ENA OB STUDY REVIEW PRACTICE TEST.
Along with motor vehicle crashes, what are the most common causes of blunt abdominal trauma in pregnant patients? A. Pedestrian incidents and assaultsB. Falls and assaultsC. Bicycle incidents and fallsD. Pedestrian and bicycle incidents - CORRECT ANSWER Your c...
ENA OB STUDY REVIEW PRACTICE
TEST.
Along with motor vehicle crashes, what are the most common causes of blunt abdominal trauma in
pregnant patients? A. Pedestrian incidents and assaultsB. Falls and assaultsC. Bicycle incidents and
fallsD. Pedestrian and bicycle incidents - CORRECT ANSWER Your correct answer: B Motor vehicle
crashes, falls, and assaults are the most common causes of blunt abdominal trauma in pregnant
patients. Pedestrian and bicycle incidents are not common causes of blunt abdominal trauma in
pregnant patients.
In which situation is an emergency cesarean section most likely to result in a favorable outcome for the
mother and the fetus? A. A patient who is 34 weeks pregnant and has fetal limbs palpable outside the
uterine bordersB. A patient who is 36 weeks pregnant and has been in cardiac arrest for 30 minutes
before arrivalC. A patient who is 22 weeks pregnant and has cardiac arrest on arrival in the emergency
departmentD. A patient who is 30 weeks pregnant and presents with shock and signs of fetal distress -
CORRECT ANSWER Your incorrect answer: C The patient who is 30 weeks pregnant and presents with
shock and signs of fetal distress describes a compromised mother and a compromised—but potentially
viable—fetus. Emergency cesarean section may result in maternal recovery and a good fetal outcome.
Fetal limb palpation outside the uterine borders indicates a complete uterine rupture. This catastrophic
injury is associated with almost 100% fetal mortality. Although a fetus at 36 weeks' gestation is viable,
the best maternal and fetal outcomes occur when emergency surgical delivery occurs within 5 minutes
of maternal arrest. At 22 weeks' gestation, the fetus is not viable so even if an emergency cesarean
section were performed within 5 minutes of the patient's arrival, the fetus would not have a favorable
outcome.
Which heart rate is normal for a term fetus? A. 95 beats per minuteB. 106 beats per minuteC. 127 beats
per minuteD. 175 beats per minute - CORRECT ANSWER Your correct answer: C The normal heart rate
for a term fetus ranges from 110 to 160 beats per minute. A heart rate of 127 beats per minute is within
the normal range. The other heart rates are outside the normal range.
You are caring for a young pregnant woman who is the victim of intimate partner abuse. She states that
she is 38 weeks pregnant and expresses concern that she may lose the baby. Which of these findings is
the best indicator of a potentially viable fetus? A. Two kicks in 1 hourB. Palpable fetal limbs outside the
uterine borderC. A fetal heart rate that is consistently above 160 beats per minuteD. A fetal heart rate
that varies from 110 to 140 beats per minute - CORRECT ANSWER Your correct answer: D A fetal heart
rate of 110 to 140 beats per minute falls within the normal range, which is 100 to 160 beats per minute
in a term fetus or 120 to 160 beats per minute in a preterm fetus. Minimal fetal movement (such as two
kicks in 1 hour) and palpable fetal limbs outside the uterine border are not indications of viability.
, You are caring for a pregnant trauma patient who was involved in a motor vehicle crash. She is
experiencing uterine contractions and reports severe abdominal and back pain. You note abdominal
rigidity even between her contractions. Her uterus feels firm and symmetrical. What should you
suspect? A. Fetal demiseB. Uterine ruptureC. Abruptio placentaeD. Supine hypotensive syndrome -
CORRECT ANSWER Your incorrect answer: A In a pregnant trauma patient, abdominal pain and rigidity
should prompt investigation for abruptio placentae. One of the first signs of fetal demise is lack of fetal
movement, which is not indicated in this scenario. Uterine rupture may involve pain and rigidity, but
probably not uterine symmetry. Supine hypotensive syndrome does not result in abdominal and back
pain, abdominal rigidity, and uterine contractions.
What is the most common cause of fetal injury from penetrating trauma? A. Burns involving the
maternal abdomenB. Stab wounds to the maternal abdomenC. Gunshot wounds to the maternal lower
abdomenD. Gunshot wounds to the maternal upper abdomen - CORRECT ANSWER Your correct answer:
C Gunshot wounds are more common than stab wounds or burns in the obstetric population. Fetal
injury is most likely to result from a wound to the mother's lower abdomen.
You are assigned to care for a pregnant patient who, at 16 weeks' gestation, fell at home but sustained
no obvious injuries. Her heart rate is 102 beats per minute. Based on the information provided, what
should be your next step? A. Initiate two large-bore intravenous catheters.B. Prepare to administer two
units of packed red blood cells.C. Reassess the patient in 15 minutes.D. Position the patient on her side.
- CORRECT ANSWER Your correct answer: C A heart rate of 102 beats per minute may be normal for a
pregnant patient, but it should not be dismissed. Instead, it should be rechecked and documented so
that trends can be detected. The scenario does not provide enough information to indicate that volume
resuscitation with crystalloids or blood is indicated. Aortocaval compression is not a concern at 16
weeks' gestation.
Which resuscitative intervention can cause uteroplacental vasoconstriction and adverse fetal effects? A.
DefibrillationB. Vasopressor administrationC. Aggressive management of ventilationD. Lateral
displacement of the uterus during compressions - CORRECT ANSWER Your correct answer: B Although
all of these interventions may be used for resuscitation, only vasopressor administration causes
uteroplacental vasoconstriction.
Why may nitrazine paper be used? A. To differentiate amniotic fluid from vaginal fluid B. To detect
fetomaternal hemorrhageC. To establish gestational ageD. To rule out abruptio placentae - CORRECT
ANSWER Your correct answer: A Nitrazine paper is one way to test for amniotic fluid. It is not used to
detect fetomaternal hemorrhage, establish gestational age, or rule out abruptio placentae.
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