravenous infusion dose of Oxytocin for active management of atonic PPH is:
Right Answer: B
Rationale: For treating established atonic PPH, 20-40 IU Oxytocin in 500-1000 mL crystalloid infused rapidly is standard. Undiluted rapid IV push of oxytocin is avoided due to severe hypotension.
Rationale: For treating established atonic PPH, 20-40 IU Oxytocin in 500-1000 mL crystalloid infused rapidly is standard. Undiluted rapid IV push of oxytocin is avoided due to severe hypotension.
16. What is the standard dose and recommended route of Carboprost tromethamine (15-methyl PGF2-alpha) in refractory atonic PPH?
Right Answer: C
Rationale: Carboprost (Prostin 15M) is given as 250 mcg deep IM, repeatable every 15-90 minutes up to a maximum cumulative dose of 2 mg (8 doses).
Rationale: Carboprost (Prostin 15M) is given as 250 mcg deep IM, repeatable every 15-90 minutes up to a maximum cumulative dose of 2 mg (8 doses).
17. Carboprost tromethamine (PGF2-alpha) is strictly contraindicated in women suffering from which co-morbidity?
Right Answer: B
Rationale: PGF2-alpha is a potent bronchoconstrictor and can trigger life-threatening acute bronchospasm in asthmatic patients.
Rationale: PGF2-alpha is a potent bronchoconstrictor and can trigger life-threatening acute bronchospasm in asthmatic patients.
18. The WHO recommended dose of Misoprostol (PGE1) for the treatment of atonic PPH when injectable uterotonics are unavailable is:
Right Answer: B
Rationale: WHO recommends 800 mcg Misoprostol sublingually (or rectally) for refractory or resource-limited PPH management. Common side effects are high-grade shivering and pyrexia.
Rationale: WHO recommends 800 mcg Misoprostol sublingually (or rectally) for refractory or resource-limited PPH management. Common side effects are high-grade shivering and pyrexia.
19. In the WOMAN trial, early administration of which antifibrinolytic agent within 3 hours of birth was proven to significantly reduce death due to PPH?
Right Answer: C
Rationale: The WOMAN trial showed Tranexamic Acid 1 g IV given over 10 minutes within 3 hours of delivery reduces bleeding mortality without increasing thromboembolic events.
Rationale: The WOMAN trial showed Tranexamic Acid 1 g IV given over 10 minutes within 3 hours of delivery reduces bleeding mortality without increasing thromboembolic events.
20. In Traumatic PPH, a characteristic clinical finding that distinguishes it from Atonic PPH is:
Right Answer: B
Rationale: If vaginal bleeding persists as a bright red continuous trickle while the uterine fundus is rock-hard and well-contracted, cervical, vaginal, or perineal laceration (traumatic PPH) must be suspected.
Rationale: If vaginal bleeding persists as a bright red continuous trickle while the uterine fundus is rock-hard and well-contracted, cervical, vaginal, or perineal laceration (traumatic PPH) must be suspected.
21. What is the maximum recommended filling volume of sterile saline when inserting a Bakri postpartum balloon catheter?
Right Answer: B
Rationale: Bakri balloon tamponade is inflated with 300-500 mL of warm normal saline to exert hydrostatic pressure against the bleeding placental bed.
Rationale: Bakri balloon tamponade is inflated with 300-500 mL of warm normal saline to exert hydrostatic pressure against the bleeding placental bed.
22. What is the maximum duration for which an intrauterine balloon catheter (e.g., Bakri balloon) should be left in situ?
Right Answer: B
Rationale: Balloon tamponade is removed within 24 hours (usually deflated gradually after 12-24 hours) to minimize the risk of severe intrauterine infection and tissue necrosis.
Rationale: Balloon tamponade is removed within 24 hours (usually deflated gradually after 12-24 hours) to minimize the risk of severe intrauterine infection and tissue necrosis.
23. In refractory atonic PPH requiring surgical laparotomy, which uterine compression suture technique is most widely utilized?
Right Answer: B
Rationale: B-Lynch uterine compression suture exerts longitudinal compression (“brace suture”) on the uterine corpus, effectively compressing vessels without occluding cavity outflow.
Rationale: B-Lynch uterine compression suture exerts longitudinal compression (“brace suture”) on the uterine corpus, effectively compressing vessels without occluding cavity outflow.
24. What is the internal iliac artery branch that is bilaterally ligated as an emergency fertility-preserving procedure to control severe PPH?
Right Answer: B
Rationale: Bilateral ligation of the anterior division of the internal iliac (hypogastric) artery reduces pelvic pulse pressure by 85%, stopping bleeding while preserving pelvic collateral perfusion.
Rationale: Bilateral ligation of the anterior division of the internal iliac (hypogastric) artery reduces pelvic pulse pressure by 85%, stopping bleeding while preserving pelvic collateral perfusion.
25. When the chorionic villi directly attach abnormally to the myometrium without invading it due to deficient decidua basalis, it is termed:
Right Answer: B
Rationale: Accreta = villi attached to myometrium; Increta = villi invade deeply into myometrium; Percreta = villi penetrate through myometrium and serosa into adjacent organs (e.g., bladder).
Rationale: Accreta = villi attached to myometrium; Increta = villi invade deeply into myometrium; Percreta = villi penetrate through myometrium and serosa into adjacent organs (e.g., bladder).
26. In acute uterine inversion during the third stage of labour, the immediate step before administering any uterotonic agent is:
Right Answer: B
Rationale: The inverted fundus must be repositioned immediately manually (Johnson’s maneuver) before cervical ring spasm sets in. Uterotonics are given ONLY AFTER the uterus is restored to prevent trapping.
Rationale: The inverted fundus must be repositioned immediately manually (Johnson’s maneuver) before cervical ring spasm sets in. Uterotonics are given ONLY AFTER the uterus is restored to prevent trapping.
27. A postpartum woman exhibits severe neurogenic and hypovolemic shock out of proportion to visible external blood loss right after vigorous cord traction. The nurse should immediately inspect for:
Right Answer: B
Rationale: Traction on the cord with an uncontracted uterus causes uterine inversion. Sudden stretching of pelvic peritoneum and ovaries triggers severe vagal parasympathetic (neurogenic) shock.
Rationale: Traction on the cord with an uncontracted uterus causes uterine inversion. Sudden stretching of pelvic peritoneum and ovaries triggers severe vagal parasympathetic (neurogenic) shock.
28. A secondary PPH occurring on day 10 postpartum with subinvolution is most likely due to:
Right Answer: B
Rationale: Retained cotyledons undergoing necrosis and secondary infection (endometritis) are the primary cause of late/secondary postpartum hemorrhage.
Rationale: Retained cotyledons undergoing necrosis and secondary infection (endometritis) are the primary cause of late/secondary postpartum hemorrhage.
29. What is the shock index (Heart Rate / Systolic BP) cut-off value that alerts to massive postpartum blood loss and early occult hypovolemic shock?
Right Answer: B
Rationale: Normal obstetric shock index is 0.7-0.9. A Shock Index >= 0.9 to 1.0 indicates significant blood loss requiring blood transfusion and ICU readiness before systolic BP drops.
Rationale: Normal obstetric shock index is 0.7-0.9. A Shock Index >= 0.9 to 1.0 indicates significant blood loss requiring blood transfusion and ICU readiness before systolic BP drops.
30. Sheehan’s syndrome is a known long-term endocrine consequence of massive PPH characterized by:
Right Answer: B
Rationale: Severe hypovolemic shock in PPH leads to avascular necrosis of the hypertrophied anterior pituitary gland, presenting with agalactia (failure of lactation) and secondary amenorrhea.
Rationale: Severe hypovolemic shock in PPH leads to avascular necrosis of the hypertrophied anterior pituitary gland, presenting with agalactia (failure of lactation) and secondary amenorrhea.
APH PPH MCQs for Nursing Officer, PGIMER 2026 Nursing Exam Preparation, Obstetrics and Gynaecology High Yield MCQs, Placenta Previa and Abruptio Placentae MCQs, Postpartum Hemorrhage Management Questions
PGIMER Nursing Officer 2026, PGIMER OBG MCQs, APH MCQs, PPH MCQs, Placenta Previa MCQs, Abruptio Placentae Questions, Postpartum Hemorrhage Nursing Management, Uterotonic Drugs in PPH, Bakri Balloon Tamponade, B Lynch Suture Nursing, NORCET 2026 OBG, PGIMER Chandigarh Staff Nurse Bharti, Nursing Officer Test Series, OBG High Yield MCQs, Staff Nurse Exam Preparation 2026
