Section 1 OVERVIEW and answer chapter 1.pptx

Section 1 OVERVIEW, chapter

1. Which of the following is defined as the sum of stillbirths and neonatal deaths per 1000 total births? Fetal death rate Infant mortality rate Perinatal mortality rate Neonatal mortality rate Answer : C

2. A patient presents with severe preeclampsia at 37 weeks’ gestation. Labor is induced and she spontaneously delivers a 3260-g neonate. In the delivery room she complains of a severe headache and suddenly collapses. She is unable to be resuscitated. An autopsy reveals the following finding. Based on gestational age, how would her neonate be classified? a. Postterm b. Full term c. Post dates d. Early term Answer : D

3. How would the maternal death in Question 1–2 be classified? a. Perinatal death b. Nonmaternal death c. Direct maternal death d. Indirect maternal death Answer : C

4. The perinatal period starts after delivery at 20 weeks’ gestation or older. When does it end? a. 7 days after birth b. 28 days after birth c. 6 weeks after birth d. 1 year after birth Answer : B

5. Which of the following is an example of an indirect maternal death? Septic shock following an abortion Hemorrhage following uterine atony Aspiration following an eclamptic seizure Aortic rupture at 36 weeks’ gestation in a patient with Marfan syndrome Answer : D

6. A 30-year-old multigravida presents with ruptured membranes at term but without labor. Following induction with misoprostol, her labor progresses rapidly, and she spontaneously delivers a liveborn 3300-g neonate. Immediately after delivery, she complains of dyspnea. She becomes apneic and pulseless and is unable to be resuscitated. Photomicrographs from her autopsy reveal fetal squames (arrows) within the pulmonary vasculature. How would her death be classified? a. Perinatal death b. Nonmaternal death c. Direct maternal death d. Indirect maternal death Answer : C

7. A patient presents at 22 weeks’ gestation with spontaneous rupture of membranes and delivers a 489-g male infant who dies at 4 hours of life. Her last menstrual period and early sonographic evaluation confirm her gestational dating. All except which of the following definitions accurately apply to this delivery? a. Abortus b. Preterm neonate c. Early neonatal death d. Extremely low birthweight Answer : A

8. Which of the following is accurate regarding pregnancy rates in the United states? The fertility rate has been stable since 1990. The lowest birth rate ever was recorded in 2015. The birth rate increased for adolescents in 2015. More than half of births in the United States are unintended at the time of conception Answer : D

9. Which of the following is defined as the number of maternal deaths that result from the reproductive process per 100,000 live births? a. Maternal mortality rate b. Maternal mortality ratio c. Direct maternal death rate d. Pregnancy-related death rate Answer : B

10. A 26-year-old woman is brought to the emergency department with abdominal pain and dizziness. On exam she is found to be pale and tachycardic. Her urine pregnancy test is positive and her hemoglobin is 5 g/dL. Bedside ultrasound reveals a left adnexal mass and free fluid. She is taken to the operating room for a ruptured ectopic pregnancy. While in the operating room she arrests and is unable to be resuscitated . How would her death be classified? a. Perinatal death b. Nonmaternal death c. Indirect maternal death d. Pregnancy-related death Answer : D

11. Most infant deaths occur in which of the following groups? a. Low-birthweight infants b. Infants of diabetic mothers c. Infants with congenital anomalies d. Infants with chromosome abnormalities Answer : A

12. Which of the following is the most common cause of pregnancy-related deaths in the United States? a. Sepsis b. Hemorrhage c. Cardiovascular d. Thromboembolism Answer : C

13. Which of the following explains the trend on this graph? Data from MacDorman MF, Declercq E: Trends and characteristics of United States outof-hospital births 2004–2014: new information on risk status and access to care. Birth 43(2):116, 2016a. MacDorman MF, Declercq E, Cabral H, et al: Recent increases in the U.S. maternal mortality rate: disentangling trends from measurement issues. Obstet Gynecol 128(3):447, 2016b. An increase in maternal deaths Improved reporting of maternal deaths More pregnant women suffer from severe chronic health conditions All of the above Answer : D

14. Which of the following obstetrical complications contributes the least to the pregnancy-related death rate in the United States? a. Infection b. Preeclampsia c. Amniotic fluid embolus d. Anesthetic complications Asnwer : D

15. Which racial group has the highest maternal mortality rate? a. White b. Black c. Asian d. Hispanic Answer : B

16. All except which of the following is an example of a “near miss”? A postpartum patient who falls in the shower without injury High spinal anesthesia resulting in intubation, admission to the intensive-care-unit, and a ventilator-associated pneumonia Failure to give Rh immunoglobulin to a Rh-negative postpartum patient who ultimately has no change in antibody screen A delay in sending the human immunodeficiency virus (HIV) screening test of a laboring patient who ultimately has a negative test result Answer : B

17. For every maternal death that occurs in the United States, how many women experience a severe morbidity? a. 50 b. 100 c. 200 d. 500 Asnwer : C

18. Which of the following is a severe maternal morbidity indicator? a. Hypertension b. Cystic fibrosis c. Sickle cell crisis d. Systemic lupus erythematosus Answer : C

19. Which of the following is a lesson from former President Barack Obama’s summary of the Affordable Care Act? Pragmatism is important Special interests pose an obstacle to change Change is difficult in the face of hyperpartisanship All of the above Answer : D

20. Medicaid insures approximately what percentage of the births in the United States? a. 25% b. 33% c. 48% d. 62% Answer : C

21. What insurance type covered more than half of all hospital stays for preterm and low-birthweight infants? a. Medicaid b. Medicare c. Private insurance d. Health maintenance organizations Answer : A

22. Which of the following is a cause of excessive health care costs in the United States? a. Greater life expectancy b. Better healthcare outcomes c. Greater use of medical technology d. All of the above Answer : C

23. Which of the following best describes the primary role of the Ob/Gyn hospitalist? Assist other obstetricians in procedures Be a backup for physicians taking calls from home Care for hospitalized patients who have no primary doctor Care for hospitalized obstetrical patients and help manage their emergencies Answer : D

24. What do some hospitals hope to gain by having an Ob/Gyn hospitalist? a. Less cost b. Fewer near misses c. Improved quality and safety d. Improved patient satisfaction Answer : C

25. What percentage of home births are attended by nurse midwives certified by the American Midwife Certification Board? a. 26% b. 33% c. 52% d. 78% Answer : B

26. Which of the following is accurate regarding home birth in the United States? The American College of Obstetricians and Gynecologists endorses home births They are associated with a higher perinatal mortality rate than births occurring in medical facilities Randomized trials suggest their outcomes are equivalent to those of births occurring in medical facilities None of the above Answer : B

27. For which of the following purposes would fetal chromosomal microarray analysis be potentially beneficial? Evaluating a stillborn fetus Screening the fetus of an advanced-age mother Evaluating the fetus with trisomy 21 and adoubleoutlet right ventricle Screening the fetus at 12 weeks’ gestation whose mother personally carries a balanced translocation Answer : A

28. Which of the following contributes to the current health care fiscal crisis? Prices for surgical procedures Prices charged by health insurance companies Expensive interventions without robust evidence All of the above Answer : D

29. What population is most affected by governmental interference with the reproductive rights of women? a. Immigrants b. Black women c. Rural population d. Indigent population Answer : D

30. The increase in opioid abuse in pregnancy has led to which of the following? A rise in neonatal abstinence syndrome Increase in intrauterine growth restriction Improvement in pain control during labor Increase in neurologic anomalies diagnosed in utero Answer : A

31. A 16-year-old G1 delivers an infant with a complex congenital heart defect. The death of the newborn at 5 days of life due to the congenital heart defect would be counted in which of the following rates? a. Infant mortality rate b. Perinatal mortality rate c. Early neonatal death rate d. All of the above Answer : D

32. As the patient in Question 1–31 makes family planning decisions in the postpartum period, which of the following will cause her to be most affected by governmental interference with women’s reproductive rights? a. Age b. Ethnicity c. Pregnancy within the last year d. Prior child with a congenital anomaly Answer : A