Master Labor Management: Quizzes for Obstetrics and Gynecology Students

Question 1

Which of the following is NOT a medical indication for performing a cesarean section?

Accepted Answer

Maternal request

Answer

Placenta previa

Answer

Fetal distress

Answer

Breech presentation

Question 2

What is the first-line pharmacological agent for pain relief during the first stage of labor?

Accepted Answer

Nitrous oxide

Answer

Fentanyl

Answer

Meperidine

Answer

Epidural anesthesia

Question 3

Which of the following is a contraindication for vacuum extraction?

Accepted Answer

Incomplete cervical dilation

Answer

Nulliparity

Answer

Fetal distress

Answer

Absence of a skilled operator

Question 4

What is the primary objective of electronic fetal monitoring during labor?

Accepted Answer

Early detection of fetal distress

Answer

Assessment of maternal well-being

Answer

Optimization of labor progression

Answer

Prevention of unnecessary interventions

Question 5

Which of the following is NOT a component of the partograph?

Accepted Answer

Maternal temperature

Answer

Cervical dilation

Answer

Fetal heart rate pattern

Answer

Uterine contractions

Question 6

In the management of a patient with suspected chorioamnionitis, which approach is appropriate?

Accepted Answer

Antibiotics, continuous fetal monitoring, and delivery if severe

Answer

Antibiotics only

Answer

Continuous fetal monitoring only

Answer

Observation without intervention

Question 7

In labor management, what is the main purpose of utilizing the Bishop score?

Accepted Answer

Evaluating the probability of a successful vaginal birth

Answer

Predicting the risk of premature labor

Answer

Assessing the health of the fetus

Question 8

In the management of postpartum hemorrhage, which intervention is considered the initial step?

Accepted Answer

Uterine massage

Answer

Blood transfusion

Answer

Hysterectomy

Answer

Embolization

Question 9

What is the primary reason for performing an episiotomy?

Accepted Answer

To prevent severe perineal tears

Answer

To help deliver a baby in the breech position

Answer

To reduce fetal distress

Answer

To control bleeding after birth

Question 10

Why is an episiotomy performed during labor?

Accepted Answer

To prevent severe tears in the perineum during delivery of a large baby.

Answer

To decrease the risk of postpartum bleeding.

Answer

To improve the baby's oxygen supply.

Question 11

What is the primary indication for performing an episiotomy during labor?

Accepted Answer

To prevent severe perineal lacerations

Answer

To relieve fetal distress

Answer

To facilitate assisted vaginal delivery

Answer

To shorten the second stage of labor

Question 12

Which method of pain relief during labor is considered the most effective at providing comprehensive pain

Accepted Answer

Epidural analgesia

Answer

Nitrous oxide

Answer

Pudendal nerve block

Answer

Transcutaneous electrical nerve stimulation

Question 13

What is the primary function of oxytocin in labor management?

Accepted Answer

To stimulate uterine contractions

Answer

To provide pain relief

Answer

To promote cervical ripening

Question 14

What is the purpose of using the Bishop score in labor management?

Accepted Answer

To assess cervical ripeness and readiness for labor

Answer

To predict the risk of postpartum hemorrhage

Answer

To evaluate fetal growth

Answer

To determine maternal readiness for labor

Question 15

What is the recommended initial management approach for a patient with premature rupture of membranes?

Accepted Answer

Expectant management with close monitoring for signs of infection

Answer

Immediate induction of labor

Answer

Cesarean delivery

Answer

Prophylactic antibiotics

Question 16

Which element is considered a fundamental principle of comprehensive labor management?

Accepted Answer

Collaboration and shared decision-making between the patient and healthcare team

Answer

Exclusive reliance on technology for monitoring

Answer

Strict adherence to a predetermined protocol

Question 17

Which of the following is the most common reason for performing an episiotomy?

Accepted Answer

To prevent a severe perineal tear

Answer

To assist with delivery of a breech presentation

Answer

To expedite a prolonged labor

Answer

To manage persistent fetal malposition

Question 18

Which of the following is a major risk factor for postpartum hemorrhage?

Accepted Answer

Retained placental fragments

Answer

Induction of labor

Answer

Episiotomy

Answer

Preeclampsia

Question 19

Which of the following is a clinical sign suggestive of placental abruption?

Accepted Answer

Vaginal bleeding

Answer

Oligohydramnios

Answer

Preeclampsia

Answer

Uterine tenderness

Question 20

Which of the following is a common indication for performing a cesarean section?

Accepted Answer

Placenta previa

Answer

Preterm labor

Answer

Oligohydramnios

Answer

Gestational hypertension

Question 21

Which of the following is a component of the APGAR score?

Accepted Answer

Reflex irritability

Answer

Gender

Answer

Length

Answer

Apgar index

Question 22

Which of the following is the primary indication for episiotomy during vaginal delivery?

Accepted Answer

To prevent excessive perineal lacerations during the delivery of the fetal head.

Answer

To reduce the risk of postpartum hemorrhage.

Answer

To increase vaginal elasticity and facilitate delivery in a nulliparous woman.

Question 23

Which of the following methods of pain relief during labor is NOT classified as pharmacological?

Accepted Answer

Acupuncture

Answer

Epidural anesthesia

Answer

Opioid analgesics

Answer

Regional nerve blocks

Question 24

Which of the following correctly describes the first stage of labor?

Accepted Answer

Characterized by cervical dilatation from 0 to 10 centimeters.

Answer

Involves the expulsion of the fetus.

Answer

Ends with the delivery of the placenta.

Question 25

Which of the following is a potential sign of impending uterine rupture during labor?

Accepted Answer

Abdominal pain that is severe and unrelieved by analgesics.

Answer

Increased uterine activity

Answer

Vaginal bleeding

Answer

Fetal bradycardia

Question 26

Which of the following conditions is an absolute contraindication to vaginal delivery?

Accepted Answer

Placenta previa after 28 weeks of gestation.

Answer

Estimated fetal weight of 4000 grams

Answer

Breech presentation at 34 weeks of gestation

Question 27

What is the primary indication for vacuum extraction during labor?

Accepted Answer

Fetal distress during the second stage of labor.

Answer

Shoulder dystocia.

Answer

Maternal exhaustion.

Answer

Delivery of a preterm infant.

Question 28

Which of the following factors is most strongly associated with the risk of postpartum hemorrhage?

Accepted Answer

Uterine atony

Answer

Preterm delivery

Answer

Preeclampsia

Answer

Gestational diabetes

Question 29

Which measure is considered the most effective in preventing postpartum infections?

Accepted Answer

Rigorous hand hygiene.

Answer

Uterine evacuation

Answer

Episiotomy repair

Answer

Prophylactic antibiotics

Question 30

Which of the following is a potential sign of fetal macrosomia?

Accepted Answer

A symphysis-fundal height measurement greater than 35 centimeters.

Answer

Estimated fetal weight of less than 2500 grams.

Answer

Amniotic fluid index less than 5 centimeters.

Question 31

Which of the following is a contraindication to prostaglandin use for induction of labor?

Accepted Answer

Previous Cesarean delivery

Answer

Uterine fibroids

Answer

History of asthma

Answer

Gestational hypertension

Question 32

A 33-year-old primigravida at 39 weeks of gestation presents in active labor with regular contractions. On examination, her cervix is 4 cm dilated, 80% effaced, and the fetal head is at -1 station. Which of the following is the most appropriate initial management?

Accepted Answer

Monitor the patient's progress and provide supportive measures.

Answer

Administer oxytocin to augment labor.

Answer

Perform an amniotomy to stimulate labor.

Question 33

A patient in active labor requests an epidural analgesia. Which of the following is an absolute contraindication to epidural analgesia?

Accepted Answer

Active bleeding disorder

Answer

Previous cesarean section

Answer

Premature rupture of membranes

Answer

Fetal bradycardia

Question 34

A nulliparous patient in the second stage of labor is experiencing prolonged pushing. What is the most likely cause of this?

Accepted Answer

Fetal malposition or malpresentation

Answer

Uterine atony

Answer

Maternal fatigue

Answer

Inadequate hydration

Question 35

Which of the following is a risk factor for precipitous labor?

Accepted Answer

Previous rapid labor

Answer

Fetal macrosomia

Answer

Gestational diabetes

Answer

Maternal obesity

Question 36

A patient in labor is experiencing a prolonged latent phase. What is the MOST appropriate management strategy?

Accepted Answer

Rest and reassurance

Answer

Amniotomy

Answer

Induction of labor

Question 37

A patient in labor is diagnosed with cephalopelvic disproportion (CPD). What is the most likely intervention?

Accepted Answer

Cesarean delivery

Answer

Vacuum-assisted delivery

Answer

Forceps-assisted delivery

Question 38

Which of the following is an indication for an episiotomy?

Accepted Answer

Shoulder dystocia

Answer

Premature rupture of membranes

Answer

Fetal bradycardia

Answer

Prolonged latent phase

Question 39

A patient in labor is experiencing a prolonged deceleration in fetal heart rate. What is the most appropriate initial action?

Accepted Answer

Change maternal position and administer oxygen

Answer

Administer intravenous fluids

Answer

Prepare for a cesarean delivery

Answer

Perform an amniotomy

Question 40

A patient is experiencing a postpartum hemorrhage. Which of the following is the most effective initial treatment?

Accepted Answer

Uterine massage and intravenous oxytocin

Answer

Administering antibiotics

Answer

Surgical repair of the laceration

Answer

Blood transfusion

Question 41

Which of the following is an indication for labor induction?

Accepted Answer

Premature rupture of membranes at term

Answer

Intrauterine growth restriction

Answer

Oligohydramnios

Answer

Gestational hypertension

Question 42

When is an episiotomy typically performed?

Accepted Answer

To prevent perineal lacerations during delivery

Answer

To control postpartum bleeding

Answer

None of the above

Answer

To facilitate vaginal delivery

Question 43

What is the primary goal of the second stage of labor?

Accepted Answer

Delivery of the baby

Answer

Expulsion of the placenta

Answer

Dilation of the cervix to 10 cm

Answer

Crowning of the baby's head

Question 44

According to current guidelines, what is the recommended monitoring frequency for fetal heart rate during the active phase of labor (cervical dilation of 4-10 cm)?

Accepted Answer

Every 30 minutes with intermittent auscultation or continuous electronic monitoring

Answer

Continuous monitoring throughout labor

Answer

Every hour with intermittent auscultation

Answer

Every 15 minutes with intermittent auscultation

Question 45

Sudden onset of severe abdominal pain and vaginal bleeding is most indicative of which obstetric emergency?

Accepted Answer

Placental abruption

Answer

Preeclampsia/eclampsia

Answer

Uterine rupture

Answer

Amniotic fluid embolism

Question 46

What is the immediate action when recognizing signs of fetal distress, such as a prolonged deceleration or bradycardia, during labor?

Accepted Answer

Inform the healthcare provider immediately and prepare for possible intervention

Answer

Change the mother's position

Answer

Prepare for an emergency cesarean section

Answer

Administer oxygen to the mother

Question 47

Which of the following factors is associated with an increased risk of postpartum hemorrhage?

Accepted Answer

History of uterine atony

Answer

Nulliparity

Answer

Short duration of labor

Answer

Small infant size

Question 48

A 32-year-old primigravida presents at 39 weeks gestation with regular contractions and a cervical dilation of 4 cm. The fetal heart rate is 140 bpm with moderate variability. What is the most appropriate next step in management?

Accepted Answer

Continue monitoring and provide reassurance or support measures, such as comfort measures and position changes.

Answer

Perform an amniotomy to accelerate labor.

Answer

Administer oxytocin to augment labor.

Answer

Prepare for a cesarean delivery.

Question 49

A 28-year-old nullipara is in active labor at 6 cm dilation. She complains of intense back pain. On examination, the fetal presenting part is occiput posterior. Which of the following maneuvers would be most beneficial to relieve her pain?

Accepted Answer

Application of counterpressure to the sacral area.

Answer

Administration of epidural anesthesia.

Answer

Immediate cesarean delivery.

Answer

Use of a birthing ball.

Question 50

A 35-year-old multigravida is in active labor with a cervical dilation of 8 cm. The fetal heart rate tracing shows a prolonged deceleration lasting more than 2 minutes. Which of the following is the most appropriate initial action?

Accepted Answer

Change maternal position and administer oxygen.

Answer

Administer intravenous fluids.

Answer

Administer tocolytics to stop contractions.

Answer

Perform an emergency cesarean delivery.

Question 51

A 25-year-old primigravida is in the second stage of labor. The fetal head is at +2 station, and the patient is pushing effectively. However, the fetal heart rate is dropping with each contraction. Which of the following is the most likely cause of this fetal heart rate pattern?

Accepted Answer

Cord compression.

Answer

Fetal head compression.

Answer

Maternal hypotension.

Answer

Uterine hyperstimulation.

Question 52

Which of the following is NOT a recognized indication for performing an episiotomy?

Accepted Answer

Prevention of perineal lacerations in a nulliparous woman with a large fetus

Answer

Shoulder dystocia.

Answer

Fetal distress.

Question 53

A 30-year-old nullipara is undergoing a vaginal delivery. As the fetal head crowns, the physician notes that the fetal shoulder is impacted against the pubic bone. What is the MOST appropriate initial maneuver to address this situation?

Accepted Answer

McRoberts maneuver.

Answer

Cesarean delivery.

Answer

Symphysiotomy.

Answer

Fundal pressure.

Question 54

A 27-year-old primigravida is in labor with a cervical dilation of 8 cm. She is requesting pain relief. Which of the following pain management options is MOST likely to provide the most effective pain relief for labor?

Accepted Answer

Epidural anesthesia.

Answer

Opioids.

Answer

Regional nerve block.

Answer

Nitrous oxide.

Question 55

A 38-year-old nullipara is in the active phase of labor. The fetal heart rate tracing shows a baseline rate of 120 bpm with minimal variability and recurrent late decelerations. Which of the following interventions is MOST likely to improve the fetal heart rate tracing?

Accepted Answer

Change maternal position to the left lateral decubitus.

Answer

Administer oxytocin to augment labor.

Answer

Perform an amniotomy.

Question 56

Which of the following is a key component of a successful vaginal delivery?

Accepted Answer

Adequate cervical dilation and fetal descent.

Answer

Use of forceps.

Answer

Administration of oxytocin.

Answer

Performance of an episiotomy.

Question 57

A 29-year-old multigravida is in labor at 39 weeks gestation. She has a history of a previous cesarean delivery. Which of the following is the MOST important factor to consider when determining the possibility of a vaginal birth after cesarean (VBAC)?

Accepted Answer

The type of previous cesarean incision.

Answer

The patient's desire for a VBAC.

Answer

The presence of a previous vaginal delivery.

Answer

The gestational age at the previous delivery.