ALSO PRE TEST QUESTIONS WITH
COMPLETE ANSWERS
A ss26 ssyear-old ssgravida ss2 sspara ss1 ssfemale ssat ss9 ssweeks' ssestimated ssgestational
ssage ss(by sslast ssnormal ssmenstrual ssperiod) sspresents ssto ssthe ssEmergency
ssDepartment sscomplaining ssof ssheavy ssvaginal ssbleeding sswhich ssbegan sstwo sshours
ssearlier. ssShe ssdenies sshaving ssany sssexual ssintercourse ssin ssthe sspast ssseven
ssdays. ssHer ssvital sssigns ssare ssstable. ssA ssquantitative ssserum sshCG ssreturns ssat ssa
ssvalue ssof ss3200 ssmIU/mL ssand ssa sstransvaginal ssultrasound ssreveals ssa ssmean
ssgestational sssac ssdiameter ssof ss30mm ssand ssno ssembryo. ssShe ssreports sspassing
ssno sstissue ssand ssa ssspeculum ssexamination ssreveals ssthe sscervix ssis ssvisually
ssclosed. ssIn sscounseling ssthe sspatient ssabout ssher ssoptions, sswhich ssof ssthe
ssfollowing ssstatements ssis sstrue? ss- ssANS-Medical ssmanagement sswith ssmisoprostol
ssis ssmore sseffective ssthan ssexpectant ssmanagement ssCorrect
Which ssof ssthe ssfollowing ssis ssa sscontraindication ssfor ssmedical ssmanagement ssof ssan
ssectopic sspregnancy sswith ssmethotrexate? ss- ssANS-Presence ssof ssembryonic
sscardiac ssactivity ssCorrect
A ss19-yo ssprimigravida ssat ssapproximately ss40 ssweeks' ssestimated ssgestational ssage
sscomes ssto ssthe sshospital sswith sspainful sscontractions. ssShe sshas ssreceived ssno
ssprenatal sscare. ssExamination: ssCervix ssis ss4 sscm ssdilated ssand ss80% sseffaced ssat
ssstation ss-1. ssBlood sspressure ssis ss164/111 ssmm ssHg, ssand ssa ssurine ssdipstick
ssshows ss3+ ssprotein. ssShe ssreports sshaving sshad sssevere ssheadaches ssfor ssthree
ssdays ssand sshas ssnoticed ssswelling ssin ssher sshands ssand ssfeet. ssMoments ssafter
ssher ssblood ssis ssdrawn ssand ssIV ssaccess ssis ssobtained, ssshe sshas ssa ssgeneralized
sstonic-clonic ssseizure. ssWhich ssof ssthe ssfollowing ssis ssthe ssmost ssappropriate
ssimmediate sscourse ssof ssaction? ss- ssANS-Administer ssmagnesium sssulfate sssix
ssgrams ssIV ssover ss15-20 ssminutes ssCorrect
A ss29 ssyear-old ssgravida ss3 sspara ss2 ssfemale ssat ss28 ssweeks' ssestimated
ssgestational ssage ssis ssfound ssto sshave ssa sspulmonary ssembolus. ssShe ssis
sshemodynamically ssstable ssand ssyou ssare ssdiscussing sstherapeutic ssanticoagulation
sswith ssher. ssAccording ssto ssthe ss2012 ssAmerican ssCollege ssof ssChest ssPhysicians
ssGuidelines, ssthe sstreatment ssof sschoice ssfor ssvenous ssthromboembolism ssin
sspregnancy ssis sswhich ssone ssof ssthe ssfollowing? ss- ssANS-Low-molecular ssweight
ssheparin ssCorrect
, According ssto ssthe ssNICHD ssFetal ssHeart ssRate ssClassification ssSystem, sswhich
sscategory sstracing ssrequires ssprompt ssevaluation ssand ssexpedient ssinterventions ssto
ssaddress ssthe sspattern ss(as ssthe sstracing ssin ssthis sscategory ssis ssconsidered
ssabnormal ssand sspredictive ssof ssabnormal ssfetal ssacid-base ssstatus ssat ssthe sstime
ssof ssobservation)? ss- ssANS-Category ssIII sselectronic ssfetal ssmonitoring sstracing
ssCorrect
A sscesarean ssdelivery ssmay ssbe ssconsidered ssdue ssto ssfailed ssinduction ssafter ssarrest
ssof sslabor ssin sswhich ssof ssthe ssfollowing ssprimiparous sslabor ssscenarios? ss- ssANS-
After ssmaximum ssoxytocin ssdosing ssfor sssix sshours sswith ssruptured ssmembranes,
ssthere ssis ssfailure ssto ssgenerate ssadequate sscontractions ssor ssprogress ssat ss7 sscm
ssCorrect
Which ssof ssthe ssfollowing ssdefines ssan ssocciput ssposterior ssposition? ss- ssANS-Fetal
ssocciput sstoward ssthe ssmaternal ssspine ssCorrect
All ssof ssthe ssfollowing ssare sstrue ssstatements ssregarding ssmultiple ssgestation
sspregnancies ssEXCEPT: ss- ssANS-There ssis ssa ssdecreased ssincidence ssof sscongenital
ssanomalies ssCorrect
A ss32-year-old ssgravida ss2 sspara ss1 ssfemale ssat ss40 ss6/7 ssweeks' ssestimated
ssgestational ssage sshas ssbeen ssfully ssdilated ssfor ssfour sshours, ssand sshas ssnow ssbeen
sspushing ssfor sstwo sshours. ssShe ssis ssphysically ssand ssemotionally ssexhausted, ssso
ssyou sshave ssa ssdiscussion sswith ssher ssregarding ssassisted ssvaginal ssdelivery.
ssWhich ssof ssthe ssfollowing ssare ssprerequisites ssto ssan ssinstrumented ssdelivery? ss-
ssANS-Lack ssof sssuspicion ssof sssevere sscephalopelvic ssdisproportion ssCorrect
Which ssof ssthe ssfollowing ssis ssan ssantenatal ssrisk ssfactor ssfor ssshoulder ssdystocia? ss-
ssANS-Maternal ssobesity ssCorrect
Documentation ssin ssthe ssmedical ssrecord ssafter ssa ssdelivery sswith ssa ssshoulder
ssdystocia ssis ssan ssessential ssrisk ssmanagement sstool. ssWhich ssof ssthe ssfollowing
ssshould ssbe ssdocumented ssin ssthe ssmedical ssrecord sspertaining ssto ssthe
sscircumstances ssthat sstook ssplace ssduring ssthe ssshoulder ssdystocia? ss- ssANS-The
sselapsed ssamount ssof sstime ssfrom ssdelivery ssof ssthe ssfetal sshead ssuntil sscomplete
ssdelivery ssof ssthe ssbaby ssCorrect
Postpartum sshemorrhage ssis ssa sscommon ssmaternal ssmorbidity ssin sshigh ssresource
sscountries ssand ssis sson ssthe ssrise. ssWhich ssone ssof ssthe ssfollowing ssis ssthe ssmost
sscommon sscause ssof sspostpartum sshemorrhage? ss- ssANS-Atonic ssuterus ssCorrect
You ssare ssattending ssthe ssdelivery ssof ssa ss36-year-old ssgravida ss6 sspara ss5 ssfemale
ssat ssterm. ssHer sspregnancy sshas ssbeen ssuncomplicated, sswith ssthe ssexception ssof
sschronic sshypertension sstreated sswith ssLabetalol ss100 ssmg sspo ssBID. ssAfter ssa
ssnormal ssspontaneous ssvaginal ssdelivery, ssyou ssnote ssa sslarge ssgush ssof ssblood,
ssprompt ssdelivery ssof ssthe ssplacenta, ssand ssbrisk ssvaginal ssbleeding. ssIn ssaddition
COMPLETE ANSWERS
A ss26 ssyear-old ssgravida ss2 sspara ss1 ssfemale ssat ss9 ssweeks' ssestimated ssgestational
ssage ss(by sslast ssnormal ssmenstrual ssperiod) sspresents ssto ssthe ssEmergency
ssDepartment sscomplaining ssof ssheavy ssvaginal ssbleeding sswhich ssbegan sstwo sshours
ssearlier. ssShe ssdenies sshaving ssany sssexual ssintercourse ssin ssthe sspast ssseven
ssdays. ssHer ssvital sssigns ssare ssstable. ssA ssquantitative ssserum sshCG ssreturns ssat ssa
ssvalue ssof ss3200 ssmIU/mL ssand ssa sstransvaginal ssultrasound ssreveals ssa ssmean
ssgestational sssac ssdiameter ssof ss30mm ssand ssno ssembryo. ssShe ssreports sspassing
ssno sstissue ssand ssa ssspeculum ssexamination ssreveals ssthe sscervix ssis ssvisually
ssclosed. ssIn sscounseling ssthe sspatient ssabout ssher ssoptions, sswhich ssof ssthe
ssfollowing ssstatements ssis sstrue? ss- ssANS-Medical ssmanagement sswith ssmisoprostol
ssis ssmore sseffective ssthan ssexpectant ssmanagement ssCorrect
Which ssof ssthe ssfollowing ssis ssa sscontraindication ssfor ssmedical ssmanagement ssof ssan
ssectopic sspregnancy sswith ssmethotrexate? ss- ssANS-Presence ssof ssembryonic
sscardiac ssactivity ssCorrect
A ss19-yo ssprimigravida ssat ssapproximately ss40 ssweeks' ssestimated ssgestational ssage
sscomes ssto ssthe sshospital sswith sspainful sscontractions. ssShe sshas ssreceived ssno
ssprenatal sscare. ssExamination: ssCervix ssis ss4 sscm ssdilated ssand ss80% sseffaced ssat
ssstation ss-1. ssBlood sspressure ssis ss164/111 ssmm ssHg, ssand ssa ssurine ssdipstick
ssshows ss3+ ssprotein. ssShe ssreports sshaving sshad sssevere ssheadaches ssfor ssthree
ssdays ssand sshas ssnoticed ssswelling ssin ssher sshands ssand ssfeet. ssMoments ssafter
ssher ssblood ssis ssdrawn ssand ssIV ssaccess ssis ssobtained, ssshe sshas ssa ssgeneralized
sstonic-clonic ssseizure. ssWhich ssof ssthe ssfollowing ssis ssthe ssmost ssappropriate
ssimmediate sscourse ssof ssaction? ss- ssANS-Administer ssmagnesium sssulfate sssix
ssgrams ssIV ssover ss15-20 ssminutes ssCorrect
A ss29 ssyear-old ssgravida ss3 sspara ss2 ssfemale ssat ss28 ssweeks' ssestimated
ssgestational ssage ssis ssfound ssto sshave ssa sspulmonary ssembolus. ssShe ssis
sshemodynamically ssstable ssand ssyou ssare ssdiscussing sstherapeutic ssanticoagulation
sswith ssher. ssAccording ssto ssthe ss2012 ssAmerican ssCollege ssof ssChest ssPhysicians
ssGuidelines, ssthe sstreatment ssof sschoice ssfor ssvenous ssthromboembolism ssin
sspregnancy ssis sswhich ssone ssof ssthe ssfollowing? ss- ssANS-Low-molecular ssweight
ssheparin ssCorrect
, According ssto ssthe ssNICHD ssFetal ssHeart ssRate ssClassification ssSystem, sswhich
sscategory sstracing ssrequires ssprompt ssevaluation ssand ssexpedient ssinterventions ssto
ssaddress ssthe sspattern ss(as ssthe sstracing ssin ssthis sscategory ssis ssconsidered
ssabnormal ssand sspredictive ssof ssabnormal ssfetal ssacid-base ssstatus ssat ssthe sstime
ssof ssobservation)? ss- ssANS-Category ssIII sselectronic ssfetal ssmonitoring sstracing
ssCorrect
A sscesarean ssdelivery ssmay ssbe ssconsidered ssdue ssto ssfailed ssinduction ssafter ssarrest
ssof sslabor ssin sswhich ssof ssthe ssfollowing ssprimiparous sslabor ssscenarios? ss- ssANS-
After ssmaximum ssoxytocin ssdosing ssfor sssix sshours sswith ssruptured ssmembranes,
ssthere ssis ssfailure ssto ssgenerate ssadequate sscontractions ssor ssprogress ssat ss7 sscm
ssCorrect
Which ssof ssthe ssfollowing ssdefines ssan ssocciput ssposterior ssposition? ss- ssANS-Fetal
ssocciput sstoward ssthe ssmaternal ssspine ssCorrect
All ssof ssthe ssfollowing ssare sstrue ssstatements ssregarding ssmultiple ssgestation
sspregnancies ssEXCEPT: ss- ssANS-There ssis ssa ssdecreased ssincidence ssof sscongenital
ssanomalies ssCorrect
A ss32-year-old ssgravida ss2 sspara ss1 ssfemale ssat ss40 ss6/7 ssweeks' ssestimated
ssgestational ssage sshas ssbeen ssfully ssdilated ssfor ssfour sshours, ssand sshas ssnow ssbeen
sspushing ssfor sstwo sshours. ssShe ssis ssphysically ssand ssemotionally ssexhausted, ssso
ssyou sshave ssa ssdiscussion sswith ssher ssregarding ssassisted ssvaginal ssdelivery.
ssWhich ssof ssthe ssfollowing ssare ssprerequisites ssto ssan ssinstrumented ssdelivery? ss-
ssANS-Lack ssof sssuspicion ssof sssevere sscephalopelvic ssdisproportion ssCorrect
Which ssof ssthe ssfollowing ssis ssan ssantenatal ssrisk ssfactor ssfor ssshoulder ssdystocia? ss-
ssANS-Maternal ssobesity ssCorrect
Documentation ssin ssthe ssmedical ssrecord ssafter ssa ssdelivery sswith ssa ssshoulder
ssdystocia ssis ssan ssessential ssrisk ssmanagement sstool. ssWhich ssof ssthe ssfollowing
ssshould ssbe ssdocumented ssin ssthe ssmedical ssrecord sspertaining ssto ssthe
sscircumstances ssthat sstook ssplace ssduring ssthe ssshoulder ssdystocia? ss- ssANS-The
sselapsed ssamount ssof sstime ssfrom ssdelivery ssof ssthe ssfetal sshead ssuntil sscomplete
ssdelivery ssof ssthe ssbaby ssCorrect
Postpartum sshemorrhage ssis ssa sscommon ssmaternal ssmorbidity ssin sshigh ssresource
sscountries ssand ssis sson ssthe ssrise. ssWhich ssone ssof ssthe ssfollowing ssis ssthe ssmost
sscommon sscause ssof sspostpartum sshemorrhage? ss- ssANS-Atonic ssuterus ssCorrect
You ssare ssattending ssthe ssdelivery ssof ssa ss36-year-old ssgravida ss6 sspara ss5 ssfemale
ssat ssterm. ssHer sspregnancy sshas ssbeen ssuncomplicated, sswith ssthe ssexception ssof
sschronic sshypertension sstreated sswith ssLabetalol ss100 ssmg sspo ssBID. ssAfter ssa
ssnormal ssspontaneous ssvaginal ssdelivery, ssyou ssnote ssa sslarge ssgush ssof ssblood,
ssprompt ssdelivery ssof ssthe ssplacenta, ssand ssbrisk ssvaginal ssbleeding. ssIn ssaddition
