Advanced Life Support in Obstetrics (ALSO) Exam
Questions & Verified Answers | 2025/2026 Edition |
Already Passed Content
ALSO | Emergency Obstetric Care, Maternal Resuscitation, Neonatal Stabilization,
OB Emergencies | Real Exam-Style Q&A | Expert-Verified
Introduction
This test bank provides 80 multiple-choice questions for the 2025/2026 Advanced Life
Support in Obstetrics (ALSO) exam, reflecting the written knowledge test’s format. Covering
maternal cardiac arrest, postpartum hemorrhage (PPH), shoulder dystocia, eclampsia, neonatal
resuscitation, and malpresentations, these questions align with the ALSO curriculum’s 8 core
lectures (e.g., Safety in Maternity Care, Postpartum Hemorrhage, Maternal Resuscitation) and
workshops (e.g., Shoulder Dystocia, Neonatal Resuscitation). Designed for maternity care
providers (physicians, nurses, midwives), this set ensures readiness for managing obstetric
emergencies and passing the ALSO certification exam.
Answer Format
Correct answers are highlighted in bold and green in Times New Roman font. Each question
includes a concise, evidence-based rationale to reinforce clinical reasoning.
ALSO Exam Q&A | Verified 2025/2026 Content | Emergency Maternal-Fetal
Focus | Already Passed Questions | Ready for Practice Review
1. What is the first step in managing a pregnant patient with cardiac arrest?
a) Administer epinephrine immediately
b) Perform chest compressions
c) Intubate the patient
d) Deliver the fetus
b) Perform chest compressions
Rationale: In maternal cardiac arrest, the priority is to restore circulation with chest
compressions, following the CAB (circulation, airway, breathing) sequence, with modifications
for pregnancy (e.g., uterine displacement).
2. What is the recommended timing for perimortem cesarean delivery
(PMCD) in maternal cardiac arrest?
,a) Within 10 minutes
b) Within 4–5 minutes
c) After 15 minutes
d) Only if fetal heart tones are present
b) Within 4–5 minutes
Rationale: PMCD should be initiated within 4–5 minutes of unsuccessful CPR to improve
maternal and fetal outcomes by relieving aortocaval compression.
3. A patient at 38 weeks gestation presents with shoulder dystocia. What is
the first maneuver to attempt?
a) Rubin maneuver
b) McRoberts maneuver
c) Zavanelli maneuver
d) Wood’s screw maneuver
b) McRoberts maneuver
Rationale: The McRoberts maneuver (hyperflexion of maternal hips) is the first-line,
non-invasive approach to resolve shoulder dystocia by increasing pelvic diameter.
4. What is the most common cause of postpartum hemorrhage (PPH)?
a) Uterine atony
b) Retained placenta
c) Cervical laceration
d) Coagulopathy
a) Uterine atony
Rationale: Uterine atony accounts for approximately 70–80% of PPH cases, as inadequate
uterine contraction fails to compress bleeding vessels.
5. A patient with eclampsia is seizing. What is the first-line treatment?
a) Diazepam IV
b) Magnesium sulfate IV
c) Phenytoin IV
d) Lorazepam IM
b) Magnesium sulfate IV
Rationale: Magnesium sulfate is the first-line treatment for eclamptic seizures, reducing seizure
recurrence and improving maternal outcomes.
6. During neonatal resuscitation, what is the initial step if the infant is not
breathing?
a) Administer epinephrine
b) Provide positive pressure ventilation
c) Perform chest compressions
d) Intubate immediately
b) Provide positive pressure ventilation
Rationale: Positive pressure ventilation is the initial step in neonatal resuscitation for an apneic
infant to establish adequate oxygenation and ventilation.
, 7. What is the hallmark sign of placental abruption?
a) Painless vaginal bleeding
b) Painful vaginal bleeding
c) Fetal bradycardia
d) Uterine hypotonia
b) Painful vaginal bleeding
Rationale: Placental abruption typically presents with painful vaginal bleeding due to
premature placental separation, often with uterine tenderness and fetal distress.
8. In a breech delivery, what is the first step to manage a trapped head?
a) Perform Zavanelli maneuver
b) Apply suprapubic pressure
c) Perform Mauriceau maneuver
d) Administer nitroglycerin
c) Perform Mauriceau maneuver
Rationale: The Mauriceau maneuver (flexion of the fetal head) is the first-line approach to
deliver a trapped head in breech presentation.
9. What is the primary goal of active management of the third stage of labor
(AMTSL)?
a) Reduce labor duration
b) Prevent postpartum hemorrhage
c) Enhance fetal oxygenation
d) Minimize maternal pain
b) Prevent postpartum hemorrhage
Rationale: AMTSL (uterotonic administration, controlled cord traction, uterine massage)
reduces the risk of PPH by promoting uterine contraction.
10. A patient at 32 weeks gestation presents with preterm labor. What is the
first-line tocolytic?
a) Magnesium sulfate
b) Terbutaline
c) Nifedipine
d) Indomethacin
c) Nifedipine
Rationale: Nifedipine, a calcium channel blocker, is the preferred tocolytic for preterm labor
due to efficacy and safety.
11. What is the most critical step in managing umbilical cord prolapse?
a) Administer oxygen
b) Elevate the presenting part
c) Perform immediate cesarean
d) Monitor fetal heart rate
b) Elevate the presenting part
Rationale: Elevating the presenting part relieves cord compression, buying time for emergent
cesarean delivery.
Questions & Verified Answers | 2025/2026 Edition |
Already Passed Content
ALSO | Emergency Obstetric Care, Maternal Resuscitation, Neonatal Stabilization,
OB Emergencies | Real Exam-Style Q&A | Expert-Verified
Introduction
This test bank provides 80 multiple-choice questions for the 2025/2026 Advanced Life
Support in Obstetrics (ALSO) exam, reflecting the written knowledge test’s format. Covering
maternal cardiac arrest, postpartum hemorrhage (PPH), shoulder dystocia, eclampsia, neonatal
resuscitation, and malpresentations, these questions align with the ALSO curriculum’s 8 core
lectures (e.g., Safety in Maternity Care, Postpartum Hemorrhage, Maternal Resuscitation) and
workshops (e.g., Shoulder Dystocia, Neonatal Resuscitation). Designed for maternity care
providers (physicians, nurses, midwives), this set ensures readiness for managing obstetric
emergencies and passing the ALSO certification exam.
Answer Format
Correct answers are highlighted in bold and green in Times New Roman font. Each question
includes a concise, evidence-based rationale to reinforce clinical reasoning.
ALSO Exam Q&A | Verified 2025/2026 Content | Emergency Maternal-Fetal
Focus | Already Passed Questions | Ready for Practice Review
1. What is the first step in managing a pregnant patient with cardiac arrest?
a) Administer epinephrine immediately
b) Perform chest compressions
c) Intubate the patient
d) Deliver the fetus
b) Perform chest compressions
Rationale: In maternal cardiac arrest, the priority is to restore circulation with chest
compressions, following the CAB (circulation, airway, breathing) sequence, with modifications
for pregnancy (e.g., uterine displacement).
2. What is the recommended timing for perimortem cesarean delivery
(PMCD) in maternal cardiac arrest?
,a) Within 10 minutes
b) Within 4–5 minutes
c) After 15 minutes
d) Only if fetal heart tones are present
b) Within 4–5 minutes
Rationale: PMCD should be initiated within 4–5 minutes of unsuccessful CPR to improve
maternal and fetal outcomes by relieving aortocaval compression.
3. A patient at 38 weeks gestation presents with shoulder dystocia. What is
the first maneuver to attempt?
a) Rubin maneuver
b) McRoberts maneuver
c) Zavanelli maneuver
d) Wood’s screw maneuver
b) McRoberts maneuver
Rationale: The McRoberts maneuver (hyperflexion of maternal hips) is the first-line,
non-invasive approach to resolve shoulder dystocia by increasing pelvic diameter.
4. What is the most common cause of postpartum hemorrhage (PPH)?
a) Uterine atony
b) Retained placenta
c) Cervical laceration
d) Coagulopathy
a) Uterine atony
Rationale: Uterine atony accounts for approximately 70–80% of PPH cases, as inadequate
uterine contraction fails to compress bleeding vessels.
5. A patient with eclampsia is seizing. What is the first-line treatment?
a) Diazepam IV
b) Magnesium sulfate IV
c) Phenytoin IV
d) Lorazepam IM
b) Magnesium sulfate IV
Rationale: Magnesium sulfate is the first-line treatment for eclamptic seizures, reducing seizure
recurrence and improving maternal outcomes.
6. During neonatal resuscitation, what is the initial step if the infant is not
breathing?
a) Administer epinephrine
b) Provide positive pressure ventilation
c) Perform chest compressions
d) Intubate immediately
b) Provide positive pressure ventilation
Rationale: Positive pressure ventilation is the initial step in neonatal resuscitation for an apneic
infant to establish adequate oxygenation and ventilation.
, 7. What is the hallmark sign of placental abruption?
a) Painless vaginal bleeding
b) Painful vaginal bleeding
c) Fetal bradycardia
d) Uterine hypotonia
b) Painful vaginal bleeding
Rationale: Placental abruption typically presents with painful vaginal bleeding due to
premature placental separation, often with uterine tenderness and fetal distress.
8. In a breech delivery, what is the first step to manage a trapped head?
a) Perform Zavanelli maneuver
b) Apply suprapubic pressure
c) Perform Mauriceau maneuver
d) Administer nitroglycerin
c) Perform Mauriceau maneuver
Rationale: The Mauriceau maneuver (flexion of the fetal head) is the first-line approach to
deliver a trapped head in breech presentation.
9. What is the primary goal of active management of the third stage of labor
(AMTSL)?
a) Reduce labor duration
b) Prevent postpartum hemorrhage
c) Enhance fetal oxygenation
d) Minimize maternal pain
b) Prevent postpartum hemorrhage
Rationale: AMTSL (uterotonic administration, controlled cord traction, uterine massage)
reduces the risk of PPH by promoting uterine contraction.
10. A patient at 32 weeks gestation presents with preterm labor. What is the
first-line tocolytic?
a) Magnesium sulfate
b) Terbutaline
c) Nifedipine
d) Indomethacin
c) Nifedipine
Rationale: Nifedipine, a calcium channel blocker, is the preferred tocolytic for preterm labor
due to efficacy and safety.
11. What is the most critical step in managing umbilical cord prolapse?
a) Administer oxygen
b) Elevate the presenting part
c) Perform immediate cesarean
d) Monitor fetal heart rate
b) Elevate the presenting part
Rationale: Elevating the presenting part relieves cord compression, buying time for emergent
cesarean delivery.
