CEN Obstetric and Gynecologic Emergencies

Question 1

A 26-year-old woman presents with acute pelvic pain, vaginal bleeding, and a positive pregnancy test. She has a BP of 80/50 mmHg and signs of peritoneal irritation. What is the most likely diagnosis?

Accepted Answer

Ruptured ectopic pregnancy

Answer

Hemodynamic instability with pelvic pain, vaginal bleeding, and positive pregnancy test is ruptured ectopic pregnancy until proven otherwise, requiring emergent surgical intervention.

Question 2

A 36-week pregnant patient presents with severe headache, visual disturbances, BP of 160/110 mmHg, and 3+ proteinuria. What is the diagnosis?

Accepted Answer

Severe preeclampsia

Answer

BP ≥160/110 mmHg with headache, visual changes, and proteinuria after 20 weeks meets criteria for severe preeclampsia with severe features.

Question 3

What is the drug of choice to prevent and treat seizures in eclampsia?

Accepted Answer

Magnesium sulfate 4–6 g loading dose IV

Answer

Magnesium sulfate is the drug of choice for eclampsia prophylaxis and treatment, given as a 4–6 g IV loading dose over 20–30 minutes followed by a maintenance infusion.

Question 4

A patient at 34 weeks gestation presents with painless, bright red vaginal bleeding. What is the most likely cause?

Accepted Answer

Placenta previa

Answer

Painless bright red vaginal bleeding in the third trimester is the classic presentation of placenta previa, where the placenta covers the cervical os.

Question 5

Which assessment is CONTRAINDICATED in a patient with suspected placenta previa?

Accepted Answer

Digital cervical examination

Answer

Digital cervical examination is absolutely contraindicated in placenta previa as it can disrupt the placenta, causing life-threatening hemorrhage.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Obstetric and Gynecologic Emergencies