2–21.

The mobility of which joint aids in the delivery of

the obstructed shoulder in the case of a shoulder
dystocia?
a. Sacroiliac
b. Sacrococcygeal
c. Pubic symphysis
d. All of the above
Answer : A

23–1.Which of the following may be responsible for

dystocia in labor?
a. Bony pelvis abnormalities
b. Inadequate expulsive forces
c. Soft tissue abnormalities of the reproductive tract
d. All of the above

Answer :D

23–2.The majority of labor dystocia is due to which of the

following?
a. Asynclitism
b. Fetal macrosomia
c. Childhood rickets
d. Premature rupture of membranes
Answer : A

23–3. Which of these factors influences the progress of

labor?
a. Prominent coccyx
b. Pubic symphyseal separation
c. Forward pressure by the leading fetal part
d. Cervical dilation at the time of rupture of
membranes

Answer :C

23–35.Which of the following are complications of labor

dystocia?
a. Infection
b. Uterine rupture
c. Hysterotomy incision extensions
d. All of the above
Answer : D

23–36. A 24-year-old multigravida at 41 weeks’ gestation

with a body mass index of 38 kg/m2 progresses
through the first stage of labor and becomes
complete at +2 station. She pushes for about 3 hours
with neuraxial anesthesia. She delivers a 4200-gram
infant with the assistance of forceps. The next day
your patient reports lower extremity weakness with
foot drop and pain. What is the most likely cause?
a. Obesity
b. Prolonged second stage
c. Forceps-assisted vaginal delivery
d. Complication of neuraxial anesthesia
Answer: B

27–13. Which of the following defines shoulder dystocia?

a. Clinical perception of the delivering physician.
b. Maneuvers are needed to free the anterior
shoulder.
c. Head to body delivery time is greater than
60 seconds.
d. All of the above

Answer : D

27–14. After a difficult delivery involving shoulder dystocia,

the pediatrician tells you that the infant has suffered
an injury. Which of the outcomes described below is
most likely?
a. The mother had uterine atony.
b. The infant has a humeral fracture.
c. The infant has a clavicular fracture.
d. The infant exhibits a brachial plexus injury.

Answer :D

27–15. A 33-year-old multigravida is in clinic at 39 weeks’

gestation and believes she has big baby. An ultrasound
is performed, and the estimated fetal weight is
9 pounds. Which of the following is true?
a. Planned cesarean delivery may be offered.
b. Elective induction should be scheduled soon.
c. Shoulder dystocia may be accurately predicted.
d. Fetal macrosomia is a risk factor for shoulder
dystocia.

Answer :D

27–16. The following illustration demonstrates which

maneuver for reduction of shoulder dystocia?
a. Wood’s screw
b. Rubin maneuver
c. McRoberts maneuver
d. Delivery of the posterior shoulder

Answer :C

27–17. The most common maneuver used to reduce a

shoulder dystocia is which of the following?
a. Wood’s screw
b. Rubin maneuver
c. Suprapubic pressure
d. McRoberts maneuver
Answer : C

27–21. When delivering a fetus with a lethal prognosis, you

encounter shoulder dystocia. Which of the following
maneuvers is least appropriate?
a. Cleidotomy
b. Cesarean delivery
c. Suprapubic pressure
d. McRoberts maneuver
Answer : B

27–28. Indications for episiotomy include which of the

following?
a. Breech delivery
b. Shoulder dystocia
c. Persistent occiput posterior position
d. All of the above
Answer :D

57–10.What might be said of the pregnancy yielding this

5000-g newborn?
a. The mother likely had poor glycemic control.
b. The baby was at risk for neonatal hypoglycemia.
c. The mother had an increased risk for shoulder
dystocia.
d. All of the above
Answer : D