CMS CMS Obstetric Complications & Emergency Management

Question 1

A patient at 32 weeks presents with painless, bright-red vaginal bleeding. Which condition is most likely?

Accepted Answer

Placenta previa

Answer

Placenta previa classically presents with painless, bright-red vaginal bleeding in the second or third trimester due to the placenta overlying the cervical os.

Question 2

Which triad of findings is characteristic of severe preeclampsia requiring immediate intervention?

Accepted Answer

BP ≥160/110 mmHg, severe headache, visual disturbances

Answer

Severe-range preeclampsia features BP ≥160/110 plus severe symptoms such as severe headache, visual changes, or epigastric pain, mandating magnesium sulfate and delivery planning.

Question 3

A patient experiences sudden, severe 'tearing' abdominal pain with fetal heart rate decelerations at 38 weeks. She has a prior uterine scar. The most likely diagnosis is:

Accepted Answer

Uterine rupture

Answer

Uterine rupture presents with sudden severe abdominal pain, loss of fetal station, and fetal distress, and is a life-threatening emergency requiring immediate cesarean.

Question 4

Magnesium sulfate is administered in severe preeclampsia primarily to:

Accepted Answer

Prevent eclamptic seizures

Answer

Magnesium sulfate is the drug of choice for seizure prophylaxis in severe preeclampsia; antihypertensives are used separately for blood pressure control.

Question 5

Which clinical finding most reliably distinguishes placental abruption from placenta previa?

Accepted Answer

Painful uterine contractions with dark vaginal bleeding

Answer

Placental abruption typically presents with painful, board-like uterine rigidity and dark vaginal bleeding, in contrast to the painless bleeding of placenta previa.

CMS - Clinical Midwife Specialist Practice Test

CMS - Clinical Midwife Specialist Practice Test

CMS CMS Obstetric Complications & Emergency Management