CEN Pediatric and Obstetric Emergencies 2

Question 1

A pregnant patient at 36 weeks presents with sudden painless bright red vaginal bleeding. Which condition is most likely?

Accepted Answer

Placenta previa

Answer

Placental abruption

Answer

Uterine rupture

Answer

Vasa previa

Question 2

A patient at 32 weeks gestation presents with sudden severe abdominal pain, rigid abdomen, and dark vaginal bleeding. Fetal heart tones are absent. Which complication is most likely?

Accepted Answer

Placental abruption with fetal demise

Answer

Placenta previa

Answer

Uterine rupture

Answer

Vasa previa

Question 3

A patient at 38 weeks is admitted in active labor. After a prolonged deceleration, the baby's head is not descending despite pushing. The fetal heart rate drops to 60 bpm. Which maneuver is first-line for shoulder dystocia?

Accepted Answer

McRoberts maneuver with suprapubic pressure

Answer

Fundal pressure (Kristeller maneuver)

Answer

Zavanelli maneuver

Answer

Emergency C-section

Question 4

A patient with preeclampsia at 34 weeks is being treated with IV magnesium sulfate. The nurse notes absent deep tendon reflexes and a respiratory rate of 10. Which action is immediately required?

Accepted Answer

Administer calcium gluconate IV and stop magnesium

Answer

Increase the magnesium infusion rate

Answer

Intubate the patient emergently

Answer

Administer labetalol IV

Question 5

A woman delivers a baby and 20 minutes later has heavy vaginal bleeding (estimated 600 mL). The uterus is boggy on palpation. What is the first intervention?

Accepted Answer

Administer 10 units oxytocin IM and perform uterine massage

Answer

Immediate surgical intervention

Answer

IV fluid resuscitation with 2L normal saline

Answer

Insert intrauterine balloon tamponade

Question 6

A newborn is delivered and does not cry, has poor muscle tone, and a heart rate of 60 bpm at 1 minute. After warming and stimulation, the HR remains <60. What is the next step?

Accepted Answer

Perform positive pressure ventilation and begin chest compressions

Answer

Administer epinephrine via endotracheal tube

Answer

Provide blow-by oxygen only

Answer

Wait 2 more minutes before intervening