FLORIDA BOARD OF MEDICINE
OBSTETRICS AND GYNECOLOGY
CERTIFICATION EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1. A 32-year-old G2P1 at 34 weeks' gestation presents with severe
headache, visual scotomata, right upper-quadrant pain, and blood
pressure of 172/116 mm Hg. Repeat blood pressure 15 minutes later
remains 168/112 mm Hg. Urinalysis demonstrates 3+ protein.
Platelets are 92,000/µL, AST and ALT are elevated, and serum
creatinine is 1.4 mg/dL. Which is the most appropriate immediate
management?
A. Outpatient monitoring with twice-weekly nonstress tests
B. Administration of nifedipine only and discharge after blood pressure
normalizes
C. Magnesium sulfate, urgent blood-pressure control, corticosteroids as
appropriate, and delivery after maternal stabilization
D. Expectant management until 37 weeks because the fetus is preterm
E. Intravenous fluids followed by induction after 48 hours regardless of
maternal status
Answer: C. Magnesium sulfate, urgent blood-pressure control,
corticosteroids as appropriate, and delivery after maternal
stabilization
Rationale: Severe preeclampsia with severe-range hypertension and
laboratory evidence of hepatic, hematologic, and renal involvement
represents a maternal emergency. Magnesium sulfate is indicated for
1
,seizure prophylaxis, while severe hypertension requires prompt
antihypertensive treatment to reduce the risk of intracranial
hemorrhage, stroke, cardiac complications, and placental abruption.
At 34 weeks with severe features, delivery is generally indicated after
maternal stabilization rather than prolonged expectant management.
Corticosteroids may be administered when appropriate for fetal
maturation, but they should not delay medically necessary delivery.
2. A 28-year-old primigravida at 39 weeks is in active labor. After
spontaneous rupture of membranes, the fetal heart rate tracing
demonstrates recurrent late decelerations with minimal variability.
Maternal blood pressure and temperature are normal. Oxytocin is
infusing. Which intervention should be performed first?
A. Increase the oxytocin infusion
B. Place the patient in a lateral position and discontinue oxytocin
C. Perform immediate forceps delivery
D. Administer methylergonovine
E. Perform amniotomy
Answer: B. Place the patient in a lateral position and discontinue
oxytocin
Rationale: Recurrent late decelerations indicate uteroplacental
insufficiency and require immediate intrauterine resuscitation. Initial
measures include repositioning the mother laterally, stopping
uterotonic agents such as oxytocin, correcting maternal hypotension,
and assessing for other reversible causes. Increasing oxytocin would
worsen uterine stimulation and potentially exacerbate fetal hypoxia. If
the tracing does not improve despite appropriate resuscitation,
expedited delivery may become necessary.
2
,3. A 26-year-old woman at 8 weeks' gestation presents with
unilateral pelvic pain and vaginal spotting. Her β-hCG is 3,800
mIU/mL. Transvaginal ultrasonography demonstrates no
intrauterine gestational sac and a 2.5-cm left adnexal mass. She is
hemodynamically stable and has no significant medical
comorbidities. Which diagnosis is most likely?
A. Threatened abortion
B. Complete hydatidiform mole
C. Ectopic pregnancy
D. Cervical pregnancy only
E. Degenerating leiomyoma
Answer: C. Ectopic pregnancy
Rationale: A patient with early pregnancy, unilateral pelvic pain,
vaginal bleeding, an empty uterus despite a β-hCG concentration at
which an intrauterine pregnancy would generally be expected to be
visible, and an adnexal mass should be considered to have an ectopic
pregnancy until proven otherwise. Management depends on
hemodynamic stability, ectopic size, β-hCG level, embryonic cardiac
activity, and contraindications to medical treatment. Methotrexate may
be appropriate in carefully selected stable patients, whereas surgery is
required for rupture, hemodynamic instability, or other significant
contraindications to medical therapy.
4. A 30-year-old woman presents with secondary amenorrhea,
galactorrhea, and headaches. Pregnancy testing is negative. Her
serum prolactin is 125 ng/mL, and thyroid studies are normal. MRI
demonstrates a 7-mm pituitary lesion. Which treatment is most
appropriate?
A. Combined oral contraceptive therapy alone
B. Cabergoline
3
, C. Clomiphene immediately
D. Total abdominal hysterectomy
E. Levothyroxine despite normal thyroid studies
Answer: B. Cabergoline
Rationale: The patient has symptomatic hyperprolactinemia associated
with a small prolactinoma. Dopamine agonists suppress prolactin
secretion and generally reduce tumor size. Cabergoline is commonly
preferred because of its effectiveness and tolerability. Persistent
hyperprolactinemia can cause hypogonadism, infertility, amenorrhea,
and galactorrhea. Surgery is generally reserved for selected patients
who cannot tolerate or do not respond adequately to medical therapy
or who have specific compressive complications.
5. A 35-year-old woman presents with heavy menstrual bleeding and
dysmenorrhea. Pelvic examination reveals an enlarged, irregularly
contoured uterus. Pregnancy testing is negative. Ultrasound
demonstrates several well-circumscribed masses within the uterine
wall, with the largest measuring 6 cm. Which diagnosis is most
likely?
A. Adenomyosis
B. Endometrial carcinoma
C. Uterine leiomyomas
D. Endometriosis
E. Endometrial polyp
Answer: C. Uterine leiomyomas
Rationale: Leiomyomas are benign smooth-muscle tumors of the
uterus. They can produce heavy menstrual bleeding, pelvic pressure,
dysmenorrhea, infertility, and an enlarged irregular uterus.
Submucosal fibroids particularly contribute to abnormal uterine
4
OBSTETRICS AND GYNECOLOGY
CERTIFICATION EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1. A 32-year-old G2P1 at 34 weeks' gestation presents with severe
headache, visual scotomata, right upper-quadrant pain, and blood
pressure of 172/116 mm Hg. Repeat blood pressure 15 minutes later
remains 168/112 mm Hg. Urinalysis demonstrates 3+ protein.
Platelets are 92,000/µL, AST and ALT are elevated, and serum
creatinine is 1.4 mg/dL. Which is the most appropriate immediate
management?
A. Outpatient monitoring with twice-weekly nonstress tests
B. Administration of nifedipine only and discharge after blood pressure
normalizes
C. Magnesium sulfate, urgent blood-pressure control, corticosteroids as
appropriate, and delivery after maternal stabilization
D. Expectant management until 37 weeks because the fetus is preterm
E. Intravenous fluids followed by induction after 48 hours regardless of
maternal status
Answer: C. Magnesium sulfate, urgent blood-pressure control,
corticosteroids as appropriate, and delivery after maternal
stabilization
Rationale: Severe preeclampsia with severe-range hypertension and
laboratory evidence of hepatic, hematologic, and renal involvement
represents a maternal emergency. Magnesium sulfate is indicated for
1
,seizure prophylaxis, while severe hypertension requires prompt
antihypertensive treatment to reduce the risk of intracranial
hemorrhage, stroke, cardiac complications, and placental abruption.
At 34 weeks with severe features, delivery is generally indicated after
maternal stabilization rather than prolonged expectant management.
Corticosteroids may be administered when appropriate for fetal
maturation, but they should not delay medically necessary delivery.
2. A 28-year-old primigravida at 39 weeks is in active labor. After
spontaneous rupture of membranes, the fetal heart rate tracing
demonstrates recurrent late decelerations with minimal variability.
Maternal blood pressure and temperature are normal. Oxytocin is
infusing. Which intervention should be performed first?
A. Increase the oxytocin infusion
B. Place the patient in a lateral position and discontinue oxytocin
C. Perform immediate forceps delivery
D. Administer methylergonovine
E. Perform amniotomy
Answer: B. Place the patient in a lateral position and discontinue
oxytocin
Rationale: Recurrent late decelerations indicate uteroplacental
insufficiency and require immediate intrauterine resuscitation. Initial
measures include repositioning the mother laterally, stopping
uterotonic agents such as oxytocin, correcting maternal hypotension,
and assessing for other reversible causes. Increasing oxytocin would
worsen uterine stimulation and potentially exacerbate fetal hypoxia. If
the tracing does not improve despite appropriate resuscitation,
expedited delivery may become necessary.
2
,3. A 26-year-old woman at 8 weeks' gestation presents with
unilateral pelvic pain and vaginal spotting. Her β-hCG is 3,800
mIU/mL. Transvaginal ultrasonography demonstrates no
intrauterine gestational sac and a 2.5-cm left adnexal mass. She is
hemodynamically stable and has no significant medical
comorbidities. Which diagnosis is most likely?
A. Threatened abortion
B. Complete hydatidiform mole
C. Ectopic pregnancy
D. Cervical pregnancy only
E. Degenerating leiomyoma
Answer: C. Ectopic pregnancy
Rationale: A patient with early pregnancy, unilateral pelvic pain,
vaginal bleeding, an empty uterus despite a β-hCG concentration at
which an intrauterine pregnancy would generally be expected to be
visible, and an adnexal mass should be considered to have an ectopic
pregnancy until proven otherwise. Management depends on
hemodynamic stability, ectopic size, β-hCG level, embryonic cardiac
activity, and contraindications to medical treatment. Methotrexate may
be appropriate in carefully selected stable patients, whereas surgery is
required for rupture, hemodynamic instability, or other significant
contraindications to medical therapy.
4. A 30-year-old woman presents with secondary amenorrhea,
galactorrhea, and headaches. Pregnancy testing is negative. Her
serum prolactin is 125 ng/mL, and thyroid studies are normal. MRI
demonstrates a 7-mm pituitary lesion. Which treatment is most
appropriate?
A. Combined oral contraceptive therapy alone
B. Cabergoline
3
, C. Clomiphene immediately
D. Total abdominal hysterectomy
E. Levothyroxine despite normal thyroid studies
Answer: B. Cabergoline
Rationale: The patient has symptomatic hyperprolactinemia associated
with a small prolactinoma. Dopamine agonists suppress prolactin
secretion and generally reduce tumor size. Cabergoline is commonly
preferred because of its effectiveness and tolerability. Persistent
hyperprolactinemia can cause hypogonadism, infertility, amenorrhea,
and galactorrhea. Surgery is generally reserved for selected patients
who cannot tolerate or do not respond adequately to medical therapy
or who have specific compressive complications.
5. A 35-year-old woman presents with heavy menstrual bleeding and
dysmenorrhea. Pelvic examination reveals an enlarged, irregularly
contoured uterus. Pregnancy testing is negative. Ultrasound
demonstrates several well-circumscribed masses within the uterine
wall, with the largest measuring 6 cm. Which diagnosis is most
likely?
A. Adenomyosis
B. Endometrial carcinoma
C. Uterine leiomyomas
D. Endometriosis
E. Endometrial polyp
Answer: C. Uterine leiomyomas
Rationale: Leiomyomas are benign smooth-muscle tumors of the
uterus. They can produce heavy menstrual bleeding, pelvic pressure,
dysmenorrhea, infertility, and an enlarged irregular uterus.
Submucosal fibroids particularly contribute to abnormal uterine
4
