Complications Flashcards by Shaquan Moore

Why does obesity increase maternal risk for complications in pregnancy?
A) It prolongs labor and increases resistance to induction medications
B) It limits the mother’s ability to gain necessary weight during pregnancy
C) It decreases the likelihood of Cesarean birth
D) It reduces the risk of gestational diabetes

Answer: A) It prolongs labor and increases resistance to induction medications

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Which BMI classification defines a person as “severely obese”?
A) 25 or greater
B) 30 or greater
C) 35 or greater
D) 40 or greater

Answer: D) 40 or greater

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What are some of the common complications pregnant persons with obesity are at increased risk for?
A) Premature rupture of membranes
B) Venous thromboembolism and gestational diabetes
C) Low birth weight
D) Decreased likelihood of spontaneous abortion

A) Premature rupture of membranes
B) Venous thromboembolism and gestational diabetes

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In antenatal testing, what does a “non-stress test” measure in fetal monitoring?
A) Blood pressure of the fetus
B) Fetal movement, heart rate, and response to stimuli
C) Volume of amniotic fluid
D) Length of the fetal spine

Answer: B) Fetal movement, heart rate, and response to stimuli

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What is the purpose of fetal kick counts in antenatal testing?
A) To ensure the mother is well-rested before delivery
B) To measure fetal blood flow through the umbilical cord
C) To monitor for fetal well-being through movement
D) To assess the amount of amniotic fluid surrounding the fetus

Answer: C) To monitor for fetal well-being through movement

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Why might antenatal fetal testing be particularly important for Non-Hispanic Black individuals, according to ACOG recommendations?
A) Race itself is a biologic risk for stillbirth
B) The effects of racism can negatively impact health and pregnancy outcomes
C) Genetic factors increase the risk of complications
D) They are less likely to receive prenatal care

Answer: B) The effects of racism can negatively impact health and pregnancy outcomes

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How is a biophysical profile score calculated, and what score indicates optimal fetal well-being?
A) Based on fetal movements only; a score of 4/4 is ideal
B) Based on multiple criteria including fetal breathing and fluid volume; a score of 8/8 is ideal
C) Only based on fetal heart rate accelerations; a score of 5/5 is optimal
D) Based on maternal blood pressure; a score of 2/2 is ideal

Answer: B) Based on multiple criteria including fetal breathing and fluid volume; a score of 8/8 is ideal

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What is the primary use of Doppler flow studies in fetal monitoring?
A) To assess fetal kidney function
B) To evaluate maternal blood pressure
C) To assess placental vascular resistance and umbilical blood flow
D) To measure fetal lung maturity

Answer: C) To assess placental vascular resistance and umbilical blood flow

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Which of the following is NOT a risk factor for preterm labor?
A) Prior preterm birth
B) Infections
C) High socioeconomic status
D) Multiple gestation

Answer: C) High socioeconomic status

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What is the purpose of administering antenatal glucocorticoid steroids like betamethasone to a pregnant person at risk of preterm labor?
A) To enhance maternal immune response
B) To stimulate fetal lung surfactant production
C) To increase the risk of early delivery
D) To prevent maternal hypertension

Answer: B) To stimulate fetal lung surfactant production

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Magnesium sulfate is used in preterm labor to reduce the risk of:
A) Respiratory distress syndrome in the fetus
B) Cerebral palsy by reducing intraventricular hemorrhage risk
C) Pre-eclampsia in the mother
D) Amniotic fluid imbalances

Answer: B) Cerebral palsy by reducing intraventricular hemorrhage risk

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What defines preterm labor?
A) Uterine contractions without cervical change before 40 weeks
B) Regular uterine contractions with cervical change before 37 completed weeks
C) Cervical dilation with no contractions at any gestational age
D) Fetal movement between 20 weeks and term

Answer: B) Regular uterine contractions with cervical change before 37 completed weeks

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Which condition is characterized by a low level of amniotic fluid, often caused by factors like fetal urinary tract malformations or ruptured membranes?
A) Oligohydramnios
B) Polyhydramnios
C) Normal amniotic fluid levels
D) Velamentous cord insertion

Answer: A) Oligohydramnios

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What is a common risk associated with polyhydramnios (excessive amniotic fluid levels) during pregnancy?
A) Increased likelihood of preterm labor
B) Low birth weight
C) High risk of fetal kidney dysfunction
D) Reduced chance of umbilical cord complications

Answer: A) Increased likelihood of preterm labor

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A pregnant patient has been diagnosed with velamentous cord insertion. Which of the following best describes this condition?
A) The umbilical cord has a typical insertion into the center of the placenta
B) The umbilical cord vessels branch before reaching the placenta, without Wharton’s jelly protection
C) The amniotic fluid levels are within normal range
D) The fetus is receiving inadequate blood flow due to low amniotic fluid levels

Answer: B) The umbilical cord vessels branch before reaching the placenta, without Wharton’s jelly protection

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Which amniotic fluid condition could lead to underdeveloped fetal lungs due to limited space for growth?
A) Polyhydramnios
B) Velamentous cord insertion
C) Oligohydramnios
D) Normal amniotic fluid levels

Answer: C) Oligohydramnios

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What is the definition of polyhydramnios in terms of amniotic fluid index (AFI) or maximum vertical pocket?
A) AFI less than 5 cm or maximum vertical pocket <2 cm
B) AFI greater than 25 cm or maximum vertical pocket >8 cm
C) AFI between 10-20 cm
D) AFI within the normal range

Answer: B) AFI greater than 25 cm or maximum vertical pocket >8 cm

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Which condition has an increased risk of umbilical cord prolapse upon membrane rupture, often due to excessive amniotic fluid?
A) Oligohydramnios
B) Polyhydramnios
C) Normal amniotic fluid levels
D) Velamentous cord insertion

Answer: B) Polyhydramnios

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Which amniotic fluid abnormality is associated with an increased risk of cord prolapse upon rupture?
A) Oligohydramnios
B) Polyhydramnios
C) Normal amniotic fluid levels
D) Velamentous cord insertion

Answer: B) Polyhydramnios

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In a case of velamentous cord insertion, which of the following complications might be a concern due to the lack of Wharton’s jelly around the umbilical vessels?
A) Increased amniotic fluid production
B) Higher risk of vessel rupture or compression during labor
C) Normal fetal blood flow without complications
D) Increased fetal lung development

Answer: B) Higher risk of vessel rupture or compression during labor

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A two-vessel umbilical cord is often associated with:
A) Increased fetal movement
B) Fetal growth restriction and labor intolerance
C) Decreased risk of preterm labor
D) Better fetal monitoring outcomes

Answer: B) Fetal growth restriction and labor intolerance

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What is a key management strategy for a patient diagnosed with placenta previa?
A) Encourage pelvic exercises
B) Conduct regular vaginal exams
C) Educate on bed rest and avoid vaginal exams
D) Increase physical activity to strengthen the uterine muscles

Answer: C) Educate on bed rest and avoid vaginal exams

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In cases of invasive placental conditions, which healthcare providers are commonly involved in management?
A) Only the primary OB/GYN
B) An OB, perinatologist, possibly gyn oncology, general surgeon, and hematology
C) Only a general surgeon
D) Primarily a gynecologic oncologist

Answer: B) An OB, perinatologist, possibly gyn oncology, general surgeon, and hematology

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Which invasive placental condition describes the chorionic villi penetrating through the myometrium?
A) Placenta previa
B) Placenta accreta
C) Placenta increta
D) Placenta percreta

Answer: D) Placenta percreta

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Which condition is characterized by the placenta partially or completely covering the cervical opening, often leading to painless vaginal bleeding in the second or third trimester? A) Placenta previa B) Placenta accreta C) Placenta increta D) Placenta percreta

Answer: A) Placenta previa

In which condition do the chorionic villi of the placenta invade into the myometrium, leading to a higher risk of severe bleeding during delivery? A) Placenta previa B) Placenta accreta C) Placenta increta D) Placenta percreta

Answer: C) Placenta increta

Which type of abnormal placentation is the most invasive, with chorionic villi penetrating through the myometrium and possibly affecting other organs? A) Placenta previa B) Placenta accreta C) Placenta increta D) Placenta percreta

Answer: D) Placenta percreta

This condition occurs when the placenta attaches too deeply into the uterine wall but does not penetrate the myometrium. It can increase the risk of hemorrhage during delivery. A) Placenta previa B) Placenta accreta C) Placenta increta D) Placenta percreta

Answer: B) Placenta accreta

A patient is diagnosed with a placental disorder that may require a multidisciplinary team approach for delivery due to risks of severe hemorrhage. The placenta is found to have invaded into the uterine muscle but not through it. Which condition is this? A) Placenta previa B) Placenta accreta C) Placenta increta D) Placenta percreta

Answer: C) Placenta increta

Which placental condition often necessitates cesarean delivery due to the risk of significant bleeding and difficulty detaching the placenta after birth? A) Placenta previa B) Placenta accreta C) Placenta increta D) Placenta percreta

B) Placenta accreta C) Placenta increta D) Placenta percreta

What is a key difference between placenta accreta and placenta percreta? A) Placenta accreta involves the placenta attaching to the cervix, while placenta percreta involves the placenta attaching only to the uterine lining. B) Placenta accreta involves attachment to the uterine wall without penetration into the muscle, whereas placenta percreta penetrates through the uterine muscle and potentially affects nearby organs. C) Placenta accreta involves penetration into the uterine muscle, while placenta percreta involves attachment to the uterine lining only. D) Placenta accreta causes minimal complications, while placenta percreta always causes preterm labor.

Answer: B) Placenta accreta involves attachment to the uterine wall without penetration into the muscle, whereas placenta percreta penetrates through the uterine muscle and potentially affects nearby organs.

Which of the following is NOT a risk factor for gestational diabetes? A) Advanced maternal age B) Family history of hypertension C) History of polycystic ovary syndrome (PCOS) D) Pre-pregnancy Hemoglobin A1c > 5.7

Answer: B) Family history of hypertension

What maternal complications are associated with gestational diabetes? A) Increased risk for pre-eclampsia and cesarean birth B) Reduced risk of developing type II diabetes C) Decreased risk of preterm labor D) Higher chance of carrying multiple gestations

Answer: A) Increased risk for pre-eclampsia and cesarean birth

Gestational diabetes screening typically takes place during which weeks of pregnancy? A) 20-24 weeks B) 24-28 weeks C) 28-32 weeks D) 32-36 weeks

Answer: B) 24-28 weeks

If a pregnant person has an abnormal result on the initial 1-hour glucose tolerance test, what is the next step in screening for gestational diabetes? A) Begin insulin therapy B) Retake the 1-hour glucose tolerance test C) Proceed to a 3-hour, 100-gram glucose tolerance test D) Start dietary modifications immediately

Answer: C) Proceed to a 3-hour, 100-gram glucose tolerance test

What is the preferred first-line medication for pharmacologic treatment of gestational diabetes? A) Metformin B) Glyburide C) Insulin D) Beta-blockers

Answer: C) Insulin

Which of the following is a dietary recommendation for managing gestational diabetes? A) Diet high in simple sugars B) Three large meals with no snacks C) A diet consisting of 30-40% carbohydrates, 20% protein, and 40% fat D) A protein-only diet

Answer: C) A diet consisting of 30-40% carbohydrates, 20% protein, and 40% fat

Which of the following is a potential offspring complication associated with gestational diabetes? A) Increased risk of asthma B) Macrosomia and neonatal hypoglycemia C) Premature fusion of the fontanelles D) Congenital heart defects

Answer: B) Macrosomia and neonatal hypoglycemia

What is macrosomia in relation to gestational diabetes, what weight defines a baby as macrosomic, and what causes a baby to develop this condition? A) Macrosomia means a small baby, defined as weighing less than 3,000 grams (6 lbs 10 oz), caused by low maternal glucose levels during pregnancy. B) Macrosomia means a large baby, defined as weighing more than 4,000 grams (8 lbs 13 oz), resulting from high levels of maternal glucose crossing the placenta, which causes the baby to produce excess insulin. C) Macrosomia means a baby with a small head size, defined as weighing under 2,500 grams (5 lbs 8 oz), and it results from restricted blood flow in the mother. D) Macrosomia refers to a premature baby, defined as weighing less than 3,500 grams (7 lbs 11 oz), and is caused by low blood sugar in the mother during pregnancy.

Answer: B) Macrosomia means a large baby, defined as weighing more than 4,000 grams (8 lbs 13 oz), resulting from high levels of maternal glucose crossing the placenta, which causes the baby to produce excess insulin.

Exercise recommendations for those managing gestational diabetes include: A) High-intensity training for 10 minutes a day B) Moderate-intensity aerobic exercise for 30 minutes, 5 days a week C) Light stretching twice a week D) Strength training only

Answer: B) Moderate-intensity aerobic exercise for 30 minutes, 5 days a week

What is the significance of hypertensive disorders of pregnancy (HDP) in maternal and neonatal health? A) HDP primarily affects maternal comfort but not fetal health B) HDP is a leading cause of severe maternal, fetal, and neonatal morbidity and mortality C) HDP affects only fetal outcomes D) HDP is relatively rare and generally manageable with lifestyle changes

Answer: B) HDP is a leading cause of severe maternal, fetal, and neonatal morbidity and mortality

Which of the following is considered a high-risk factor for hypertensive disorders in pregnancy? A) Nulliparity B) Age over 35 C) History of pre-eclampsia D) Prior full-term delivery

Answer: B) Age over 35 C) History of pre-eclampsia

Which classification of hypertension in pregnancy describes high blood pressure that was present before pregnancy or diagnosed before 20 weeks of gestation? A) Chronic hypertension B) Gestational hypertension C) Pre-eclampsia D) Eclampsia

Answer: A) Chronic hypertension

Which classification of hypertension in pregnancy describes high blood pressure that develops after 20 weeks of gestation and is not accompanied by proteinuria or other signs of organ damage? A) Chronic hypertension B) Gestational hypertension C) Pre-eclampsia D) Eclampsia

B) Gestational hypertension

Which condition involves high blood pressure after 20 weeks of gestation, accompanied by proteinuria or signs of organ damage, and poses risks of severe complications for both mother and baby? A) Chronic hypertension B) Gestational hypertension C) Pre-eclampsia D) Eclampsia

C) Pre-eclampsia

Which condition is characterized by the onset of seizures in a pregnant person with pre-eclampsia and no other underlying cause of seizures? A) Chronic hypertension B) Gestational hypertension C) Pre-eclampsia D) Eclampsia

D) Eclampsia

What criteria define gestational hypertension? A) Hypertension prior to 20 weeks gestation with proteinuria B) Hypertension that develops after 20 weeks of gestation without proteinuria C) Hypertension at any point during pregnancy with seizures D) Blood pressure lower than 140/90 at any gestational age

Answer: B) Hypertension that develops after 20 weeks of gestation without proteinuria

What additional symptoms, alongside high blood pressure, indicate a severe form of pre-eclampsia? A) Proteinuria and swelling only B) Severe headache unrelieved by medication, epigastric pain, or abnormal liver function tests C) Dehydration and rapid weight gain D) Muscle cramps and high blood sugar levels

Answer: B) Severe headache unrelieved by medication, epigastric pain, or abnormal liver function tests

Which of the following neurological symptoms are warning signs of severe pre-eclampsia that could lead to eclampsia? A) Severe headache unrelieved by medication B) Blurry vision or flashing lights (scotomas) C) Temporary vision loss D) Increased thirst

Answer: A) Severe headache unrelieved by medication B) Blurry vision or flashing lights (scotomas) C) Temporary vision loss

Which of the following abdominal and respiratory symptoms are concerning signs in severe pre-eclampsia? A) Epigastric or right upper quadrant (RUQ) pain B) Shortness of breath or difficulty breathing C) Nausea without abdominal pain D) Chest tightness or pulmonary edema

A) Epigastric or right upper quadrant (RUQ) pain B) Shortness of breath or difficulty breathing D) Chest tightness or pulmonary edema

Which of the following lab abnormalities and physical symptoms are associated with severe pre-eclampsia? A) Elevated liver enzymes (AST, ALT) B) Low platelet count (thrombocytopenia) C) Sudden swelling in the face and hands D) High blood sugar levels

Answer: A) Elevated liver enzymes (AST, ALT) B) Low platelet count (thrombocytopenia) C) Sudden swelling in the face and hands

HELLP syndrome is a severe complication of pregnancy associated with which of the following conditions? A) Gestational diabetes B) Pre-eclampsia C) Placenta previa D) Hyperemesis gravidarum

Answer: B) Pre-eclampsia

Which condition is characterized by new onset of hypertension and seizures in a pregnant person, without other known causes of seizures? A) Chronic hypertension B) Gestational diabetes C) Eclampsia D) Placenta previa

Answer: C) Eclampsia

What defines chronic hypertension with superimposed pre-eclampsia? A) High blood pressure before pregnancy resolves without intervention B) Development of pre-eclampsia in a person with pre-existing chronic hypertension C) Hypertension that remains stable throughout pregnancy without complications D) Severe swelling and pain in lower extremities without high blood pressure

Answer: B) Development of pre-eclampsia in a person with pre-existing chronic hypertension

Which of the following is a possible outcome of hypertensive disorders in pregnancy? A) Preterm labor, placental abruption, and pulmonary edema B) Only preterm labor with no other fetal impact C) Enhanced fetal growth and larger gestational age at birth D) Reduced risk of cardiovascular issues post-pregnancy

Answer: A) Preterm labor, placental abruption, and pulmonary edema

What life-long health risk is increased for individuals who experience pre-eclampsia during pregnancy? A) Lower blood pressure B) Improved lung function C) Increased cardiovascular risk D) Reduced cancer risk

Answer: C) Increased cardiovascular risk

What condition associated with hypertensive disorders in pregnancy involves abnormal blood clotting that can lead to massive bleeding? A) Pre-eclampsia B) Disseminated Intravascular Coagulation (DIC) C) Pulmonary edema D) Hemolysis

Answer: B) Disseminated Intravascular Coagulation (DIC)

Which lab findings are indicative of HELLP syndrome? A) High platelet count and normal liver enzymes B) Elevated liver enzymes and low platelet count C) Low white blood cell count and normal platelet count D) Normal liver enzymes and low LDH

Answer: B) Elevated liver enzymes and low platelet count

What is a common complication associated with low platelet levels (<100,000) in HELLP syndrome? A) Increased risk of infection B) Disseminated intravascular coagulation (DIC) and liver capsule rupture C) Lower risk of bleeding complications D) Improved liver function

Answer: B) Disseminated intravascular coagulation (DIC) and liver capsule rupture

What medication is used to prevent seizures in severe cases of hypertension during pregnancy? A) Labetalol B) Hydralazine C) Magnesium sulfate D) Calcium gluconate

Answer: C) Magnesium sulfate

What is the typical therapeutic range of magnesium sulfate when used to prevent seizures in pregnancy-related conditions? A) 2-5 mg/dL B) 4-8 mg/dL C) 10-12 mg/dL D) 12-15 mg/dL

Answer: B) 4-8 mg/dL

At what magnesium level would you typically expect to see the loss of deep tendon reflexes (DTRs), an early sign of magnesium toxicity? A) 4-8 mg/dL B) 9-12 mg/dL C) 12-15 mg/dL D) 15-20 mg/dL

Answer: B) 9-12 mg/dL

Respiratory depression is a serious sign of magnesium toxicity. At which level does respiratory depression usually occur? A) 4-8 mg/dL B) 8-10 mg/dL C) 12-15 mg/dL D) 18-20 mg/dL

Answer: C) 12-15 mg/dL

Which of the following levels of magnesium is most likely to lead to cardiac arrest, the most severe form of toxicity? A) 8-10 mg/dL B) 10-12 mg/dL C) 12-15 mg/dL D) Above 15 mg/dL

Answer: D) Above 15 mg/dL

At what magnesium level is a patient within the therapeutic range for seizure prevention, with a low likelihood of toxicity symptoms? A) 3 mg/dL B) 5 mg/dL C) 11 mg/dL D) 16 mg/dL

Answer: B) 5 mg/dL

What is the primary site for ectopic pregnancies? A) Endometrial lining B) Cervix C) Fallopian tube D) Ovaries

Answer: C) Fallopian tube

Which of the following is a common risk factor for ectopic pregnancy? A) History of cesarean section B) Advanced maternal age C) History of infertility or prior ectopic pregnancy D) Low BMI

Answer: C) History of infertility or prior ectopic pregnancy

Early pregnancy loss (miscarriage) most commonly occurs within which time frame? A) Second trimester B) First trimester C) After 20 weeks D) At term

Answer: B) First trimester

What percentage of all clinically recognized pregnancies result in early pregnancy loss? A) 5% B) 10% C) 25% D) 50%

Answer: B) 10%

In cases of trauma during pregnancy, which of the following is a possible consequence? A) Decreased risk of perinatal mood disorders B) Increased risk of placental abruption, fetal loss, and preterm delivery C) Improved maternal oxygenation D) Reduced need for hospitalization

Answer: B) Increased risk of placental abruption, fetal loss, and preterm delivery

What management approach is used for a patient experiencing an ectopic pregnancy diagnosed early? A) Immediate surgical intervention only B) Administration of methotrexate to stop cell division C) Close monitoring without intervention D) Bed rest and dietary changes E) Administration of Misoprosto t

Answer: B) Administration of methotrexate to stop cell division E) Administration of Misoprosto t

Which type of placenta previa is defined by the placenta partially covering the cervical opening but not entirely, sometimes leading to vaginal bleeding during pregnancy? A) Marginal placenta previa B) Complete placenta previa C) Placenta accreta D) Placenta increta

Answer: A) Marginal placenta previa

In which type of placenta previa does the placenta completely cover the cervical opening, often necessitating a cesarean delivery due to the risk of severe bleeding during labor? A) Marginal placenta previa B) Complete placenta previa C) Placenta percreta D) Velamentous cord insertion

Answer: B) Complete placenta previa

A pregnant patient is diagnosed with a placental disorder in which the placenta is positioned close to, but not covering, the cervical opening. Which type of placenta previa does this most likely indicate? A) Complete placenta previa B) Marginal placenta previa C) Placenta increta D) Placenta previa with accreta

Answer: B) Marginal placenta previa

Which type of placenta previa has a higher risk of severe bleeding during labor due to the placenta completely obstructing the cervical opening? A) Marginal placenta previa B) Complete placenta previa C) Partial placental invasion D) Placenta with umbilical cord prolapse

Answer: B) Complete placenta previa

What is the recommended delivery method for a patient with complete placenta previa? A) Vaginal delivery with careful monitoring B) Cesarean delivery C) Induced vaginal delivery D) Natural delivery without intervention

Answer: B) Cesarean delivery

Which of the following best describes marginal placenta previa? A) The placenta completely covers the cervix, requiring cesarean delivery. B) The placenta partially covers or is near the cervix but may allow for vaginal delivery depending on the progression. C) The placenta is deeply embedded in the uterine muscle. D) The placenta invades through the uterine muscle and into nearby organs.

Answer: B) The placenta partially covers or is near the cervix but may allow for vaginal delivery depending on the progression.

Which medications are commonly used to treat severe hypertension in pregnancy, particularly when immediate blood pressure control is needed? A) Insulin and metformin B) Magnesium sulfate and calcium gluconate C) Labetalol and hydralazine IV D) Aspirin and ibuprofen

Answer: C) Labetalol and hydralazine IV

Which medication is used as an antidote for magnesium sulfate toxicity in pregnant patients? A) Hydralazine B) Labetalol C) Calcium gluconate D) Insulin

Answer: C) Calcium gluconate

For a patient with severe hypertension during pregnancy, which medication would NOT be effective in directly lowering blood pressure but is often used for seizure prevention? A) Labetalol B) Hydralazine C) Magnesium sulfate D) Calcium gluconate

Answer: C) Magnesium sulfate

In pregnancy, urine output is an important measure of kidney function. Which of the following is a concerning level of urine output, suggesting possible kidney impairment? A) More than 1,000 mL per day B) 800 mL per day C) Less than 300 mL per day D) 600 mL per day

Answer: C) Less than 300 mL per day

For a diagnosis of pre-eclampsia, how much protein in a 24-hour urine collection would typically confirm significant proteinuria? A) 0.1 grams B) 0.2 grams C) 0.3 grams or more D) Less than 0.1 grams

C) 0.3 grams or more

A patient with pre-eclampsia is experiencing reduced urine output (oliguria). What is the minimum daily urine output that may indicate kidney impairment in this context? A) 1,000 mL B) 500 mL C) 300 mL D) 700 mL

Answer: C) 300 mL

Which of the following medications would be administered intravenously for severe hypertension in a pregnant patient to quickly reduce blood pressure? A) Oral metoprolol B) IV labetalol or IV hydralazine C) Oral lisinopril D) Subcutaneous insulin

Answer: B) IV labetalol or IV hydralazine