Step 2 CK First Aid Rapid Practice Test

Never perform a vaginal examination when placenta previa is suspected. The placenta lying over or near the cervical opening means digital vaginal manipulation can disrupt placental attachment and trigger life-threatening hemorrhage for both mother and fetus. The correct first step is to confirm placental location with imaging, typically a transabdominal ultrasound, before any vaginal exam. If bleeding occurs or labor is unavoidable, stabilize the patient and manage based on the placenta’s position, often planning for cesarean delivery. A limited speculum exam may be used to assess cervical bleeding, but internal digital examination should be avoided until placenta previa is ruled out.