4. Abnormal Labor and PP Hemorrhage

Which of the following is the FIRST-LINE method for labor induction when the cervix is favorable?

A patient at 41 weeks gestation presents for labor induction. Her cervix is deemed unfavorable. Which of the following methods would be MOST appropriate to initiate cervical ripening?

Which of the following contraindications to labor induction poses the GREATEST risk of maternal hemorrhage?

A patient undergoing labor induction via oxytocin infusion develops uterine hyperstimulation. Which of the following is the MOST immediate concern associated with this complication?

In the context of membrane stripping, which of the following conditions must be MET to ensure patient safety and efficacy?

You are called to evaluate a patient experiencing abnormally slow labor progress. According to the '3 Ps' model, which factor should be evaluated?

Which of the following best describes the function of tocodynamometry in assessing labor?

An obstetrician is concerned about a possible shoulder dystocia. What fetal weight would increase suspicion for this complication?

Which fetal presentation necessitates a Cesarean section?

A patient at 37 weeks gestation is in the breech position. What is the MOST appropriate intervention to attempt?

Which of the following is a risk factor for umbilical cord prolapse?

During a vaginal exam, a provider palpates a pulsating, ropelike structure. What is the MOST appropriate immediate action?

What is the BEST method for assessing pelvic adequacy during labor?

A fetus passes meconium into the amniotic fluid. What is the MOST significant potential risk associated with this:

In a prolonged second stage of labor with a Category I fetal heart tracing, what is the MOST appropriate next step?

Which of the following cervical findings indicates a 'ripe' cervix, favorable for labor induction?

A patient at 36 weeks gestation presents with preterm labor and rupture of membranes. She has not had Group B Strep (GBS) screening. Which of the following is the MOST appropriate next step?

What is the MOST common indication for Cesarean section?

Which of the following is a contraindication to a vaginal birth after cesarean (VBAC)?

Which of the following is NOT a sign of placental separation?

A postpartum patient is experiencing excessive bleeding. The uterus feels boggy upon palpation. Which of the following is the MOST likely cause of postpartum hemorrhage in this scenario?

Which of the following is the BEST initial intervention for uterine atony after delivery?

A patient is diagnosed with placenta percreta. What is the MOST likely complication associated with this condition?

In the context of labor induction, what is the primary reason for avoiding induction in a patient with a Group B Streptococcus (GBS) infection?

In a patient experiencing postpartum hemorrhage, despite bimanual massage and oxytocin administration, bleeding continues. Which of the following would be the MOST appropriate NEXT step?

A patient experiencing labor dystocia is evaluated using the '3 Ps' model. Which of the following clinical findings would be MOST directly associated with the 'Passenger' component?

Which of the following is the MOST significant risk associated with a trial of labor after cesarean (TOLAC)?

In a patient with a known placenta previa undergoing labor, which intervention is absolutely contraindicated?

Which of the following scenarios presents the HIGHEST risk for umbilical cord prolapse?

A patient is 34 weeks pregnant and presents with a transverse lie. External Cephalic Version (ECV) is considered. Which of the following is an absolute contraindication to performing ECV in this scenario?

According to the '3 Ps' model for evaluating labor abnormalities, which of the following factors relates to the contractility of the uterus?

Dysfunctional uterine contractions, a common cause of dystocia, directly impacts which aspect of the '3 Ps' in labor?

What is the expected frequency of contractions considered adequate for normal labor progression?

During active labor, how long should a contraction ideally last to facilitate effective cervical change and fetal descent?

What is the MOST likely complication associated with a fetus weighing greater than 4000-4500 g?

Which method of monitoring uterine contractions provides quantitative data regarding contraction strength?

A patient's labor is progressing abnormally slowly. Cervical dilation is minimal despite adequate contraction frequency and duration. Which aspect from the '3 Ps' is MOST likely contributing to this labor dystocia?

A patient at 38 weeks gestation is diagnosed with a frank breech presentation. Which of the following factors would be MOST important to consider before attempting an external cephalic version (ECV)?

Which of the following is the BEST immediate intervention following the discovery of a prolapsed umbilical cord during a vaginal examination?

According to the '3 Ps' of labor, what does 'passage' refer to?

A patient in the second stage of labor has been pushing for 3 hours with minimal fetal descent. Which intervention is LEAST appropriate at this time?

Which of the following findings is MOST concerning for meconium aspiration syndrome?

A patient with a history of a prior low transverse Cesarean section is requesting a trial of labor after Cesarean (TOLAC). Which factor would be a contraindication to TOLAC?

Which of the following is LEAST likely to be associated with prolonged labor?

Which statement reflects the PRIMARY goal of cervical ripening during labor induction?

In a scenario where artificial rupture of membranes (AROM) is performed, what is the MOST IMMEDIATE nursing action to ensure fetal well-being?

What is the MOST common initial pharmacological intervention for labor induction in a patient with a favorable cervix?

Which prostaglandin is administered intravaginally every 3-6 hours to induce labor in a patient with an unfavorable cervix?

A patient at 39 weeks gestation with a Bishop score of 3 requires labor induction due to oligohydramnios. Which of the following methods is CONTRAINDICATED without prior cervical ripening?

A patient is undergoing labor induction. Which finding would be MOST concerning and warrant immediate discontinuation of the induction agents?

A patient at 39 weeks gestation is undergoing membrane stripping. What condition must be met prior to ensure patient safety and efficacy?

A patient undergoing labor induction suddenly experiences a prolonged fetal heart rate deceleration immediately following an amniotomy. What is the MOST likely cause?

In the management of postpartum hemorrhage, which of the following signs definitively confirms the complete separation of the placenta from the uterine wall?

What finding during labor is an absolute contraindication to TOLAC/VBAC?

Which of the following scenarios presents the GREATEST risk of early-onset Group B Streptococcus (GBS) infection in a newborn, warranting immediate antibiotic prophylaxis during labor?

In the context of labor dystocia attributed to 'Powers', how does internal tocodynamometry MOST precisely differentiate between adequate and inadequate uterine performance?

Considering the 'Passenger' component of the '3 Ps' in labor, what clinical intervention framework is MOST effective when encountering a non-vertex presentation at term?

For a nulliparous woman at 41 weeks gestation with confirmed macrosomia (fetal weight estimated at 4600g), which labor management strategy demonstrates the MOST comprehensive risk mitigation?

In differentiating between external and internal tocodynamometry, which parameter is EXCLUSIVELY measurable via intrauterine pressure catheter (IUPC) and provides critical data for managing dysfunctional labor?

In the context of labor abnormalities and the '3 Ps', what targeted intervention MOST directly addresses dystocia arising from inadequate expulsion forces when other parameters are within normal limits?

In the context of cephalopelvic disproportion, which biometrical parameter, when exceeded, MOST critically dictates the necessity for Cesarean delivery, irrespective of maternal pelvic capacity?

Considering the 'Powers' component of the '3 Ps' in labor dystocia, which statement BEST characterizes the underlying pathophysiology when protracted active phase arrest is diagnosed despite documented adequate uterine activity via intrauterine pressure catheter (IUPC)?

When managing a shoulder dystocia, after implementing McRobert's maneuver and suprapubic pressure without success, which advanced intervention introduces the HIGHEST risk of permanent fetal brachial plexus injury, necessitating judicious application and stringent documentation?

In the context of postpartum hemorrhage secondary to uterine atony refractory to first-line uterotonics, what is the MOST compelling rationale for promptly deploying a Bakri balloon tamponade before escalating to surgical interventions such as uterine artery embolization or hysterectomy?

A patient with a history of myomectomy presents in active labor. The myomectomy involved full-thickness incision into the uterine wall. Which aspect of uterine rupture risk assessment is MOST critical in determining the safety of a Trial of Labor After Myomectomy (TOLAM)?

What is the drug of choice for labor induction when the cervix is favorable?

Besides patient comfort, what is the maximum time a transcervical Foley catheter can be left in place?

Prior to membrane stripping, what screening result must be confirmed negative?

What is the MOST common cause of neonatal sepsis?

After AROM, what is the immediate concern?

What obstetrical scenario necessitates a Cesarean section due to fetal positioning?

What percentage of singleton deliveries present as breech?

Which risk factor is directly associated with umbilical cord prolapse?

What intervention is indicated for cephalopelvic disproportion?

What is the primary aim of labor induction?

What constitutes the 'Powers' in labor?

What contraction frequency is adequate labor?

How long should contractions ideally last?

Which of the following defines dystocia?

What fetal weight raises concern?

Besides station, what fetal presentation necessitates a Cesarean section?

What describes the technique used in an External Cephalic Version (ECV)?

What action is required when umbilical cord prolapse is discovered?

What is the intended aim of inducing labor?

What finding is a contraindication to labor induction?

In assessing labor abnormalities using '3 Ps', what encompasses uterine contractility?

What describes the 'Passage' within the '3 Ps' of labor?

Which factor relates to fetal size/position in '3 Ps'?

Shoulder dystocia risk MOST increases with what fetal weight?

What parameter gives quantitative contraction strength data?

What is the drug of choice for labor induction when the cervix is favorable, according to the slides?

Besides patient comfort, what is the maximum time a transcervical Foley catheter can be left in place during labor induction to mechanically dilate the cervix?

Prior to performing membrane stripping, according to the slides, what screening result must be confirmed negative to ensure patient safety?

According to the slides, which of the following infections is the MOST common cause of neonatal sepsis?

According to the slides, after performing an amniotomy (AROM), what is the immediate concern that requires monitoring?

In a shoulder dystocia management algorithm, after McRobert's and suprapubic pressure fail, which maneuver poses the HIGHEST risk of fetal brachial plexus injury, demanding meticulous execution and documentation?

After failing first-line uterotonics for postpartum hemorrhage management, what justifies Bakri balloon tamponade deployment before escalating to surgical interventions?

During active labor in a patient with a prior myomectomy involving full-thickness uterine incision, what aspect of uterine rupture risk assessment is MOST pivotal for TOLAM?

In the context of the '3 Ps' of labor dystocia, what statement BEST captures the pathophysiology when protracted active phase arrest occurs despite documented normal uterine activity?

Which of the following biometrical parameters, when exceeded, MOST critically dictates the necessity for Cesarean delivery in cephalopelvic disproportion, irrespective of maternal pelvic capacity?

A prolonged second stage of labor increases the risk of uterine ____ and possible ____.

Which labor abnormality includes the failure of the cervix to dilate as expected?

Which of the following is an absolute contraindication to labor induction?

What is the PRIMARY aim of cervical ripening during labor induction?

In the context of umbilical cord prolapse, the MOST appropriate immediate action is to:

Which intervention is LEAST appropriate for a patient in the second stage of labor who has been pushing for 3 hours with minimal fetal descent?

Which of the following may result in fetal bradycardia?

Dystocia is characterized by abnormally slow labor progress due to __________ uterine contractions, resulting in ________ labor.

In evaluating 'Powers' during labor, an adequate contraction should occur every __________ minutes, lasting __________ seconds, with a firm uterus upon palpation.

Which method of monitoring uterine contractions provides the MOST objective data regarding contraction strength and frequency?

A fetus weighing more than __________ grams increases the risk of shoulder dystocia during delivery.

In the context of fetal 'Passenger' assessment, which presentation necessitates a Cesarean section?

For labor induction with an unfavorable cervix, mechanical dilation utilizes a Foley catheter. What is the maximum duration, beyond patient comfort, the catheter remains in place?

Membrane stripping assesses the amniotic sac off the cervix, without breaking it to stimulate contractions. Besides the adequate cervical opening and gestational age, what screening result MUST be confirmed negative prior to this procedure?

A patient is undergoing labor induction. Which finding is MOST concerning and warrants immediate discontinuation of the induction agents and continuous fetal monitoring?

A patient is undergoing labor induction via amniotomy (AROM). Following the procedure, the fetal heart rate tracing reveals repetitive late decelerations. What is the MOST appropriate next step?

Which intrapartum factor poses the GREATEST risk for early-onset Group B Streptococcus (GBS) infection in a newborn?

The MOST common cause of neonatal sepsis is which of the following?

A patient at 38 weeks gestation presents in active labor. Upon examination, a 'ropelike' structure with pulsations is felt during a vaginal exam. What is the MOST appropriate immediate action?

A patient with a history of a prior low transverse Cesarean section is requesting a trial of labor after Cesarean (TOLAC). Which of the following is an absolute contraindication to TOLAC based on the provided information?

In the context of labor abnormalities, which of the following scenarios is MOST indicative of cephalopelvic disproportion (CPD) requiring consideration for Cesarean section?

A patient at 41 weeks gestation is undergoing labor induction with oxytocin. She has had a prior Cesarean section with a low-transverse incision. Which of the following findings would be MOST concerning and warrant immediate discontinuation of oxytocin?

A patient is diagnosed with an umbilical cord prolapse. After elevating the presenting part, what is the MOST crucial next step in managing this obstetrical emergency?

In the context of labor abnormalities, the '3 Ps' framework is utilized to systematically evaluate potential contributing factors. Which of the following options accurately lists all three components of this framework?

During labor, effective uterine contractions ('Powers') are crucial for cervical dilation and fetal descent. According to the information provided, which of the following best describes the characteristics of adequate uterine contractions?

An obstetrician is evaluating the 'Passenger' component of labor in a patient experiencing dystocia. Which aspect related to the fetus is MOST directly associated with an increased risk of shoulder dystocia, as highlighted in the provided content?

To comprehensively assess the 'Powers' in a laboring patient experiencing slow progress, clinicians utilize different monitoring techniques. If quantitative data regarding the strength of uterine contractions is specifically required to differentiate between hypotonic and hypertonic uterine dysfunction, which monitoring method is MOST appropriate?

Dystocia, or difficult labor, is frequently attributed to dysfunctional uterine contractions, impacting the 'Powers' of labor. Considering the '3 Ps' model, if a primiparous woman is diagnosed with dystocia characterized by abnormally slow labor progress despite adequate pelvic dimensions and a vertex fetal presentation, which primary factor should be the MOST immediate focus of clinical re-evaluation and management?

In the context of the '3 Ps' of labor, 'Powers' most accurately refers to which of the following physiological forces?

A nulliparous patient at 40 weeks gestation is undergoing labor induction with oxytocin. After several hours, uterine contractions are frequent but of low intensity, and cervical change is minimal. According to the '3 Ps' model, which of the following is the MOST likely primary contributing factor to this labor dystocia?

Both membrane stripping and intravaginal prostaglandin E2 (PGE2) are methods used for cervical ripening and labor induction. However, membrane stripping is generally considered CONTRAINDICATED in which of the following scenarios where PGE2 might still be considered with caution?

A patient with limited prenatal care and a history of opioid use disorder presents in active labor at term. She is requesting a Trial of Labor After Cesarean (TOLAC) for a prior classical Cesarean section. Considering the social determinants of health and obstetric history, which of the following factors presents the ABSOLUTE contraindication to TOLAC in this specific clinical context?

In the immediate postpartum period, a patient exhibits persistent vaginal bleeding despite fundal massage and initial uterotonic administration. The uterus remains boggy upon palpation. Which of the following clinical findings would be MOST directly indicative of uterine atony as the primary etiology of postpartum hemorrhage, rather than retained placental tissue?

A patient at 39 weeks gestation with a Bishop score of 3 requires labor induction due to oligohydramnios. According to the slides, which of the following methods is CONTRAINDICATED without prior cervical ripening?

A patient at 40 weeks gestation is undergoing labor induction and has tested positive for Group B Streptococcus (GBS). Per the slides, which of the following interventions should be implemented?

A patient with one prior low transverse cesarean section is requesting a VBAC. According to the provided content, which of the following is a contraindication to VBAC?

Following delivery of the placenta, a nurse notes that a portion of it is missing. According to the slides, which of the following is the MOST appropriate immediate action?

A patient at 39 weeks gestation is undergoing membrane stripping. Per the provided slides, which of the following conditions must be met to ensure patient safety and efficacy?

A patient with a history of prior low transverse Cesarean section presents requesting a Trial of Labor After Cesarean (TOLAC). What is an absolute contraindication?

In a patient at 42 weeks gestation with an unfavorable cervix (Bishop score < 6) requiring labor induction, which of the following interventions is MOST appropriate as the initial step?

A patient is diagnosed with uterine atony following delivery. After initial attempts to stimulate contractions, the bleeding continues. What is the next best step?

A patient in active labor has been diagnosed with cephalopelvic disproportion (CPD). Despite adequate uterine contractions and maternal pushing efforts, there is no fetal descent. Which of the following is the MOST appropriate next step in management?

A clinician is evaluating a patient with a history of prior Cesarean section who wishes to attempt a trial of labor after cesarean (TOLAC). Which factor would be MOST suggestive of latent uterine rupture and necessitate immediate intervention?

When evaluating a patient experiencing dystocia using the '3 Ps' model, which of the following factors is MOST directly assessed using an intrauterine pressure catheter (IUPC)?

A nulliparous woman at 41 weeks gestation is diagnosed with suspected fetal macrosomia (estimated fetal weight of 4300g) via ultrasound. Which of the following management strategies should be considered when weighing the benefits of expectant management versus immediate induction?

In a patient experiencing a prolonged second stage of labor, despite adequate uterine contractions, which of the following interventions would MOST directly address a potential 'Passenger'-related cause of dystocia?

After performing McRobert's maneuver and applying suprapubic pressure without resolving a shoulder dystocia, the obstetrician decides to proceed with the Woods screw maneuver. Which of the following potential complications associated with the Woods screw maneuver requires the HIGHEST level of caution and preparation?

During the evaluation of labor abnormalities using the '3 Ps', a patient is noted to have adequate uterine contractions by IUPC and no fetal malpresentation. However, progress is still slow. Which of the following factors related to the 'Passage' would be LEAST likely to contribute to this scenario?

A primigravid patient at term is diagnosed with a frank breech presentation. Which of the following factors is MOST crucial to consider when determining the appropriateness of attempting an External Cephalic Version (ECV)?

During a vaginal examination of a patient in active labor, a pulsating, ropelike structure is palpated alongside the fetal presenting part. What is the MOST appropriate IMMEDIATE next step in managing this clinical finding?

A patient at 39 weeks gestation with a Bishop score of 3 requires labor induction due to oligohydramnios; the patient is GBS positive. Which of the following methods is CONTRAINDICATED without prior cervical ripening?

A patient at 41 weeks gestation with oligohydramnios is undergoing labor induction. Her cervix is unfavorable. Considering the provided information, which of the following labor induction methods is MOST appropriate as an initial step?

A patient with a history of a prior low transverse Cesarean section is requesting a trial of labor after Cesarean (TOLAC). Which of the following is an absolute contraindication to TOLAC?

A patient at 35 weeks gestation presents with preterm labor and rupture of membranes. Her GBS status is unknown. What is the MOST appropriate next step in management?

Which of the following scenarios presents the GREATEST contraindication to attempting a Trial of Labor After Cesarean (TOLAC)?

What is the MOST common causative organism of early-onset neonatal sepsis?

During the second stage of labor, a prolonged deceleration of the fetal heart rate is observed immediately following artificial rupture of membranes (AROM). What is the MOST likely underlying cause of this fetal heart rate pattern?

A multigravid patient is experiencing labor dystocia characterized by slow cervical dilation despite adequate contraction frequency and intensity. According to the '3 Ps' of labor, which of the following factors is MOST likely contributing to this protracted labor?

Which of the following scenarios presents the GREATEST risk of early-onset Group B Streptococcus (GBS) infection in a newborn?

A fetus is assessed to be macrosomic, with an estimated fetal weight of 4600 grams at term. Considering this factor ALONE, which of the following labor management strategies would be MOST appropriate to mitigate potential complications?

A nulliparous woman at 41 weeks gestation with confirmed macrosomia (fetal weight estimated at 4600g) is in active labor. Despite adequate uterine contractions, labor is not progressing. Given the risks associated with macrosomia, what is the MOST appropriate next step?

In the context of labor abnormalities, differentiate between 'failure to progress' and 'arrested progress'. Which of the following BEST describes 'arrested progress' in the second stage of labor?