Multiple Choice Questions (MCQ)

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Category: Obstetrics & Gynecology--->Normal and Abnormal Labor and Delivery
Page: 2

Question 6#Print Question

A 27-year-old G2P1 at 38 weeks’ gestation is admitted in active labor. She has had one prior uncomplicated vaginal delivery and has no medical problems. She reports an allergy to penicillin, and says she had a rash. Her vital signs are normal, and the fetal heart tracing is category I. Her prenatal record indicates that her group B Streptococcus (GBS) culture at 36 weeks was positive.

What is the best choice for antibiotic prophylaxis during labor?

a. Cefazolin
b. Clindamycin
c. Erythromycin
d. Desensitization then treatment with penicillin
e. Vancomycin

Question 7#Print Question

A 38-year-old G6P4 undergoes a primary cesarean delivery under regional analgesia for malpresentation of twins at 37 weeks. Immediately after the delivery of the placenta, the anesthesiologist notes maternal seizure activity with profound hypoxia and hypotension. The patient is intubated and provided with circulatory support with vasopressors. Massive hemorrhage from the surgical site ensues, and the patient is given uterotonic agents and blood products.

What is the most likely cause of her hemorrhage?

a. Amniotic fluid embolism
b. Halogenated anesthetic agent
c. Placenta accreta
d. Severe preeclampsia with HELLP syndrome
e. Uterine atony from overdistended uterus

Question 8#Print Question

A 23-year-old G1 at 38 weeks’ gestation presents in active labor at 6-cm dilated with ruptured membranes. On cervical examination the fetal nose, eyes, and lips can be palpated. The fetal heart tracing is 140 beats per minute with accelerations and no decelerations.

Which of the following is the most appropriate next step in management for this patient?

a. Perform immediate cesarean delivery
b. Allow spontaneous labor with vaginal delivery
c. Perform forceps rotation in the second stage of labor to convert mentum posterior to mentum anterior and to allow vaginal delivery
d. Allow the patient to labor spontaneously until complete cervical dilation is achieved and then perform an internal podalic version with breech extraction
e. Attempt manual conversion of the face to vertex in the second stage of labor

Question 9#Print Question

A 32-year-old G3P2 at 39 weeks’ gestation presented to labor delivery with ruptured membranes. On examination, she was contracting regularly, and her cervix was 4-cm dilated. Her history was significant for two prior vaginal deliveries, with her largest child weighing 3800 g. Over the next 2 hours she progressed to 7-cm dilation. Four hours later, she remained 7-cm dilated. She had regular contractions and IUPC showed MVUs of 220. The estimated fetal weight by ultrasound was 3200 g.

Which of the following labor abnormalities best describes this patient?

a. Prolonged latent phase
b. Protracted active phase
c. Hypertonic dysfunction
d. Secondary arrest of dilation
e. Second stage arrest

Question 10#Print Question

A 29-year-old P0 at 41 weeks’ gestation presents in labor. At the time of delivery, a shoulder dystocia is encountered. An episiotomy is cut to assist with dystocia maneuvers.

Compared with a midline episiotomy, which of the following is an advantage of mediolateral episiotomy?

a. Ease of repair
b. Fewer breakdowns
c. Less blood loss
d. Lower incidence of dyspareunia
e. Less chance of extension of the incision

Category: Obstetrics & Gynecology--->Normal and Abnormal Labor and Delivery
Page: 2 of 7