ALARM COURSE EXAM PRACTICE QUESTIONS
COMPLETE WITH 100% VERIFIED ANSWERS AND
DETAILED EXPLANATIONS
1. Which delivery manoeuvre should be avoided when using a vacuum
extractor?
A) Flexion
B) Traction
C) Rotation
D) Extension
Correct Answer: C) Rotation
Explanation: Rotation should not be performed with a vacuum extractor
due to increased risk of intracranial hemorrhage and scalp injury.
Vacuum extraction should only involve traction in the axis of the pelvis.
Forceps may be used for rotation if needed.
2. What is the recommended prophylactic oxytocin administration in
the third stage of labour?
A) Only in primiparous women
B) Only with epidural anesthesia
C) Only in prolonged labour
D) At all deliveries
Correct Answer: D) At all deliveries
Explanation: Prophylactic oxytocin should be offered at all deliveries as
,part of active management of the third stage of labour to reduce the
risk of postpartum hemorrhage.
3. Which uterine incision is an absolute contraindication to a trial of
labour after cesarean (TOLAC)?
A) Low transverse
B) Low vertical
C) Inverted "T" incision
D) Classical incision
Correct Answer: C) Inverted "T" incision
Explanation: An inverted "T" incision in the uterus is an absolute
contraindication to TOLAC due to a significantly increased risk of uterine
rupture.
4. Which fetal blood gas values meet the criteria for linking cerebral
palsy to intrapartum asphyxia at 37 weeks?
A) Umbilical arterial pH 7.15, base deficit 8 mmol/L
B) Umbilical arterial pH 6.98, base deficit 12 mmol/L
C) Umbilical arterial pH 7.25, base deficit 6 mmol/L
D) Umbilical arterial pH 7.10, base deficit 10 mmol/L
Correct Answer: B) Umbilical arterial pH 6.98, base deficit 12 mmol/L
Explanation: Criteria for intrapartum asphyxia include umbilical arterial
pH <7.0 and base deficit ≥12 mmol/L, along with neonatal
encephalopathy and spastic quadriplegic or dyskinetic cerebral palsy.
,5. Which of the following is NOT an indication for Group B Strep
chemoprophylaxis?
A) Previous infant with invasive GBS disease
B) GBS bacteriuria during current pregnancy
C) Positive GBS screening at 35-37 weeks
D) Maternal fever during labour
Correct Answer: D) Maternal fever during labour
Explanation: Maternal fever is not an indication for GBS
chemoprophylaxis alone. Indications include previous infant with GBS
disease, GBS bacteriuria, positive screening, or unknown status with risk
factors.
6. Which statement is correct regarding initial management of
significant antepartum hemorrhage?
A) Small bore IV access is sufficient
B) Large bore IV access is recommended
C) IV access is not required initially
D) Central line placement is mandatory
Correct Answer: B) Large bore IV access is recommended
Explanation: Large bore IV access (14-16 gauge) is recommended in
significant antepartum hemorrhage to allow for rapid fluid resuscitation
if needed.
7. Which is NOT an indication for induction of labour?
A) Post-term pregnancy
B) Prelabour rupture of membranes
, C) Suspected fetal macrosomia with previous large baby
D) Maternal diabetes
Correct Answer: C) Suspected fetal macrosomia with previous large
baby
Explanation: Suspected fetal macrosomia with a previous large baby is
not an indication for induction. Induction for macrosomia alone is not
recommended.
8. What is the correct regimen for Betamethasone administration to
reduce neonatal RDS?
A) 6 mg IM q12h x 4 doses
B) 12 mg IM q12h x 2 doses
C) 12 mg IM q24h x 2 doses
D) 24 mg IV single dose
Correct Answer: C) 12 mg IM q24h x 2 doses
Explanation: Betamethasone 12 mg IM every 24 hours for 2 doses is the
preferred regimen for antenatal steroids to reduce RDS.
9. A primigravida at 36 weeks with BP 150/95 mmHg and 3+
proteinuria is admitted. What is the most likely diagnosis?
A) Chronic hypertension
B) Gestational hypertension
C) Preeclampsia with severe features
D) Transient hypertension
Correct Answer: C) Preeclampsia with severe features
Explanation: BP ≥140/90 with significant proteinuria (3+) at ≥20 weeks
COMPLETE WITH 100% VERIFIED ANSWERS AND
DETAILED EXPLANATIONS
1. Which delivery manoeuvre should be avoided when using a vacuum
extractor?
A) Flexion
B) Traction
C) Rotation
D) Extension
Correct Answer: C) Rotation
Explanation: Rotation should not be performed with a vacuum extractor
due to increased risk of intracranial hemorrhage and scalp injury.
Vacuum extraction should only involve traction in the axis of the pelvis.
Forceps may be used for rotation if needed.
2. What is the recommended prophylactic oxytocin administration in
the third stage of labour?
A) Only in primiparous women
B) Only with epidural anesthesia
C) Only in prolonged labour
D) At all deliveries
Correct Answer: D) At all deliveries
Explanation: Prophylactic oxytocin should be offered at all deliveries as
,part of active management of the third stage of labour to reduce the
risk of postpartum hemorrhage.
3. Which uterine incision is an absolute contraindication to a trial of
labour after cesarean (TOLAC)?
A) Low transverse
B) Low vertical
C) Inverted "T" incision
D) Classical incision
Correct Answer: C) Inverted "T" incision
Explanation: An inverted "T" incision in the uterus is an absolute
contraindication to TOLAC due to a significantly increased risk of uterine
rupture.
4. Which fetal blood gas values meet the criteria for linking cerebral
palsy to intrapartum asphyxia at 37 weeks?
A) Umbilical arterial pH 7.15, base deficit 8 mmol/L
B) Umbilical arterial pH 6.98, base deficit 12 mmol/L
C) Umbilical arterial pH 7.25, base deficit 6 mmol/L
D) Umbilical arterial pH 7.10, base deficit 10 mmol/L
Correct Answer: B) Umbilical arterial pH 6.98, base deficit 12 mmol/L
Explanation: Criteria for intrapartum asphyxia include umbilical arterial
pH <7.0 and base deficit ≥12 mmol/L, along with neonatal
encephalopathy and spastic quadriplegic or dyskinetic cerebral palsy.
,5. Which of the following is NOT an indication for Group B Strep
chemoprophylaxis?
A) Previous infant with invasive GBS disease
B) GBS bacteriuria during current pregnancy
C) Positive GBS screening at 35-37 weeks
D) Maternal fever during labour
Correct Answer: D) Maternal fever during labour
Explanation: Maternal fever is not an indication for GBS
chemoprophylaxis alone. Indications include previous infant with GBS
disease, GBS bacteriuria, positive screening, or unknown status with risk
factors.
6. Which statement is correct regarding initial management of
significant antepartum hemorrhage?
A) Small bore IV access is sufficient
B) Large bore IV access is recommended
C) IV access is not required initially
D) Central line placement is mandatory
Correct Answer: B) Large bore IV access is recommended
Explanation: Large bore IV access (14-16 gauge) is recommended in
significant antepartum hemorrhage to allow for rapid fluid resuscitation
if needed.
7. Which is NOT an indication for induction of labour?
A) Post-term pregnancy
B) Prelabour rupture of membranes
, C) Suspected fetal macrosomia with previous large baby
D) Maternal diabetes
Correct Answer: C) Suspected fetal macrosomia with previous large
baby
Explanation: Suspected fetal macrosomia with a previous large baby is
not an indication for induction. Induction for macrosomia alone is not
recommended.
8. What is the correct regimen for Betamethasone administration to
reduce neonatal RDS?
A) 6 mg IM q12h x 4 doses
B) 12 mg IM q12h x 2 doses
C) 12 mg IM q24h x 2 doses
D) 24 mg IV single dose
Correct Answer: C) 12 mg IM q24h x 2 doses
Explanation: Betamethasone 12 mg IM every 24 hours for 2 doses is the
preferred regimen for antenatal steroids to reduce RDS.
9. A primigravida at 36 weeks with BP 150/95 mmHg and 3+
proteinuria is admitted. What is the most likely diagnosis?
A) Chronic hypertension
B) Gestational hypertension
C) Preeclampsia with severe features
D) Transient hypertension
Correct Answer: C) Preeclampsia with severe features
Explanation: BP ≥140/90 with significant proteinuria (3+) at ≥20 weeks
