Obstetrics: Medications and Uses

Which antihypertensive medication is contraindicated during pregnancy due to the risk of fetal renal toxicity?

A pregnant patient with gestational diabetes is not responding adequately to dietary modifications. Which medication is the preferred first-line pharmacologic treatment?

What is the primary mechanism of action of magnesium sulfate when used in the context of preterm labor?

Which of the following tocolytic medications is generally avoided due to the risk of significant maternal side effects?

A patient at 32 weeks gestation presents with preterm labor. Which medication is administered to promote fetal lung maturity?

Which contraceptive method is considered safe for breastfeeding mothers but requires strict daily adherence?

A patient who desires long-acting reversible contraception (LARC) is concerned about potential weight gain. Which option is least likely to be associated with this side effect?

During the third stage of labor, after delivery of the placenta, a patient experiences excessive bleeding. Which medication is most appropriate to control postpartum hemorrhage?

In which clinical scenario is methotrexate contraindicated?

A patient presents at 8 weeks gestation with an unruptured ectopic pregnancy. Her vital signs are stable, and she has no contraindications. Which medication is most appropriate for the management of this condition?

A pregnant patient with chronic hypertension is started on an antihypertensive medication. Which medication is the MOST appropriate first-line choice that also avoids causing reflex tachycardia?

Which of the following calcium channel blockers is MOST likely to be used in a hypertensive emergency during pregnancy?

A patient with gestational diabetes is not well controlled with diet and exercise. Which oral hypoglycemic agent is generally considered second-line due to being Pregnancy Category B?

Which medication used to prevent preterm labor also serves a dual purpose of providing seizure prophylaxis in patients with eclampsia?

A patient at 30 weeks' gestation presents with contractions and cervical change. Considering both maternal safety and efficacy, which tocolytic is generally LEAST preferred due to potentially significant maternal side effects?

A 25-year-old postpartum patient is breastfeeding and desires contraception. Which contraceptive method is MOST suitable, requiring strict daily adherence?

A patient is seeking long-acting reversible contraception (LARC) but is particularly concerned about weight gain. Which of the following options is LEAST likely to be associated with weight gain?

Following delivery, a patient experiences excessive postpartum bleeding despite fundal massage and initial interventions. Which medication is MOST appropriate as a first-line treatment to control postpartum hemorrhage?

Methotrexate is used to treat ectopic pregnancies. In which clinical scenario is the use of methotrexate ABSOLUTELY contraindicated?

A patient at 7 weeks gestation is diagnosed with an unruptured ectopic pregnancy. Her beta-hCG is 3000 mIU/mL, and she is hemodynamically stable. Which medication is MOST appropriate for the initial management of this condition?

For a pregnant patient with chronic hypertension, __________ is a first-line antihypertensive that avoids causing __________ .

In a hypertensive emergency during pregnancy, __________ is the calcium channel blocker most likely to be administered.

For gestational diabetes poorly controlled by diet and exercise, __________ is generally considered a second-line oral hypoglycemic agent, classified as Pregnancy Category B.

Which medication used to prevent preterm labor also serves a dual purpose of providing __________ in patients with __________?

A patient at 30 weeks' gestation presents with contractions and cervical change. Considering both maternal safety and efficacy, __________ is generally the LEAST preferred tocolytic due to potentially significant maternal side effects.

A 25-year-old postpartum patient is breastfeeding and desires contraception. The __________ is MOST suitable, requiring strict daily adherence.

A patient is seeking long-acting reversible contraception (LARC) but is particularly concerned about weight gain. The following option is LEAST likely to be associated with weight gain.

Following delivery, a patient experiences excessive postpartum bleeding despite fundal massage and initial interventions. __________ is MOST appropriate as a first-line treatment to control postpartum hemorrhage.

__________ is used to treat ectopic pregnancies. In which clinical scenario is the use of __________ ABSOLUTELY contraindicated?

A patient at 7 weeks gestation is diagnosed with an unruptured ectopic pregnancy. Her beta-hCG is 3000 mIU/mL, and she is hemodynamically stable. __________ is MOST appropriate for the initial management of this condition?

A patient with a history of asthma experiences postpartum hemorrhage. Which medication should be avoided?

Which of the following medications would be LEAST appropriate as a first-line treatment for chronic hypertension in a pregnant patient?

A patient at risk for preterm labor receives betamethasone. What is the primary purpose of this medication?

Which of the following is a long-acting reversible contraceptive (LARC) method that may also reduce heavy menstrual bleeding?

A patient is receiving magnesium sulfate for preterm labor. Which of the following represents a sign of magnesium toxicity?

Which of the following tocolytics is a calcium channel blocker?

A patient with gestational diabetes is on metformin but requires additional medication to control her blood glucose. Which of the following would be most appropriate?

Which of the following is TRUE regarding Progestin-only pills (POPs)?

A patient at 6 weeks gestation presents with an unruptured ectopic pregnancy. Her beta-hCG level is 4500 mIU/mL. Which of the following characteristics would make her ineligible for management using Methotrexate?

A patient is prescribed nifedipine for hypertension in pregnancy. Which counseling point is MOST important to emphasize?

A 36-year-old pregnant patient with a known history of hypertension is currently managed with labetalol. She reports experiencing increased fatigue and mild dizziness despite her blood pressure being well-controlled. Which course of action is MOST appropriate, considering both the patient's symptoms and the medication's effects?

A patient at 34 weeks of gestation presents with preterm labor and is started on nifedipine. After 48 hours, her contractions have subsided, but she now reports a persistent headache and facial flushing. Her blood pressure is slightly lower than her baseline. What is the MOST appropriate next step?

A patient with gestational diabetes is initially managed with metformin. However, her fasting blood glucose levels remain consistently above the target range. Which of the following interventions would be MOST appropriate, considering the need for effective glycemic control and the safety profile during pregnancy?

A patient at 28 weeks gestation presents with preterm labor and is given betamethasone to promote fetal lung maturity. Forty-eight hours after the first dose, the patient's contractions have not subsided, and her cervix continues to dilate. What is the MOST appropriate next step in managing this patient?

A breastfeeding patient requests contraception at her postpartum visit. She is 6 weeks postpartum, fully breastfeeding, and desires a highly effective method. Which of the following options is MOST appropriate, considering the impact on lactation and the need for reliable contraception?

A patient presents at 6 weeks gestation with an unruptured ectopic pregnancy. Her beta-hCG level is 5500 mIU/mL. What factor would MOST strongly contraindicate the use of methotrexate in the management of her ectopic pregnancy?

Following a vaginal delivery, a patient experiences postpartum hemorrhage despite fundal massage and oxytocin administration. The patient has a history of well-controlled asthma. Which of the following medications would be MOST appropriate as the next step in managing her hemorrhage?

A patient with a history of hypertension is admitted for labor induction at term. Her blood pressure is well-controlled on labetalol. During the induction process, she develops a severe headache and her blood pressure rises significantly. Which calcium channel blocker would be MOST appropriate for managing her hypertensive emergency?

A patient is started on magnesium sulfate for preterm labor. Which assessment finding would warrant immediate discontinuation of the magnesium sulfate infusion due to potential toxicity?

A patient at 9 weeks gestation is considering her options for terminating her pregnancy. She has a history of heavy menstrual bleeding and desires a non-surgical option. Which method is MOST appropriate, considering her history and preference?

Which of the following antihypertensive medications is LEAST appropriate for managing chronic hypertension in a pregnant patient with a history of asthma?

A pregnant patient with gestational hypertension requires immediate blood pressure control. Which of the following medications is most suitable for intravenous administration in a hypertensive emergency?

Which of the following oral hypoglycemic agents is generally considered the first-line choice for managing gestational diabetes when dietary modifications are insufficient?

A pregnant patient with gestational diabetes is prescribed metformin. What guidance should the patient receive regarding the medication's transfer to the fetus?

A patient at 28 weeks gestation presents with preterm contractions. Which medication, administered for neuroprotection, also has the potential side effect of causing maternal respiratory depression?

A 24-year-old pregnant patient is diagnosed with previously well-controlled chronic hypertension now exacerbated at 30 weeks gestation. Her current medication, atenolol, has become less effective, and her physician decides a change is necessary. Considering the totality of evidence and current guidelines, which of the following represents the MOST judicious choice for substitution, balancing efficacy, fetal safety, and minimal disruption to the existing therapeutic regimen?

An astute clinician is managing a patient with gestational diabetes mellitus (GDM) who has demonstrated poor glycemic control despite adherence to both dietary modifications and maximal doses of metformin. The patient is averse to initiating insulin therapy due to concerns about injection discomfort and lifestyle disruption. Considering emerging evidence and patient preferences, selection from which of the following adjunctive agents would represent the zenith of clinical judgement, maximizing efficacy, minimizing neonatal risks, and aligning with patient-centered care principles?

Which of the following medications is a prostaglandin E1 analog used for cervical ripening?

Dinoprostone is available in which of the following forms?

Which of the following statements is true regarding the use of oxytocin (Pitocin) for labor induction?

A transcervical Foley catheter balloon primarily facilitates cervical ripening through which mechanism?

Which intervention for cervical ripening requires a negative Group B Streptococcus (GBS) status before it can be safely performed?

What is the primary risk associated with amniotomy (artificial rupture of membranes)?

Which type of anesthesia involves a single injection into the subarachnoid space, providing rapid pain relief but with a shorter duration?

In which clinical scenario is general anesthesia most likely indicated during labor and delivery?

RhoGAM is administered to Rh-negative mothers to prevent which of the following complications?

Surfactant replacement therapy is MOST indicated for neonates experiencing which of the following conditions?

Which of the following cervical ripening agents is contraindicated in a patient with a history of prior uterine surgery?

A patient with an unfavorable cervix requires cervical ripening. Which of the following methods involves the mechanical dilation of the cervix?

A patient is undergoing labor induction with oxytocin. However, the provider notes that administration of oxytocin is ineffective for cervical ripening, but is used once what has occurred?

Which of the following methods of cervical ripening requires the patient to have a Group B Streptococcus (GBS)-negative status?

Which type of neuraxial anesthesia provides rapid and profound pain relief but is primarily used for cesarean sections (C-sections) due to its limited duration?

During an operative vaginal delivery, which type of anesthesia is MOST appropriate for numbing the perineum, vulva, and lower vagina?

In which of the following clinical scenarios is general anesthesia MOST likely indicated during labor and delivery?

An Rh-negative mother has just delivered an Rh-positive baby. To prevent alloimmunization, when should RhoGAM be administered?

A patient at 40 weeks gestation is undergoing labor induction. After several hours of oxytocin administration, she reports extreme thirst, headache, and muscle cramps. Serum sodium levels are found to be significantly decreased. Which of the following is the MOST likely cause of her symptoms, considering the medications used?

During a prolonged labor, a patient with a history of migraines requests pain relief. She has a known allergy to opioids. Which of the following anesthesia options would be MOST appropriate, balancing efficacy, contraindications, and potential side effects?

Which cervical ripening agent is associated with an increased risk of uterine rupture in women with a history of prior uterine surgery?

A patient is undergoing labor induction with oxytocin. However, the provider notes that administration of _______ is ineffective for cervical ripening but is used once ______ has occurred.

A patient at 39 weeks gestation presents for labor induction. Her cervix is closed, firm, and posterior. Considering available cervical ripening agents, which is contraindicated given a history of a previous classical cesarean delivery?

A laboring patient who is GBS-positive is being considered for membrane stripping. Which of the following is the MOST appropriate course of action?

A patient is in active labor and requests pain relief. After evaluation, an epidural is initiated. Which of the following best describes the MOST common combination of medications administered via epidural for labor analgesia?

A patient is undergoing a non-emergent cesarean section but has a contraindication to neuraxial anesthesia. Which of the following is the HIGHEST risk associated with the use of general anesthesia in this scenario?

An Rh-negative mother gives birth to an Rh-positive baby. The direct Coombs test on the newborn is negative. Under which circumstance is RhoGAM administration MOST critical?

What is the PRIMARY mechanism by which a transcervical Foley catheter balloon promotes cervical ripening?

A patient at 28 weeks gestation is admitted with preterm labor and a closed cervix. The physician decides to use a prostaglandin analog for cervical ripening but wants to minimize the risk of uterine tachysystole. Which of the following is the MOST appropriate choice and route of administration?

A patient who is in the second stage of labor, is experiencing severe perineal pain and requires an episiotomy. An epidural is already in place, but it is not providing adequate perineal anesthesia. Which of the following is the MOST appropriate additional intervention?

A patient with a history of a prior low transverse cesarean section is undergoing labor induction. After cervical ripening, oxytocin is initiated. Which finding would be MOST concerning and warrant immediate discontinuation of oxytocin?

A patient at 27 weeks gestation presents in preterm labor and is dilated to 3 cm. After initial management, the decision is made to proceed with tocolysis and administer betamethasone for fetal lung maturity. Which concurrent intervention is MOST critical to consider alongside betamethasone administration?