answers
A 26 year-
old gravida 2 para 1 female at 9 weeks' estimated gestational age (by last normal menstrual period) pr
esents to the Emergency Department complaining of heavy vaginal bleeding which began two hours ea
rlier. She denies having any sexual intercourse in the past seven days. Her vital signs are stable. A quan
titative serum hCG returns at a value of 3200 mIU/mLHand a transvaginal ultrasound reveals a mean ge
stational sac diameter of 30mm and no embryo. She reports passing no tissue and a speculum examin
ation reveals the cervix is visually closed. In counseling the patient about her options, which of the foll
owing statements is true? -
correct answer-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 me
thotrexate? CORRECT ANSWER>>-Presence of embryonic cardiac activity Correct
A 19-
yo primigravida at approximately 40 weeks' estimated gestational age comes to the hospital with painf
ul 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 se
vere headaches for three days and has noticed swelling in her hands and feet. Moments after her bloo
d 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?
CORRECT ANSWER>>-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 embo
lus. She is hemodynamically stable and you are discussing therapeutic anticoagulation with her. Accord
ing to the 2012 American College of Chest Physicians Guidelines, the treatment of choice for venous th
romboembolism in pregnancy is which one of the following? CORRECT ANSWER>>-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 consid
, ered abnormal and predictive of abnormal fetal acid-base status at the time of observation)?
CORRECT ANSWER>>-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 foll
owing primiparous labor scenarios? CORRECT ANSWER>>-
After maximum oxytocin dosing for six hours with ruptured membranes, there is failure to generate ad
equate contractions or progress at 7 cm Correct
Which of the following defines an occiput posterior position? CORRECT ANSWER>>-
Fetal occiput toward the maternal spine Correct
All of the following are true statements regarding multiple gestation pregnancies EXCEPT:
CORRECT ANSWER>>-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 h
ours, and has now been pushing for two hours. She is physically and emotionally exhausted, so you ha
ve a discussion with her regarding assisted vaginal delivery. Which of the following are prerequisites to
an instrumented delivery? CORRECT ANSWER>>-
Lack of suspicion of severe cephalopelvic disproportion Correct
Which of the following is an antenatal risk factor for shoulder dystocia? CORRECT ANSWER>>-
Maternal obesity Correct
Documentation in the medical record after a delivery with a shoulder dystocia is an essential risk mana
gement tool. Which of the following should be documented in the medical record pertaining to the cir
cumstances that tookHplace during the shoulder dystocia? CORRECT ANSWER>>-
The elapsed amount of time from delivery of the fetal head until complete delivery of the baby Correc
t
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? CORRECT
ANSWER>>- Atonic uterus Correct