Question Notes

Printed on: 2/5/2021

Learner: Lord Mvoula

Test Name Objective 25: Preterm Rupture Completion Date 2021-02-05T16:52:58

of the Membranes (2019)
Score 8.0 of 10.0 (80.00%) Timespent 00:15:54
Result Passed

Question Result / Notes

Order Name Score Notes

1 A 29-year-old G1P0 woman at 31 weeks 1.0
gestation presents with watery discharge
from the vagina starting two hours ago. Her
prenatal course has been uncomplicated
and she takes prenatal vitamins and iron.
She denies substance abuse, smoking, or
alcohol use. On examination, her blood
pressure is 110/70, pulse 84 beats/minute,
temperature 98.6°F (37.0°C). Which of the
following is the most appropriate next step
in the management of this patient?
2 A 29-year-old G1P0 woman presents at 31 1.0
weeks gestation with preterm premature
rupture of membranes six hours ago. She
notes that for the last hour she has had
some occasional contractions. Her prenatal
course has been uncomplicated and she
takes prenatal vitamins and iron. She denies
substance abuse, smoking, or alcohol use.
Her blood pressure is 110/70, pulse 84
beats/minute, temperature 98.6°F (37.0°C).
What is the role of tocolysis in this patient?
3 A 25-year-old G1P0 woman at 29 weeks 1.0
gestation presents to labor and delivery
complaining of contractions every three
minutes. On exam, her blood pressure is
120/70, pulse is 100 beats/minute,
temperature is 100.7°F (38.2°C); and fetal
heart tones are 160 beats/minute. The fetal
heart rate tracing shows variable
decelerations to 80 beats/minute, but is
otherwise reassuring. Her pelvic
examination reveals gross rupture of
membranes, her cervix is dilated to 6 cm,
and ultrasound reveals the baby is in the
breech presentation. What of the following
explains the variable decelerations?
4 A 33-year-old G2P1 woman at 29 weeks 1.0
gestation presents with confirmed preterm
premature rupture of membranes. She
denies labor. She takes prenatal vitamins
and iron. She denies substance abuse,
smoking, or alcohol use. Her prior
pregnancy was delivered vaginally at 41
weeks after spontaneous rupture of
membranes. Her blood pressure is 110/70,
pulse 84 beats/minute, temperature 98.6°F
(37.0°C). Which of the following is the next
best step in the management of this patient?
 Question Notes

Printed on: 2/5/2021

Order Name Score Notes

5 A 28-year-old G1 woman at 31 weeks 0.0
gestation presents with complaints of fluid
leaking from the vagina for the last two
hours. She denies contractions. The fetal
heart rate baseline is 150 beats/minute and
the tracing is a Category I. The fetus is in
the cephalic presentation. Her blood
pressure is 130/70, pulse 80 beats/minute,
and temperature is 98.6°F (37.0°C). The
fern and nitrazine tests are positive.
Amniotic fluid index is 12. She is counseled
concerning expectant management. For
which of the following is the neonate at
greatest risk?
6 A 25-year-old G2P1 woman at 20 weeks 1.0
gestation is diagnosed with preterm
premature rupture of the membranes. She
denies labor. She takes prenatal vitamins
and iron. She denies substance abuse,
smoking, or alcohol use. Her prior
pregnancy was delivered vaginally at 36
weeks after preterm premature rupture of
membranes. Her vital signs are: blood
pressure 110/70, pulse 84 beats/minute,
temperature 98.6°F (37.0°C). Her amniotic
fluid index is 2. The patient’s fetus is
greatest risk for which of the following?
7 A 22-year-old G2P1 woman presents for 1.0
prenatal care at approximately 10 weeks
gestation. Her first pregnancy was
complicated by preterm premature rupture
of the membranes at 28 weeks gestation.
Which of the following interventions could
reduce the risk of preterm premature rupture
of the membranes during this pregnancy?
8 A 32-year-old G2P1 woman at 36 weeks 1.0
gestation presents with preterm premature
rupture of the membranes that occurred 36
hours ago. She takes prenatal vitamins and
iron. She denies substance abuse, smoking,
or alcohol use. She had an episode of
threatened preterm labor one week ago at
which time she received betamethasone.
Her prior pregnancy delivered vaginally at
34 weeks after preterm premature rupture of
membranes. Her vitals signs are: blood
pressure 110/70, pulse 84 beats/minute,
temperature 98.6°F (37.0°C). The estimated
fetal weight is 2700 g. She is having one
contraction per hour and fetal heart tracing
is Category I. Which of the following is the
most appropriate next step in the
management of this patient?
 Question Notes

Printed on: 2/5/2021

Order Name Score Notes

9 A 21-year-old G2P1 woman at 27 weeks 1.0
gestation presents with leakage of watery
fluid from the vagina that began two hours
ago. She reports that she and her boyfriend
had intercourse about two hours before she
noted the leakage of fluid. Her pregnancy
has been uncomplicated, and she is taking
prenatal vitamins. She does not smoke or
use alcohol. Her previous pregnancy was
delivered at term. Her vital signs are: blood
pressure 120/80, pulse 68 beats/minute,
and temperature is 98.6°F (37.0°C). On
examination, there is a pool of blood tinged
fluid which is nitrazine positive and has no
ferning. Her amniotic fluid index is 15.
Which of the following is the next most
appropriate step in her management?
10 A 28-year-old G1 woman at 33 weeks 0.0
gestation presents with complaints of fluid
leaking from the vagina. Preterm premature
rupture of membranes is diagnosed. The
patient is experiencing contractions every
minute that are very painful. She also notes
some vaginal bleeding. The fetal heart rate
baseline is 150 beats/minute and the tracing
is a Category I. The fetus is in the cephalic
presentation. Her blood pressure is 130/70,
pulse 80 beats/minute, and temperature is
98.6°F (37.0°C). Which of the following is
the next most appropriate step in her
management?