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153 Cards in this Set
- Front
- Back
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M. S. comes to the office indicating her period
is 1 month overdue. Her level of pregnancy diagnosis is? a. Positive b. Presumptive c. Possible d. Probable |
B
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R. L. states she is trying to get pregnant and
had unprotected intercourse on day 14 of her usual 28-day menstrual cycle. However, the pregnancy test was negative 3 days later. Appropriate management would be to: a. Order an ultrasound b. Prescribe progesterone c. Repeat the test in a week d. Order a serum pregnancy test |
C
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Pregnancy tests detect:
a. Estrogen b. Human chorionic gonadotropin c. Human placental lactogen d. Progesterone |
B
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During the first few weeks of pregnancy, progesterone
is secreted by the: a. Placenta b. Corpus luteum c. Endometrium d. Trophoblasts |
B
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Blood in the chorionic villi pertains to whose
circulation? a. Mother b. Mother and fetus c. Placenta d. Fetus |
D
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The vessels of the umbilical cord are:
a. One vein with oxygenated blood and two arteries with deoxygenated blood b. One vein with deoxygenated blood and two arteries with oxygenated blood c. Two veins with oxygenated blood and one artery with deoxygenated blood d. Two veins with deoxygenated blood and one artery with oxygenated blood |
A
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The uterus is palpable at the symphysis pubis at:
a. 6 weeks b. 8 weeks c. 12 weeks d. 16 weeks |
C
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Implantation occurs _______ after fertilization.
a. 24–48 hours b. 3–4 days c. 6–7 days d 9–10 days |
C
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Placental transport of substances occurs by:
a. Simple perfusion b. Facilitated diffusion c. Active osmosis d. Active perfusion |
B
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The human zygote consists of:
a. 46 chromosomes from each parent b. 2 pairs of sex chromosomes c. 23 chromosomes d. 23 pairs of chromosomes |
D
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The trophoblast will ultimately become the:
a. Placenta b. Embryo c. Blastocyst d. Umbilical cord |
A
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M. R. presents for an antepartal visit at 26
weeks and wants to know how big the fetus is. Your response would be that the fetus is approximately: a. 0.5 lb b. 1 lb c. 2 lb d. 4 lb |
C
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At her initial visit, M. R. was a healthy primigravida,
but you heard a Grade I systolic murmur. Your management would be: a. A cardiology consult b. Chest radiograph c. Immediate referral d. No intervention |
D
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The drop in diastolic blood pressure during
normal pregnancy is partly the result of: a. Plasma volume expansion b. Progesterone’s effect on vessel walls c. Increased cardiac output d. Pooling of plasma in tissues |
B
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Changes in the respiratory system due to pregnancy
may cause: a. Tachypnea b. Cough c. Increased chest diameter d. Pale nasal mucosa |
C
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C. D., a primigravida, came in for a visit at 34
weeks stating she has “a lot of vaginal discharge,” but no other problems. On exam you see a white, odorless discharge of moderate quantity. Your next step would be: a. Treat for candida b. Check for trichomoniasis c. Reassure that this is normal d. Send a vaginal culture |
C
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R. P. comes for a 24-week visit and mentions
that her interest in sex has increased greatly. You respond to her concern because you know that increased libido is: a. A normal variation of response in pregnancy b. An abnormal response of changing image c. Reflective of repressed desire to disrupt the pregnancy d. The early sign of a parenting disorder |
A
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R. Q., at her 36-week visit, tells you that she is
having nightmares that include labor as well as fears of having an abnormal baby. Your best response is: a. Tell her there is nothing to worry about, as most babies are fine b. Encourage her to tell you more about the nightmares and her fears c. Make her an appointment with a mental health nurse practitioner d. Reassure her that there are dangers about which we all have to worry |
B
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Initial management of constipation in pregnancy
should include suggestions for: a. Increased protein intake b. Limitation of calcium rich foods c. Use of a laxative d. Increased intake of fiber and fluids |
D
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P. J. has had three spontaneous abortions and
is now pregnant for the fourth time. The term that defines her status is: a. Multipara b. Nullipara c. Primigravida d. Primipara |
B
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The calculation of estimated date of birth (EDB)
by Naegele’s rule is based on: a. A 28-day menstrual cycle b. Average length of pregnancy of 290 days c. 32-day cycle d. Length of pregnancy of 270 days |
A
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A. B. is pregnant for the third time. Her
obstetrical history indicates she has had two miscarriages and one twin birth at 36 weeks. One twin died but the other is alive and well. The four-digit descriptor of this history is: a. 0121 b. 0221 c. 2021 d. 2201 |
B
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D. M. comes for her first antepartal visit. When
asked the date of her last menstrual period, she indicates she has not had one since she has been nursing her 6-month-old daughter. You diagnose that she is pregnant. How would you determine estimated date of birth (EDB)? a. Determine when she expected to get her period and calculate from there b. Document quickening and extrapolate from there c. Send her to fetal assessment unit for an ultrasound d. Get good sexual history and use last coitus as the basis for calculation |
C
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R. P., G1 P0, comes for her 20-week visit. Her
abdominal exam shows the uterine fundus to be half way between the symphysis and the umbilicus. This finding leads you to consider: a. Intrauterine growth restriction (IUGR) b. Nothing, since it is normal c. Oligohydramnios d. She is not eating and gaining enough weight |
A
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25. In your abdominal exam using Leopold’s
maneuvers, the first step is to determine fetal: a. Attitude b. Position c. Engagement d. Lie |
D
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D. P. presents for her first antepartal visit. She is
9 weeks pregnant and requests that you listen for the FHT. Your response would be: a. “No, there’s no reason to since it can’t be heard yet anyway.” b. “Sure, I’ll listen but we may not hear it yet.” c. “Sure we can listen since it’ll be there now.” d. “We don’t usually do that at this visit.” |
B
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Normal findings on speculum and pelvic examination
of a pregnant woman include: a. Eversion of the squamocolumnar junction b. Pale vaginal mucosa c. Open cervical os d. Firm, slightly enlarged cervix |
A
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Clinical pelvimetry of a woman with an
adequate pelvis would provide which of the following findings? a. Ischial tuberosities of 10 cm and a flat sacrum b. Convergent sidewalls c. Pubic arch of 90 degrees with diagonal conjugate of greater than 11.5 cm d. Protuberant ischial spines |
C
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The value of clinical pelvimetry rests in its
ability to: a. Predict successful vaginal birth b. Identify the characteristics of the woman’s pelvis c. Determine if she will have a breech presentation d. Predict an occiput posterior position |
B
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F. R., a primigravida at 16 weeks, states that she
is concerned because she has not felt the baby move yet. Your response should be: a. “Most women with a first pregnancy don’t feel movement until around 20 weeks.” b. “You’re worrying too much, just relax.” c. “I’ll order an ultrasound, just to be sure everything is fine.” d. “I’d like you to return in a week so we can recheck it.” |
A
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Maternal serum alphafetoprotein screening is
performed in what time frame? a. 8–12 weeks b. 12–15 weeks c. 15–19 weeks d. 20–24 weeks |
C
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CDC recommends screening for group B streptococcus
(GBS) at what point? a. At the first visit b. When labor starts c. At 20 weeks d. At 35–37 weeks |
D
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The triple screen tests for:
a. AFP, progesterone, hCG b. AFP, estriol, hCG c. Estriol, progesterone, hPL d. Estradiol, progesterone, AFP |
B
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A nonstress test containing 2 fetal heart accelerations
lasting 15 seconds that are 15 beats per minute above the baseline is: a. Negative b. Positive c. Nonreactive d. Reactive |
D
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The recommended folic acid supplement for
a woman with a past history of a baby with a neural tube defect is: a. 4 mg per day starting before conception b. 0.4 mg per day starting with a missed period c. 2 mg per day prior to conception d. 0.4 mg per day throughout pregnancy |
A
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B. D. comes for her first antepartal visit. She is
5 ft 4 in and weighs 190 lb (BMI 33). Weight goal for the pregnancy should be: a. Maintain current weight b. Gain 11–20 lb c. Gain 25–35 lb d. Lose 10–15 lb |
B
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Exercise guidelines for healthy pregnant
women include suggestions to: a. Discontinue exercise at 20 weeks b. Begin intense program of exercise, especially if prepregnant weight was high c. Modify the existing program if symptoms occur d. Limit fluids before exercising |
C
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Anticipatory guidance concerning sexual
activity during pregnancy includes: a. Sexual intercourse may continue until early third trimester in an uncomplicated pregnancy. b. Sexual intercourse is contraindicated throughout pregnancy if there is a past history of preterm labor. c. The pregnant woman’s sexual desire may change throughout pregnancy. d. Most pregnant women do not desire sex after the first trimester. |
C
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Breastfeeding should be encouraged for:
a. All women whose families strongly support the idea b. All pregnant women who are not HIV positive c. Those with adequate breast tissue d. Women who desire to do so |
B
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M. D. comes for her first antepartal visit at
8 weeks and tells you she has nausea every morning, but is able to eat and drink in the afternoon. Your management at this point would include: a. Prescription for antinausea medicine b. Vitamin B6 50 mg bid c. Small frequent meals d. Carbonated beverage on rising |
C
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The fatigue of early pregnancy is best managed
by: a. Ruling out a thyroid problem b. Encouraging increased exercise c. Increased amounts of caffeinated drinks d. Reassurance and rest |
D
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Leg cramps may be relieved by:
a. Pointing the toes b. Hot compresses c. Flexion of the foot d. Hot tub baths |
C
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R. T. comes for her 36-week visit, during which
she mentions that her hands and feet are somewhat swollen. She has gained 2 lb since her visit 2 weeks ago; her BP is 128/76 and she has no protein in her urine. What is your plan? a. Refer to perinatologist for impending preeclampsia b. Explain the edema at this stage is normal and see her in a week c. Order bed rest with return visit in a week d. Restrict salt and fluid intake |
B
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T. G. asks about the value of childbirth preparation
classes during a second trimester visit. You tell her that the evidence indicates that they are associated with: a. Reduced use of analgesics/anesthesia during labor b. Improved parenting skills c. Decreased Cesarean rates d. Less use of IVs in labor |
A
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Diabetes screening recommendations during
pregnancy for the woman who is obese include: a. Fasting blood glucose each trimester b. Testing Hemoglobin A1C in the first trimester c. Routine screening early in pregnancy and at 24–28 weeks d. The same as for the normal weight woman |
C
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G. H. comes for her 34-week visit, at which time
the fundus measures 39 cm. Abdominal palpation reveals a large uterus and difficulty feeling fetal parts. The most likely diagnosis is: a. Multiple gestation b. Macrosomic fetus c. Uterine fibroid d. Polyhydramnios |
D
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W. T., during her initial prenatal visit, mentions
that she had a rubella immunization 3 weeks before conceiving this baby. Your plan is to: a. Advise her to consider termination of the pregnancy b. Continue regular care c. Consult with an infectious disease specialist d. Referral to perinatologist |
B
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On physical examination at an initial prenatal
visit of a 25-year-old woman who is at 14 weeks’ gestation, you feel a 1 cm mobile, nontender mass in the upper, outer quadrant of her right breast. Your plan is: a. Explain this is normal with hormonal changes of pregnancy b. Advise her you will watch at each visit to assess for any change c. Schedule a mammogram to be done in the third trimester d. Refer for further evaluation with biopsy |
B
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A pregnant woman who is 5 ft 3 in in height
has a prepregnancy weight of 115 lb. Which of the following represents the most appropriate weight for her by the end of her pregnancy? a. 125 lb b. 135 lb c. 145 lb d. 155 lb |
C
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The biophysical profile (BPP) assesses fetal wellbeing
with: a. A combination of nonstress test and ultrasound evaluation to assess five variables b. Both a contraction stress test and ultrasound evaluation of amniotic fluid volume c. Serial ultrasounds to evaluate amniotic fluid volume as well as fetal breathing and body movement and tone d. Evaluation of fetal movement with kick counts after administration of oxytocin or nipple stimulation |
A
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An appropriate plan of care for a 40-week
gestation woman with a BPP score of 8 that includes a 2 score for amniotic fluid volume includes: a. Order a contraction stress test b. Repeat the BPP in 48 hours c. Schedule a return visit after 1 week d. Admit for induction of labor and delivery |
C
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Evaluation of fetal lung maturity is a required
procedure for a: a. Scheduled delivery before 39 weeks’ gestational age b. Scheduled delivery before 37 weeks’ gestational age c. Laboring woman at 37 weeks’ gestational age d. Laboring woman at 35 weeks’ gestational age |
A
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W. M., who is 11 weeks pregnant, calls you
from the ER to say she sustained a laceration, and they want to give her a tetanus booster. You would tell her: a. All vaccinations are contraindicated in pregnancy b. It is not a problem because she doesn’t need it c. It can be given in pregnancy if needed d. She should wait until the third trimester |
C
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Drugs from which one of the following categories
may be given to a pregnant woman when the potential benefit justifies the potential fetal risk: a. Category A b. Category B c. Category C d. Category X |
C
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A woman who is pregnant for the second time,
and her first pregnancy ended with a spontaneous abortion at 10 weeks is a: a. Multigravida b. Multipara c. Primigravida d. Primipara |
A
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A pregnant woman presents for her 24-week
visit, at which time she relates that she doesn’t feel very interested in sex anymore. Your response is to: a. Tell her this is common and she should not be concerned b. Assure her the interest will return in the third trimester c. Tell her to get more rest and her interest will increase d. Get her to talk about what she’s feeling and thinking about sex |
D
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The screening test for group B streptococcus
requires that the specimen be obtained from the: a. Ectocervix and vaginal side walls b. Ectocervix and endocervical os c. Endocervical os and rectum d. Vaginal introitus and rectum |
D
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Pregnancy loss and the woman’s need for
appropriate grieving occur across the reproductive spectrum. Maladaptive grief reactions are best addressed by: a. Telling her to put the baby’s things away b. Listening to whatever the woman has to say c. Encouraging her to be strong so she’ll get past it d. Making her an appointment with a therapist |
B
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Recommended routine screening tests at an
initial antenatal visit during the first trimester include: a. Group B streptococcus culture b. Syphilis serology c. Triple marker screen d. Ultrasound |
B
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Which of the following statements concerning
influenza vaccination for pregnant women is correct? a. Vaccination is recommended for all women who will be pregnant during the influenza season. b. Pregnant women with HIV infection should not receive this vaccination. c. The pregnant woman should be offered the option of either the injection or nasal administration of the vaccine. d. Vaccination should be given only in the second or third trimester. |
A
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RDA of calories and protein during pregnancy
is: a. 3,000 kcal and 50 g/day b. 3,500 kcal and 60 g/day c. 3,800 kcal and 60 g/day d. 2,500 kcal and 60 g/day |
D
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R. H. presents for her 36-week visit. Abdominal
exam reveals a likelihood of polyhydramnios. In response to her question of where does the fluid come from, you answer: a. From the mother’s blood volume b. Through a combination of maternal serum and fetal urination c. Produced by amniotic epithelium and fetal functions d. From fluid ingested by mother |
C
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D. B., a 24-year-old primigravida, during her
initial visit asks how the fetus has genes from both her husband and herself. Your response is based on what fact? a. Mitosis occurs producing half the number of chromosomes. b. Meiosis occurs producing half the number of chromosomes. c. The egg is a somatic cell. d. Sperm is a somatic cell. |
B
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Which of the following are parts of the
placenta? a. Trophoblast, chorion, amnion b. Trophoblast, chorion, endometrium c. Chorion, amnion, umbilical cord d. Intervillous spaces, endometrium, trophoblast |
A
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The term conceptus means:
a. The embryo and placenta b. The embryo and membranes c. The embryo, membranes, and placenta d. The embryo, membranes, placenta, and endometrium |
C
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What structure in human reproduction produces
the most diverse and greatest quantity of steroid and protein hormones? a. Trophoblast b. Blastocyst c. Chorion laeve d. Deciduas basalis |
A
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At her 32-week visit, B. R. asks you to tell her
what you are looking for or feeling when doing her abdominal exam with Leopold’s maneuvers. You respond that you are: a. Determining the placement of the placenta b. Finding what direction the fetus is lying c. Evaluating the size of the uterus d. Evaluating adequacy of fetal growth |
B
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T. D. comes for an 18-week visit. Appropriate
routine screening tests at this visit include: a. Gestational diabetes testing b. Chlamydia and gonorrhea tests c. CBC or hematocrit d. Multiple marker screen |
D
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R. D. at 37 weeks calls to say she feels like the
fetus is moving less. After further inquiry you decide to send her for an NST. She asks what this is. You explain that it is an assessment of fetal well-being based on: a. Evaluation of body movements b. Breathing movements c. Fetal heart-rate response to fetal movement d. Fetal body tone |
C
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P. R. comes for a first visit at 11 weeks’ gestation.
Her history reveals her concern about sore gums that sometimes bleed. Your thinking is: a. She most likely needs to see a periodontist. b. Gingivitis is common in pregnancy with increased vascularity of connective tissue. c. She should be started on antibiotics to prevent systemic infection. d. She should be placed on a soft diet until the problem is resolved. |
B
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A woman presents at 32 weeks’ gestation with
vaginal bleeding for the past 6 hours, back pain, and irregular abdominal cramping pain. Exam reveals diffuse abdominal tenderness and increased uterine tone. You suspect: a. Marginal placenta previa b. Placental abruption c. Preterm labor d. Pyelonephritis |
B
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A postterm pregnancy is best diagnosed by:
a. Certain LMP b. Third trimester ultrasound c. Fundal growth d. Quickening |
A
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Serial beta hCG levels are done after uterine
evacuation for hydatidiform mole to: a. Assure that the woman is not pregnant in the first year after treatment b. Monitor for persistent trophoblastic proliferation c. Identify a pregnancy early so appropriate care can be provided d. Assess for a possible undetected ectopic pregnancy |
B
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P. R. indicates she is afraid of pitocin because
her sister had a uterine rupture when she was induced. Your response would be: a. Reassurance since she won’t need induction anyway b. Discuss how pitocin is given with assurance that nothing will go wrong c. Discuss alternate methods to promote uterine readiness and contractions d. Say it is the best way to get through labor and not a problem |
C
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L. M. is a G2 P1001 whose initial visit reveals a
healthy pregnant woman. Her urinalysis and culture and sensitivity (C&S) report indicates a colony count of greater than 100,000 organisms/ mL. You would: a. Refer her to a urologist to evaluate for underlying renal disease b. Encourage fluids and repeat C&S in 2 weeks c. Initiate treatment with antibiotics d. Advise her to |
C
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Antepartal care for the woman who is HIV positive
should focus mainly on: a. Assuring fetal well-being at all cost b. Frequent drug testing to assure she is not using IV street drugs c. Getting her partner tested and treated if necessary d. Maintaining her health and preventing neonatal transmission |
D
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On reviewing the record of a currently pregnant
woman, you see that she is P1112. What obstetrical history can you derive from this information ? a. Two previous pregnancies of which one infant was term and one was a premature stillbirth b. You are unable to determine an obstetric history from this information c. Three pregnancies with one term birth and premature twins d. Three pregnancies of which one was term, one premature and one abortion |
D
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Polyhydramnios is defined as:
a. AFI greater than 10 cm b. Single pocket greater than 5 cm c. AFI greater than 15 cm d. Single pocket greater than 8 cm |
D
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Etiology of polyhydramnios is associated with:
a. Maternal over-hydration b. Fetal anomalies of GI tract c. Fetal anomalies of cardiovascular system d. Maternal preeclampsia with edema |
B
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The fetal system most associated with oligohydramnios
is the: a. GI system b. Central nervous system c. Renal system d. Cardiovascular system |
C
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When speaking with a primigravida about the
way a baby develops, you would describe the embryonic stage as the: a. Period between the second and eighth weeks b. Time from implantation to 12 weeks into pregnancy c. Period when drugs are least likely to affect development d. Period from fertilization to 4 weeks |
A
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During the embryonic stage all major organ
systems are formed except: a. Heart b. Reproductive organs c. Liver d. Lungs |
D
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Determining an accurate estimated date of
birth (EDB) is critical because: a. It is the basis for making decisions toward the end of the pregnancy. b. Mothers want to know the exact date the baby will be born. c. It is all that is needed to plan a 37-week elective C-section. d. Families want to make plans around the baby’s birth. |
A
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Which of the following would not be a
normal physical examination finding during pregnancy? a. Blue color of vaginal mucosa and cervix b. Hypertrophy of nasal mucosa and gums c. Mildly enlarged, nodular thyroid d. Increased redness on palms of hands |
C
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During the last 8 weeks of pregnancy, the fetus:
a. Finishes the final formation of the renal system b. Completes the development of reproductive organs c. Experiences the closure of the foramen ovale d. Increases weight through fat accumulation |
D
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The determination of an accurate EDB is best
accomplished by using: a. The first day of the last menstrual period b. A complete menstrual history c. The use of Naegele’s rule d. Date when symptoms of pregnancy began |
B
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Dating of pregnancy by USG is most accurate in
the first trimester using: a. Crown rump length (CRL) b. Head circumference c. Abdominal circumference d. Femur length |
A
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Which of the following statements most accurately
reflects the growth of the pregnant uterus? a. At 14 weeks it begins to rise out of the pelvis, and at 24 weeks is at the umbilicus. b. At 14 weeks it is halfway to the umbilicus, and at 20 weeks is at the umbilicus. c. At 12 weeks it begins to rise out of pelvis, and at 20 weeks is at the umbilicus. d. At 10 weeks it begins to rise out of the pelvis, and at 16 weeks is at the umbilicus. |
C
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Which of the following is a presumptive sign of
pregnancy seen in the vagina? a. Hegar’s b. Piskacek’s c. Goodell’s d. Chadwick’s |
D
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Which of the following is a presumptive sign of
pregnancy seen in the vagina? a. Hegar’s b. Piskacek’s c. Goodell’s d. Chadwick’s |
C
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91. Of the four pelvic types, which is more likely to
lead to a posterior position with higher possibility of dystocia? a. Android b. Platypelloid c. Anthropoid d. Gynecoid |
A
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The characteristic gait of pregnancy results
from: a. Shift in the center of gravity as uterus enlarges b. Effects of relaxin and estrogen c. Effects of relaxin and progesterone d. Effects of increasing amounts of estrogen and progesterone |
C
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The effect of pregnancy on the cardiovascular
system is most clearly seen in: a. Lower diastolic blood pressure in third trimester b. 10% cardiac volume increase that peaks in midpregnancy c. Resting pulse increase of 10–15 beats in first trimester d. Slight decrease in cardiac output in second trimester |
B
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The usual 1 g drop in hemoglobin during pregnancy
is due to: a. Blood volume increase of 30–50% b. Decrease in iron absorption c. Decrease in production of RBC d. Increasing iron needs of the fetus |
A
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Which of the following is considered a
risk factor for psychological well-being in pregnancy? a. Limited support network b. Introversion at any point c. Ambivalence anytime d. Concern about the danger signs |
A
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The maternal mortality ratio is defined as the
number of maternal deaths that result from the reproductive process per: a. 1000 live births b. 100,000 live births c. 100,000 pregnant women d. 100,000 reproductive age women |
B
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G. R. comes for her first pregnancy visit. Her
obstetrical history includes one spontaneous abortion, one termination of pregnancy, one infant born at 36 weeks and one born at 41 weeks. Both infants are living. Her parity is: a. 2022 b. 2122 c. 1212 d. 1122 |
D
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The pelvic planes of obstetrical significance are
the: a. Inlet, midplane, and outlet b. Inlet, posterior outlet, and anterior outlet c. Inlet, posterior midplane, and anterior midplane d. Linea terminalis, posterior outlet, and anterior outlet |
A
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Which of the elements of clinical pelvimetery
defines the midplane? a. Diagonal conjugate b. Intertuberous diameter c. Ischial spines distance and sacrum d. Pubic arch |
C
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Amniocentesis is used in early pregnancy to:
a. Screen for fetal anomalies b. Diagnose fetal genetic well-being c. Evaluate maternal genetic problems d. Determine AFI and muscle tone |
B
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Chorionic villous sampling (CVS) has an advantage
over amniocentesis because it: a. Can be done 3–4 weeks earlier b. There is less risk for infection c. There is less risk for limb deformities d. There is greater specificity in test results |
A
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When considering the use of fetal movement
counting for a particular woman, it is important to know that: a. Fetuses move constantly so it can be done at any time. b. Fetal movement is strongest at 29–38 weeks. c. Most women don’t feel the fetus move before 24 weeks. d. There is only one way to perform fetal movement counts. |
B
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The basis for the nonstress test (NST) to assess
fetal well-being is that: a. Fetal movement will increase the mother’s heart rate. b. The fetus responds to an increase in heart rate by accelerating movement. c. Fetal movement should cause no significant change in FHR. d. Fetal heart rate accelerates in association with fetal movement. |
D
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Contraindications to contraction stress testing
(CST) include: a. Gestational age greater than 37 weeks b. History of ectopic pregnancy c. Nonreactive nonstress test (NST) d. Placenta previa |
D
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Cordocentesis may be used:
a. As an adjunct to chorionic villi sampling (CVS) b. To obtain blood samples for fetal fibronectin test c. To provide fetal blood transfusion d. To relieve pressure on a prolapsed cord |
C
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Substances classified as addictive:
a. Are only illegal drugs b. Include only those inhaled or injected c. Include both legal and illegal drugs d. Do not include alcohol |
C
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Which of the following is most common during
pregnancy? a. Binge drinking b. Cigarette smoking c. Marijuana smoking d. Occasional alcohol use |
B
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When faced with a woman who manifests clear
evidence of being a victim of violence, your first goal is: a. Evaluate her safety b. Get her to a shelter c. Tell her to press charges d. Get photos of all injuries |
A
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Correct information concerning pregnancies
with first trimester bleeding includes: a. Approximately 10% of women have some bleeding in the first trimester. b. Bleeding that occurs between 10 and 12 weeks is often caused by implantation. c. Cervical incompetence is a common cause of first trimester bleeding. d. 90% of pregnancies in which FHT are heard will continue to term after early bleeding. |
D
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A patient presents with an LMP of 8 weeks
ago and a positive urine pregnancy test. She is having a small amount of bleeding for the past 12 hours, along with some mild abdominal cramping. A pelvic exam reveals a closed cervix and a slightly enlarged uterus. Differential diagnosis for this woman includes: a. Complete abortion and threatened abortion b. Ectopic pregnancy and inevitable abortion c. Ectopic pregnancy and threatened abortion d. Incomplete abortion and inevitable abortion |
C
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An example of an autosomal recessive disease
is: a. BRCA 2 breast cancer b. Cystic fibrosis c. Hemophilia d. Trisomy 21 |
B
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A 34-week pregnant woman presents stating
she noticed a small amount of blood on her underwear this morning about an hour after having sexual intercourse. She is not having any pain or contractions. Your initial differential diagnosis for this woman would include: a. Cervicitis b. Incompetent cervix c. Placental abruption d. Premature rupture of membranes |
A
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Risks to the fetus in a postterm pregnancy are
related to all of the following except: a. Fetal macrosomia b. Meconium aspiration c. Polyhydramnios d. Uteroplacental insufficiency |
C
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Symmetric growth restriction is more likely than
asymmetric growth restriction to: a. Be related to multiple gestation b. First become apparent in late pregnancy c. Occur as a result of maternal medical illness d. Result from maternal cigarette smoking |
D
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Loss of a fetus in the second trimester is most
frequently related to: a. Hydatidiform mole b. Inevitable abortion c. Ectopic pregnancy d. Incompetent cervix |
B
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As a result of an early USG, a low-lying placenta
is verified for B. T. What do you tell her regarding this? a. Approximately 30% of women with lowlying placenta in early pregnancy will have placenta previa in the third trimester. b. Approximately 30% of women have a lowlying placenta in the first trimester. c. Regular vaginal examinations will be done in the third trimester to monitor any obstruction of the cervix. d. Vaginal delivery is contraindicated if there is a marginal placenta previa. |
B
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A pregnant woman has the following history:
vaginal delivery at 38 wks; spontaneous abortion at 8 wks; elective abortion at 13 wks; vaginal delivery at 34 wks; 2 living children; is now 28 wks pregnant. Her gravity and parity are: a. G5 P1122 b. G5 P0222 c. G3 P2002 d. G3 P2112 |
A
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Which of the following tests is diagnostic rather
than screening? a. MSAFP b. Nuchal translucency US c. Amniocentesis d. USG at 10 weeks |
C
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An elevated maternal AFP result is associated
with which of the following? a. Down syndrome b. Neural tube defect c. Autosomal recessive gene d. X-linked recessive inheritance |
B
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Which of the following factors would predispose
a pregnant woman to having a baby with GBS disease? a. History of previous GBS-positive infant b. Bacterial vaginosis in current pregnancy c. Frequent urinary tract infections prior to pregnancy d. Streptococcal pharyngitis in the third trimester |
A
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V. R. comes for her 38-week visit, during which
she reports that her friend gave birth last week and had a placental abruption. She is now concerned that she might have the same. What information would you share with her about this? a. In the event of bleeding near term, 50% are related to placental abruption. b. In the third trimester, she has a 30% chance of having a placental abruption. c. The likelihood of her having this occur is basically zero at this time. d. It is associated with risk factors such as hypertension, smoking, and trauma. |
D
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Genotype refers to:
a. The expression of genes present in an individual b. The dominant genes that will be inherited by a fetus c. The pair of genes for each characteristic inherent in an individual d. The recessive genes that will be passed on to a fetus |
C
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Which of the following women should receive
RhoGAM postpartum? a. Nonsensitized Rh negative mother with an Rh negative baby b. Nonsensitized Rh negative mother with an Rh positive baby c. Sensitized Rh negative mother with an Rh negative baby d. Sensitized Rh negative mother with an RH positive baby |
B
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124. Aneuploidy describes which of the following
situations? a. Down syndrome b. BRCA 1 and 2 inheritance c. Cystic fibrosis genes d. Sickle cell anemia |
A
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B. T., G2 P0010, comes for her first antepartal
visit. Her history indicates she had a pregnancy loss at 18 weeks. She is gravely concerned that it will happen again in this pregnancy. You discuss cervical cerclage, mentioning the following facts: a. Will be done after 12–14 weeks and is 80–90% successful b. Will be done after 16–20 weeks and is 80–90% successful c. Will be done after 16–20 weeks and is 50–60% successful d. Will be done after 12–14 weeks and is 50–60% successful |
A
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The CDC’s recommended treatment for primary
syphilis in a 10-week pregnant woman is: a. Benzathine penicillin G 2.4 units IM x 1 dose after the first trimester b. Benzathine penicillin G 2.4 units IM x 1 dose at the time of diagnosis c. Benzathine penicillin G 2.4 units IM weekly x 3 doses d. Benzathine penicillin G 2.4 units IM at the time of diagnosis and repeat in 4 weeks if no decline in RPR titer |
B
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At an initial prenatal visit, a woman is diagnosed
with bacterial vaginosis. She is not having any symptoms of vaginal infection. You will advise her that: a. All pregnant women should be treated if they have asymptomatic bacterial vaginosis. b. Pregnant women who are at risk for preterm delivery should be treated if they have asymptomatic bacterial vaginosis. c. Only pregnant women at risk for preterm delivery should be treated for symptomatic bacterial vaginosis. d. Pregnant women who are at risk for preterm delivery should be tested for asymptomatic bacterial vaginosis in early third trimester. |
B
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CDC’s recommended treatment for trichomoniasis
during pregnancy is: a. Metronidazole 2 g orally b. Clindamycin 300 mg orally bid x 7 days c. Azithromycin 1 g orally d. Ceftriaxone 125 mg IM |
A
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Symmetric intrauterine growth restriction:
a. Generally becomes evident in midpregnancy b. Is usually associated with placental abnormalities c. Is caused by conditions that result in a reduction in cell size d. Is a neonatal diagnosis made when the infant falls below the 10th percentile |
A
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M. K. is a 34-year-old G5 P4004. Her 1-hour
50 g glucose challenge test at 28 weeks was 154 mg/dL. Follow-up 100 g glucose tolerance test produced the following results: 100, 192, 185, and 160 mg/dL. Your plan for M. K. includes: a. Obtaining fasting glucose tests at 32 and 36 weeks to assure that levels stay at or below 100 mg/dL b. Referring her to a nutritionist to help her limit further weight gain to no more than 10 lb. c. Referring her to a perinatologist for periumbilical blood sampling to determine fetal blood glucose levels d. Screening for diabetes at 6–12 weeks postpartum |
D
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At 20 weeks’ gestation a pregnant woman
was seen and fundal height was 1 cm below the umbilicus. At today’s 24-week visit, fundal height is at the umbilicus. She is feeling regular fetal movement and fetal heart rate is 140 bpm. The most appropriate management for this patient is: a. Ordering a biophysical profile b. Ordering an ultrasound c. Performing a nonstress test at this visit d. Scheduling her next visit for 4 weeks from today |
B
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Ectopic pregnancy is consistent with no intrauterine
sac on transvaginal ultrasound and an hCG titer of less than: a. 100 IU/L b. 1500 IU/L c. 6500 IU/L d. 10,000 IU/L |
C
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L. H. is an 18-year-old female who is 16 weeks
pregnant. She has a positive chlamydia test. Appropriate management includes: a. Erythromycin base 500 mg orally qid for 7 days and ceftrixone 125 mg IM b. Azithromycin 1 g orally in a single dose and perform test of cure in 3–4 weeks c. Ofloxacin 300 mg orally bid for 7 days and rescreen in the third trimester d. Spectinomycin 2 g IM now and repeat in 1 week |
B
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M. I. is a 29-year-old G4 P2012 at 41 weeks
today. She complains of occasional cramping, denies leaking/bleeding, but states she passed her “mucus plug” yesterday. She asks how she’ll know if she’s in labor since both her previous births were induced. You respond that: a. True labor occurs when contractions are 7–8 minutes apart and last for 45 seconds. b. Real labor is when contractions are 2–3 minutes apart and are very painful. c. Labor contractions usually become more regular and more intense over time. d. Contractions begin slowly; once they are 4–5 minutes apart, it is real labor. |
C
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Hyperthyroidism in pregnancy is diagnosed by:
a. Elevated free thyroxine (T4) levels b. Low free T3 levels c. Elevated TSH d. Elevated total thyroxine (TT4) levels |
A
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ABO incompatibility occurs in what percentage
of pregnancies? a. 15% b. 20–25% c. 25–40% d. 5–8% |
B
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T. W., a 32-year-old G2 P1001, is Rh negative.
Her first pregnancy was uneventful, and she received RhoGAM after the birth. She read on the Internet that problems were much more likely with the second pregnancy. You respond that: a. Since she reports she has had no transfusions since the previous birth, there is no problem. b. The RhoGAM she received in the last pregnancy will prevent any problems in this pregnancy. c. She was not sensitized in the first pregnancy, and you will provide monitoring and treatment to prevent it in this pregnancy. d. It is likely that her fetus is Rh– so there is no real concern that she will have any problems related to this. |
C
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At 28 weeks’ gestation, a patient’s Hgb is 11.2
g/dL. At her initial first trimester visit, her Hgb was 12.8 g/dL. Management will include: a. Obtaining a CBC and ferritin level b. Asking if she is having difficulty tolerating her iron supplement and change to a different type if needed c. Rechecking her history to see if she may be at risk for an inherited anemia d. Encouraging her to continue getting dietary iron and taking her iron supplement |
D
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Folic acid deficiency anemia is characterized by:
a. Hemoglobin at 9 g/dL or less b. Low ferritin levels c. Elevated serum iron binding capacity d. Macrocytic erythrocytes |
D
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Which of the following statements is true concerning
sickle cell hemoglobinopathies: a. Trait indicates that one parent has sickle cell disease. b. Disease is present when the person inherits a sickle cell gene from each parent. c. G-6-PD deficiency is a potential complication of sickle cell disease. d. 1 in 100 African Americans has sickle cell trait. |
B
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Normal changes of pregnancy may confound
a diagnosis of appendicitis. With this in mind, you should note the following as a critical sign or symptom pointing to possible appendicitis in pregnancy: a. Persistent abdominal pain and tenderness b. Intermittent lower abdominal cramping c. Elevated WBC level d. Nausea and vomiting |
A
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M. D., a 32-year-old P1, during a discussion of
infant care and breastfeeding, says, “My first baby didn’t like the breast, then I didn’t have enough milk, so I stopped breastfeeding after two weeks.” What is your response to her statement? a. Tell her she probably misinterpreted what was going on and shouldn’t have stopped nursing. b. Delve further into what occurred and how she came to the conclusions that led her to stop breastfeeding. c. Let her know she probably wasn’t drinking enough fluids so didn’t have enough milk to feed the baby. d. Reassure her that she was listening to her body and had done the right thing for herself and her infant. |
B
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M. B., G1 P0, comes for her 36-week visit with a
piece of paper in her hand. “I’m really confused about this birth plan business. What am I supposed to do about my birth? Don’t I just show up when I’m in labor?” How will you counsel her today? a. “It really doesn’t matter what you write because the hospital has its own plan.” b. “You will need to be very detailed about each element of the birth experience so you get what you want.” c. “The plan provides the opportunity for you to make choices about events associated with the birth.” d. “The healthcare provider who is there when you are in labor will tell you what is best for you and how to do it.” |
C
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Y. L., G2 P1001, comes for her first visit. She is
concerned about the possibility of a UTI since her sister was recently hospitalized for pyelonephritis. What facts would you give her to enhance her understanding? a. UTIs do occur in about 10% of pregnancies. b. 25% of women with UTI in pregnancy will develop pyelonephritis. c. If she has a history of UTIs before pregnancy, she will be screened with a urine culture each trimester. d. Pregnant women are typically screened for asymptomatic bacteruria in early pregnancy. |
D
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Who is at greatest risk for developing a UTI in
pregnancy? a. Adolescents b. Woman pregnant with twins c. Women older than 35 years d. Woman with diabetes |
D
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L. T. returns for the reading of the PPD that was
placed during her first prenatal visit. You read the result as 10 mm of induration. L. T. is American-born, healthy, and has no known history of contact with the disease. How do you interpret this result to her? a. It is positive and she needs referral to an infectious disease specialist. b. It is unclear and she should have a chest radiograph to be certain. c. It is positive and you should give her a prescription for INH. d. It is negative since she has no high-risk characteristics for the disease. |
D
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Which of the following statements concerning
HIV in women is correct? a. The main route of acquiring the infection in women is IV drug use. b. Viral load is the strongest predictor for transmission of infection to infant during birth process. c. C-section is the recommended route of delivery for all HIV-infected women to reduce the risk of transmission of infection to infant. d. Breastfeeding should only be recommended if the mother’s viral load is less than 200 copies/ml. |
B
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S. R. has reached her 39th week of pregnancy.
On abdominal exam you measure a fundal height of 42 cm. Leopold’s maneuvers provides you with an EFW of 4200 g. What factors would help to ease your mind about the fetal size? a. She has wide hips and will have no problem with a big baby. b. She is 5 ft 10 in with an anthropoid pelvis and her husband is 6 ft 4 in. c. She is totally unconcerned and knows this baby will fit. d. The fetus is not yet engaged so the height is greater than expected. |
B
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Many conditions are associated with preterm
birth. Of the 28% of births that occur preterm, what is the condition that contributes most to these births? a. IUGR b. Preeclampsia c. Fetal demise d. Abruptio placenta |
B
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A patient who is 32 weeks pregnant has had
symptoms of preterm labor and has a history of preterm delivery at 34 weeks. A fetal fibronectin test is negative. You advise her that: a. She has a 60% chance of going into labor within the next week. b. It is really too early in her pregnancy for this test to be of much value. c. The result offers some reassurance that she will not go into labor in the next 2 weeks. d. It is really too late in her pregnancy for this test to be of much value. |
C
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A decision is made to start tocolytic therapy for
a 30-week gestation woman in preterm labor. Betamethasone IM has also been ordered. This is done because the administration of corticosteroids: a. Decreases the respiratory side-effects of tocolytic drugs b. Decreases the incidence of premature rupture of membranes c. Enhances the effects of tocolytic drugs d. Reduces the incidence of newborn respiratory distress syndrome |
D
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G. F. comes for her 32-week visit, and you determine
she has a breech presentation. Your plan for her is to: a. Send her to Maternal Fetal Medicine for external cephalic version b. Refer her to perinatologist for care decision and treatment c. Send her for ultrasound to confirm breech presentation d. Wait until 36 weeks to see if spontaneous version has occurred |
D
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A pregnant woman presents for her 32-week
visit with no complaints. All findings from previous visits have been normal. Today she has blood pressure of 145/95. Expected additional findings if she has mild preeclampsia include: a. Lower extremity edema b. 1 to 2+ proteinuria on dipstick urine c. Right upper epigastric pain d. Elevated liver function tests |
B
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