OBGYN APGO UWise Practice MCQs
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Questions & Correct Verified Answers.
Graded A
A 16-year-old G1P0 woman at 39 weeks gestation presents to labor and
delivery reporting a gush of blood-tinged fluid approximately five hours ago
and the onset of uterine contractions shortly thereafter. She reports
contractions have become stronger and closer together over the past hour.
The fetal heart rate is 140 to 150 with accelerations and no decelerations.
Uterine contractions are recorded every 2-3 minutes. A pelvic exam reveals
that the cervix is 4 cm dilated and 100 percent effaced. Fetal station is 0.
After walking around for 30 minutes the patient is put back in bed after
complaining of further discomfort. She requests an epidural. However,
obtaining the fetal heart rate externally has become difficult because the
patient cannot lie still. What is the most appropriate next step in the
management of this patient?
A. Place the epidural
B. Apply a fetal scalp electrode
C. Perform a fetal ultrasound to as - ANSB. If the fetal heart rate cannot be
confirmed using external methods, then the most reliable way to document
fetal well-being is to apply a fetal scalp electrode. Putting in an epidural
without confirming fetal status might be dangerous. Although ultrasound will
provide information regarding the fetal heart rate, it is not practical to use
,this to monitor the fetus continuously while the epidural is placed. An
intrauterine pressure catheter will provide information about the strength
and frequency of the patient's contractions, but will not provide information
regarding the fetal status. Closer fetal monitoring via a fetal scalp electrode
should be performed.
A 17-year-old G0 female presents with vaginal spotting for the last three
days. Her last menstrual period was six weeks ago. Vitals signs are normal.
Abdominal and pelvic examination reveals a 10-week sized uterus. Beta-
HCG is 80,000 mIU. What is the best next step in the management of this
patient?
A. Repeat Beta-HCG in 24 hours
B. Repeat Beta-HCG in 48 hours
C. Pelvic ultrasound
D. Dilation and curettage
E. Routine prenatal care - ANSC. In the face of discrepancy between
dates and uterine size, a pelvic ultrasound is indicated to confirm dates,
exclude multiple gestation, uterine abnormalities, and molar pregnancy.
There is no single Beta-hCG value that is diagnostic for a molar pregnancy.
A quantitative Beta-hCG, though, is crucial at determining whether or not a
pelvic (transvaginal) ultrasound will confirm a very early gestation. With a
Beta-hCG above the discriminatory zone (>1500 mIU), an IUP should be
easily identified on transvaginal ultrasound. If an IUP is not seen, the
ultrasound findings (in conjunction with the Beta-hCG level) should identify
a mole (multiple internal echoes) or an ectopic (absence of intra-uterine
gestation). Additional Beta-HCG levels are not indicated at this time.
,Suction curettage will provide a pathologic specimen that can distinguish
between a normal and molar pregnancy, but it is used only as a therapeutic
intervention. Routine prenatal care would be appropriate only after
establishing a normal pregnancy.
A 17-year-old G1P1 female delivered a term infant two days ago. She is
not interested in breastfeeding and she asks for something to suppress
lactation. Which of the following is the safest method of lactation
suppression in this patient?
A. Bromocriptine
B. Breast binding, ice packs and analgesics
C. Medroxyprogesterone acetate
D. Oral contraceptives
E. Manual milk expression - ANSB. Hormonal interventions for preventing
lactation appear to predispose to thromboembolic events, as well as a
significant risk of rebound engorgement. Bromocriptine, in particular, is
associated with hypertension, stroke and seizures. The safest method to
suppress lactation is breast binding, ice packs and analgesics. The patient
should avoid breast stimulation or other means of milk expression, so that
the natural inhibition of prolactin secretion will result in breast involution.
A 19-year-old G1P0 woman at 39 weeks gestation presents in labor. She
denies ruptured membranes. Her prenatal course was uncomplicated and
ultrasound at 18 weeks revealed no fetal abnormalities. Her vital signs are:
blood pressure 120/70; pulse 72; temperature 101.0° F (38.3° C); fundal
height 36 cm; and estimated fetal weight of 2900 gm. Cervix is dilated to 4
, cm, 100% effaced and at +1 station. She receives 10 mg of morphine
intramuscularly for pain and soon after has spontaneous rupture of the
membranes. Light meconium-stained fluid was noted and, five minutes
later, the fetal heart rate tracing revealed variable decelerations with good
variability. What is the most likely cause for the variable decelerations?
A. Umbilical cord compression
B. Meconium
C. Maternal fever
D. Uteroplacental insufficiency
E. Umbilical cord prolapse - ANSA. Variable decelerations are typically
caused by cord compression and are the most common decelerations seen
in labor. Placental insufficiency is usually associated with late
decelerations. Head compression typically causes early decelerations.
Oligohydramnios can increase a patient's risk of having umbilical cord
compression; however, it does not directly cause variable decelerations.
Umbilical cord prolapse occurs in 0.2 to 0.6% of births. Sustained fetal
bradycardia is usually observed.
A 19-year-old G1P0 woman at 41-weeks gestation with two prior prenatal
visits at 35-weeks and 40-weeks, presents in active labor. Review of
available maternal labs shows: blood type O+; RPR non-reactive; HBsAg
negative; and HIV negative. She delivers a small female infant who cries
spontaneously. On examination, you find the infant has a slightly flattened
nasal bridge. Her ears are small and slightly rotated. What is the most
appropriate next step in the management of this patient?
sha2507 Test bank. Newest 2025-2026.
Questions & Correct Verified Answers.
Graded A
A 16-year-old G1P0 woman at 39 weeks gestation presents to labor and
delivery reporting a gush of blood-tinged fluid approximately five hours ago
and the onset of uterine contractions shortly thereafter. She reports
contractions have become stronger and closer together over the past hour.
The fetal heart rate is 140 to 150 with accelerations and no decelerations.
Uterine contractions are recorded every 2-3 minutes. A pelvic exam reveals
that the cervix is 4 cm dilated and 100 percent effaced. Fetal station is 0.
After walking around for 30 minutes the patient is put back in bed after
complaining of further discomfort. She requests an epidural. However,
obtaining the fetal heart rate externally has become difficult because the
patient cannot lie still. What is the most appropriate next step in the
management of this patient?
A. Place the epidural
B. Apply a fetal scalp electrode
C. Perform a fetal ultrasound to as - ANSB. If the fetal heart rate cannot be
confirmed using external methods, then the most reliable way to document
fetal well-being is to apply a fetal scalp electrode. Putting in an epidural
without confirming fetal status might be dangerous. Although ultrasound will
provide information regarding the fetal heart rate, it is not practical to use
,this to monitor the fetus continuously while the epidural is placed. An
intrauterine pressure catheter will provide information about the strength
and frequency of the patient's contractions, but will not provide information
regarding the fetal status. Closer fetal monitoring via a fetal scalp electrode
should be performed.
A 17-year-old G0 female presents with vaginal spotting for the last three
days. Her last menstrual period was six weeks ago. Vitals signs are normal.
Abdominal and pelvic examination reveals a 10-week sized uterus. Beta-
HCG is 80,000 mIU. What is the best next step in the management of this
patient?
A. Repeat Beta-HCG in 24 hours
B. Repeat Beta-HCG in 48 hours
C. Pelvic ultrasound
D. Dilation and curettage
E. Routine prenatal care - ANSC. In the face of discrepancy between
dates and uterine size, a pelvic ultrasound is indicated to confirm dates,
exclude multiple gestation, uterine abnormalities, and molar pregnancy.
There is no single Beta-hCG value that is diagnostic for a molar pregnancy.
A quantitative Beta-hCG, though, is crucial at determining whether or not a
pelvic (transvaginal) ultrasound will confirm a very early gestation. With a
Beta-hCG above the discriminatory zone (>1500 mIU), an IUP should be
easily identified on transvaginal ultrasound. If an IUP is not seen, the
ultrasound findings (in conjunction with the Beta-hCG level) should identify
a mole (multiple internal echoes) or an ectopic (absence of intra-uterine
gestation). Additional Beta-HCG levels are not indicated at this time.
,Suction curettage will provide a pathologic specimen that can distinguish
between a normal and molar pregnancy, but it is used only as a therapeutic
intervention. Routine prenatal care would be appropriate only after
establishing a normal pregnancy.
A 17-year-old G1P1 female delivered a term infant two days ago. She is
not interested in breastfeeding and she asks for something to suppress
lactation. Which of the following is the safest method of lactation
suppression in this patient?
A. Bromocriptine
B. Breast binding, ice packs and analgesics
C. Medroxyprogesterone acetate
D. Oral contraceptives
E. Manual milk expression - ANSB. Hormonal interventions for preventing
lactation appear to predispose to thromboembolic events, as well as a
significant risk of rebound engorgement. Bromocriptine, in particular, is
associated with hypertension, stroke and seizures. The safest method to
suppress lactation is breast binding, ice packs and analgesics. The patient
should avoid breast stimulation or other means of milk expression, so that
the natural inhibition of prolactin secretion will result in breast involution.
A 19-year-old G1P0 woman at 39 weeks gestation presents in labor. She
denies ruptured membranes. Her prenatal course was uncomplicated and
ultrasound at 18 weeks revealed no fetal abnormalities. Her vital signs are:
blood pressure 120/70; pulse 72; temperature 101.0° F (38.3° C); fundal
height 36 cm; and estimated fetal weight of 2900 gm. Cervix is dilated to 4
, cm, 100% effaced and at +1 station. She receives 10 mg of morphine
intramuscularly for pain and soon after has spontaneous rupture of the
membranes. Light meconium-stained fluid was noted and, five minutes
later, the fetal heart rate tracing revealed variable decelerations with good
variability. What is the most likely cause for the variable decelerations?
A. Umbilical cord compression
B. Meconium
C. Maternal fever
D. Uteroplacental insufficiency
E. Umbilical cord prolapse - ANSA. Variable decelerations are typically
caused by cord compression and are the most common decelerations seen
in labor. Placental insufficiency is usually associated with late
decelerations. Head compression typically causes early decelerations.
Oligohydramnios can increase a patient's risk of having umbilical cord
compression; however, it does not directly cause variable decelerations.
Umbilical cord prolapse occurs in 0.2 to 0.6% of births. Sustained fetal
bradycardia is usually observed.
A 19-year-old G1P0 woman at 41-weeks gestation with two prior prenatal
visits at 35-weeks and 40-weeks, presents in active labor. Review of
available maternal labs shows: blood type O+; RPR non-reactive; HBsAg
negative; and HIV negative. She delivers a small female infant who cries
spontaneously. On examination, you find the infant has a slightly flattened
nasal bridge. Her ears are small and slightly rotated. What is the most
appropriate next step in the management of this patient?
