BCEN Obstetric and Gynecological Emergencies

Question 1

A pregnant patient at 32 weeks presents with sudden, painless, bright red vaginal bleeding. Which condition should the nurse suspect first?

Accepted Answer

Placenta previa

Answer

Placenta previa typically presents with painless, bright red vaginal bleeding due to the low-lying placenta covering or near the cervical os.

Question 2

A patient at 28 weeks gestation presents with severe headache, visual disturbances, and BP of 168/110 mmHg with 3+ proteinuria. What is the priority nursing intervention?

Accepted Answer

Administer magnesium sulfate IV

Answer

Magnesium sulfate is the drug of choice for seizure prophylaxis in severe preeclampsia and eclampsia, making it the first priority.

Question 3

A patient presents with sudden severe abdominal pain, vaginal bleeding, and a rigid board-like uterus. Fetal heart tones are absent. Which condition is most likely?

Accepted Answer

Placental abruption

Answer

Placental abruption presents with painful vaginal bleeding and a rigid, tender uterus due to concealed hemorrhage behind the placenta, which can cause fetal death.

Question 4

A woman with 8 weeks amenorrhea and a positive pregnancy test presents with sudden severe unilateral lower abdominal pain, BP 88/56 mmHg, and HR 122 bpm. Which intervention is MOST urgent?

Accepted Answer

Establish large-bore IV access and prepare for emergency surgery

Answer

A ruptured ectopic pregnancy causes life-threatening hemorrhage; immediate large-bore IV access and surgical intervention are critical priorities in the hemodynamically unstable patient.

Question 5

Which medication is the first-line treatment for postpartum hemorrhage caused by uterine atony?

Accepted Answer

Oxytocin (Pitocin)

Answer

Oxytocin promotes uterine contractions and is the first-line uterotonic agent for uterine atony, the most common cause of postpartum hemorrhage.

(BCEN) Board of Certification of Emergency Nursing Practice Test

(BCEN) Board of Certification of Emergency Nursing Practice Test

BCEN Obstetric and Gynecological Emergencies