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NBME Obstetrics And Gynecology Form 4



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National Board of Medical Examiners
Obstetrics & Gynecology Self-Assessment


1. A 32-year-old woman, gravida 5, para 4, at 40 weeks' gestation is brought to the emergency department because of bright red vaginal bleeding for 1 hour. Contractions have occurred every 2 to 3 minutes for 5 hours. Her pregnancy had been uncomplicated. Ultrasonography at 22 weeks' gestation showed no evidence of placenta Previa. Her temperature is 370C (98.60F), pulse is 120/min, respirations are 18/min, and blood pressure is 90/60 mm Hg, Physical examination shows a tender abdomen with a firm uterus. The fetal heart rate is 140/min. On speculum examination, there is copious bright red bleeding from the external cervical os. The cervix is 4 cm dilated and 80% effaced. The physician informs the patient and her husband that emergency cesarean delivery is recommended. The patient and her husband state that,because of their religious beliefs, the elders of their church must agree to a surgical delivery before they can give their consent. Which of the following is the most appropriat.... I am really sorry I ll complete this as soon as i get the chance
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