CPM Emergency Obstetric Complications

Question 1

Which maneuver is the first-line intervention for shoulder dystocia?

Accepted Answer

McRoberts maneuver with suprapubic pressure

Answer

Zavanelli maneuver with immediate surgical backup

Answer

Woods screw internal rotation maneuver

Answer

Delivery of the posterior arm

Question 2

According to standard obstetric guidelines, postpartum hemorrhage is defined as blood loss exceeding:

Accepted Answer

500 mL after vaginal delivery or 1,000 mL after cesarean

Answer

250 mL after vaginal delivery

Answer

750 mL regardless of delivery route

Answer

1,000 mL after vaginal delivery

Question 3

A client at 38 weeks gestation develops sudden severe headache, visual disturbances, and epigastric pain at a planned homebirth. The MOST appropriate immediate action is:

Accepted Answer

Initiate emergency transport to the hospital immediately

Answer

Administer oral antihypertensive and recheck BP in 30 minutes

Answer

Place client in left lateral position and continue monitoring

Answer

Perform fundal massage and assess for bleeding

Question 4

Uterine atony, the most common cause of postpartum hemorrhage, is best described as:

Accepted Answer

Failure of the uterus to contract adequately after delivery of the placenta

Answer

Premature separation of the placenta from the uterine wall

Answer

Incomplete expulsion of placental fragments

Answer

Lacerations of the cervix causing excessive bleeding

Question 5

When a prolapsed umbilical cord is identified at a homebirth, the CPM's priority intervention is:

Accepted Answer

Elevate the presenting part off the cord and initiate emergency transport immediately

Answer

Attempt to manually replace the cord back into the uterus

Answer

Apply warm moist dressings to the cord and observe for spontaneous resolution

Answer

Position the client prone and perform emergency fundal pressure

Question 6

Which of the following presentations is MOST consistent with placental abruption?

Accepted Answer

Painful dark red vaginal bleeding with uterine rigidity

Answer

Painless bright red vaginal bleeding in the third trimester

Answer

Mucus-tinged show with irregular contractions

Answer

Gradual onset of mild uterine contractions with slight spotting

Question 7

A client delivers a 4,300g infant and has excessive vaginal bleeding. Uterine massage reveals a firmly contracted uterus. The next priority assessment is:

Accepted Answer

Inspect the birth canal for genital tract lacerations

Answer

Repeat oxytocin dose for suspected uterine atony

Answer

Retained placenta evaluation with manual exploration

Answer

Assess for uterine inversion by measuring fundal height