1. A 25-year-old G1P0 at 28 weeks gestation presents with sudden onset of shortness of breath and a productive cough. Which of the following is the most likely diagnosis? A. Asthma exacerbation B. Pulmonary embolism C. Acute bronchitis D. Pneumonia Answer: B. Pulmonary embolism Rationale: Pregnancy is a hypercoagulable state, increasing the risk of thromboembolic events such as pulmonary embolism, which can present with sudden onset respiratory symptoms. 2. A patient at 32 weeks gestation is diagnosed with pre-eclampsia. Which of the following lab findings is most indicative of severe disease? A. Platelet count of 150,000/µL B. Serum creatinine of 1.2 mg/dL C. AST levels twice the upper limit of normal D. Urine protein/creatinine ratio of 0.3 Answer: C. AST levels twice the upper limit of normal Rationale: Elevated liver enzymes, such as AST, can indicate severe pre-eclampsia, which may necessitate early delivery. 3. A 30-year-old G2P1 presents with heavy vaginal bleeding at 36 weeks gestation. Ultrasound reveals placenta previa. What is the initial management? A. Immediate cesarean delivery B. Vaginal delivery with episiotomy C. Bed rest and observation D. Administration of betamethasone Answer: C. Bed rest and observation Rationale: In the absence of active labor or life-threatening hemorrhage, initial management of placenta previa typically involves bed rest and observation. 4. A primigravida at 40 weeks gestation is in active labor and her fetus is found to be in breech presentation. What is the most appropriate next step in management? A. External cephalic version