57. Which of the following could inhibit performance of Leopold maneuvers?

a. Maternal obesity

b. Oligohidramnions

c. Posterior placenta

d. Supine postioning

58. On palpation of the fetal head during vaginal examination, it is noted that sagital sututre is
transverse and close to the pubic symphisis. The posterior ear can be easily palpated . This is
called which of the following?

a. Mentoanterior position

b. Anterior asynclitism

c. Mentoposterior position

d. Posterior asynclitism

59. Which of the following statements about the preparatory division of the first stage of labor is
true?

a. Cervical dilatation is the most rapid

b. it is also referred to as the active phase of labor

c. it is unaffected by sedation or conduction analgesia

d. Connective tissue components of the cervix change considerably

60. in the setting of painful contractions but intact membranes, which of the following cervical
dilatations are presumed to be a reasonably reliable threshold for the diagnosis of labor?

a. 1-2 cm

b. 3-4 cm

c. 5-6 cm

d. 7-8 cm

61. A term primigravida presents with contractions at 1 cm dilatation. She is uncomfortable and
upset. You sedate the patient. Six hours later, she has made no cervical change, and the
contractions have abated. Which of the following is the likely diagnosis?
 a. Arrest of dilatation

b. Prolonged latent phase

c. False labor

d. Protracted labor

62. The stage of labor that begins when cervical dilatation is complete and ends with delivery of
the fetus is which of the following?

a. First stage

b. Second stage

c. Third stage

d. Fourth stage

63. A 20-year-old G1P0 at 37 weeks’ gestation present to triage complaining of fluid leakage. A
speculum examination is performed, and small amount of watery discharge is identified in the
vault. Nitrazine paper indicates a pH of 7. Another reliable rest includes which of the following?

a. Microscopy to detect arborization of ferning of fluid

b. Sonography to assess amniotic fluid volume

c. Indigo carmine injection into the amniotic sac

d. Methylene blue injection into the amniotic sac

64. A patient in active labor is noted to be 75% effaced. Her cervical length approximates which
of the following?

a. 4 cm

b. 3 cm

c. 2 cm

d. 1 cm

65. Which of the following statements regarding labor management is true?

a. Maternal vitals should be evaluated every 15 minutes

b. Periodic pelvic examination should be performed at 1 hour intervals

c. Fetal heart rate should be checked during a contractions once per hour
 d. Food should be withheld during active labor and delivery

66. Which of the following is a risk factor for postpartum urinary retention?

a. Multiparity

b. Labor < 10 hours in duration

c. Labor augmentation

d. Not being catheterized during labor

67. The advantage of RItgen maneuveris which of the following?

a. It favors neck flexion

b. It decreases the likelihood of third degree laceration

c. It prevents shoulder dystocia

d. It allows controlled delivery of the head

68. A close friend with a nervous nature who is pregnant calls you with concerns that the baby
will be “strangled” by the umbilical cord. You respond to her most appropriately with which of
the following?

a. That’s worrisome. I’ll check for you with sonography

b. A nuchal cord occurs in 25% of deliveries and usually causes no harm

c. I understand you fear. Nuchal cord is a serious contributor to perinatal mortality

d. You shouldn’t think about it because a nuchal cord is rare

69. Delaying cord clamping by 3 minutes has been encouraged by some because it provides an
additional 80 mL of blood to the neonate. The possible disadvantage of this includes which of
the following?

a. Exsanguination

b. Hyperbilirubinemia

c. Hypoglycemia

d. Meconium aspiration syndrome

70. Which of the following is a sign of placental separation?

a. Sudden gush of blood

 b. Umbilical cord appears to shorten

c. Uterus shrinks down as the placenta moves into the lower uterine segment

d. Uterus softnes

71. Which of the following is a physiologic change associated with an travenous bolus of
oxytocin?

a. Increased blood pressure

b. Decreased cardiac output

c. Increased heart rate

d. Increased body temperature

72. Which of the following is true about oxytocin?

a. It is an effective orally as it is intravenously

b. It is a powerful duretic that could cause dehydration in large doses

c. The half life with intravenous infusion is 3 minutes

d. Oxytocin should not be given prior to delivery of the placenta because this could

prolong the third stage of labor

73. You are asked by a flight attendant to assist in delivering a woman’s term fetus while abroad
an airplane. The baby and placenta are delivered without incident. You determine the woman has
uterine atony despite massage. In the absence of my medications, which of the following is a
reasonable next step?

a. Have the patient consume a large quantity of water

b. Pack her vagina with an available T-shirt

c. Suggest nipple stimulation

d. Place a tourniquet at her waist

74. Intravenous administration of ergot alkaloids should be avoided because it can initiate which
of the following?

a. Anaphylaxis

b. Transient bronchoconstriction
c. Bleeding

d. Transient hypertension