ALSO Pre test questions & answers
A 26 year-old gravida 2 para 1 female at 9 weeks' estimated gestational age (by last normal
menstrual period) presents to the Emergency Department complaining of heavy vaginal
bleeding which began two hours earlier. She denies having any sexual intercourse in the past
seven days. Her vital signs are stable. A quantitative serum hCG returns at a value of 3200
mIU/mL and a transvaginal ultrasound reveals a mean gestational sac diameter of 30mm and no
embryo. She reports passing no tissue and a speculum examination reveals the cervix is visually
closed. In counseling the patient about her options, which of the following statements is true? -
ANSWERS-Medical management with misoprostol is more effective than expectant
management Correct
Which of the following is a contraindication for medical management of an ectopic pregnancy
with methotrexate? - ANSWERS-Presence of embryonic cardiac activity Correct
A 19-yo primigravida at approximately 40 weeks' estimated gestational age comes to the
hospital with painful contractions. She has received no prenatal care. Examination: Cervix is 4
cm dilated and 80% effaced at station -1. Blood pressure is 164/111 mm Hg, and a urine dipstick
shows 3+ protein. She reports having had severe headaches for three days and has noticed
swelling in her hands and feet. Moments after her blood is drawn and IV access is obtained, she
has a generalized tonic-clonic seizure. Which of the following is the most appropriate immediate
course of action? - ANSWERS-Administer magnesium sulfate six grams IV over 15-20 minutes
Correct
A 29 year-old gravida 3 para 2 female at 28 weeks' estimated gestational age is found to have a
pulmonary embolus. She is hemodynamically stable and you are discussing therapeutic
anticoagulation with her. According to the 2012 American College of Chest Physicians
Guidelines, the treatment of choice for venous thromboembolism in pregnancy is which one of
the following? - ANSWERS-Low-molecular weight heparin Correct
According to the NICHD Fetal Heart Rate Classification System, which category tracing requires
prompt evaluation and expedient interventions to address the pattern (as the tracing in this
, category is considered abnormal and predictive of abnormal fetal acid-base status at the time of
observation)? - ANSWERS-Category III electronic fetal monitoring tracing Correct
A cesarean delivery may be considered due to failed induction after arrest of labor in which of
the following primiparous labor scenarios? - ANSWERS-After maximum oxytocin dosing for six
hours with ruptured membranes, there is failure to generate adequate contractions or progress
at 7 cm Correct
Which of the following defines an occiput posterior position? - ANSWERS-Fetal occiput toward
the maternal spine Correct
All of the following are true statements regarding multiple gestation pregnancies EXCEPT: -
ANSWERS-There is a decreased incidence of congenital anomalies Correct
A 32-year-old gravida 2 para 1 female at 40 6/7 weeks' estimated gestational age has been fully
dilated for four hours, and has now been pushing for two hours. She is physically and
emotionally exhausted, so you have a discussion with her regarding assisted vaginal delivery.
Which of the following are prerequisites to an instrumented delivery? - ANSWERS-Lack of
suspicion of severe cephalopelvic disproportion Correct
Which of the following is an antenatal risk factor for shoulder dystocia? - ANSWERS-Maternal
obesity Correct
Documentation in the medical record after a delivery with a shoulder dystocia is an essential
risk management tool. Which of the following should be documented in the medical record
pertaining to the circumstances that took place during the shoulder dystocia? - ANSWERS-The
elapsed amount of time from delivery of the fetal head until complete delivery of the baby
Correct
Postpartum hemorrhage is a common maternal morbidity in high resource countries and is on
the rise. Which one of the following is the most common cause of postpartum hemorrhage? -
ANSWERS-Atonic uterus Correct
A 26 year-old gravida 2 para 1 female at 9 weeks' estimated gestational age (by last normal
menstrual period) presents to the Emergency Department complaining of heavy vaginal
bleeding which began two hours earlier. She denies having any sexual intercourse in the past
seven days. Her vital signs are stable. A quantitative serum hCG returns at a value of 3200
mIU/mL and a transvaginal ultrasound reveals a mean gestational sac diameter of 30mm and no
embryo. She reports passing no tissue and a speculum examination reveals the cervix is visually
closed. In counseling the patient about her options, which of the following statements is true? -
ANSWERS-Medical management with misoprostol is more effective than expectant
management Correct
Which of the following is a contraindication for medical management of an ectopic pregnancy
with methotrexate? - ANSWERS-Presence of embryonic cardiac activity Correct
A 19-yo primigravida at approximately 40 weeks' estimated gestational age comes to the
hospital with painful contractions. She has received no prenatal care. Examination: Cervix is 4
cm dilated and 80% effaced at station -1. Blood pressure is 164/111 mm Hg, and a urine dipstick
shows 3+ protein. She reports having had severe headaches for three days and has noticed
swelling in her hands and feet. Moments after her blood is drawn and IV access is obtained, she
has a generalized tonic-clonic seizure. Which of the following is the most appropriate immediate
course of action? - ANSWERS-Administer magnesium sulfate six grams IV over 15-20 minutes
Correct
A 29 year-old gravida 3 para 2 female at 28 weeks' estimated gestational age is found to have a
pulmonary embolus. She is hemodynamically stable and you are discussing therapeutic
anticoagulation with her. According to the 2012 American College of Chest Physicians
Guidelines, the treatment of choice for venous thromboembolism in pregnancy is which one of
the following? - ANSWERS-Low-molecular weight heparin Correct
According to the NICHD Fetal Heart Rate Classification System, which category tracing requires
prompt evaluation and expedient interventions to address the pattern (as the tracing in this
, category is considered abnormal and predictive of abnormal fetal acid-base status at the time of
observation)? - ANSWERS-Category III electronic fetal monitoring tracing Correct
A cesarean delivery may be considered due to failed induction after arrest of labor in which of
the following primiparous labor scenarios? - ANSWERS-After maximum oxytocin dosing for six
hours with ruptured membranes, there is failure to generate adequate contractions or progress
at 7 cm Correct
Which of the following defines an occiput posterior position? - ANSWERS-Fetal occiput toward
the maternal spine Correct
All of the following are true statements regarding multiple gestation pregnancies EXCEPT: -
ANSWERS-There is a decreased incidence of congenital anomalies Correct
A 32-year-old gravida 2 para 1 female at 40 6/7 weeks' estimated gestational age has been fully
dilated for four hours, and has now been pushing for two hours. She is physically and
emotionally exhausted, so you have a discussion with her regarding assisted vaginal delivery.
Which of the following are prerequisites to an instrumented delivery? - ANSWERS-Lack of
suspicion of severe cephalopelvic disproportion Correct
Which of the following is an antenatal risk factor for shoulder dystocia? - ANSWERS-Maternal
obesity Correct
Documentation in the medical record after a delivery with a shoulder dystocia is an essential
risk management tool. Which of the following should be documented in the medical record
pertaining to the circumstances that took place during the shoulder dystocia? - ANSWERS-The
elapsed amount of time from delivery of the fetal head until complete delivery of the baby
Correct
Postpartum hemorrhage is a common maternal morbidity in high resource countries and is on
the rise. Which one of the following is the most common cause of postpartum hemorrhage? -
ANSWERS-Atonic uterus Correct
