Question 1

The fundus of a pregnant woman is located just above the symphysis pubis. This indicates a pregnancy of:

Accepted Answer

A)  16 weeks 
B)  12 weeks 
C)  10 weeks 
D)  6 weeks 
A)  16 weeks 
B)  12 weeks 
C)  10 weeks 
D)  6 weeks B

Question 2

A pregnant woman with hyperemesis gravidarum should be checked for:

Accepted Answer

A)  Multiple pregnancy 
B)  Hyperadrenalism 
C)  Hyperthyroidism 
D)  Fibroid tumor 
A)  Multiple pregnancy 
B)  Hyperadrenalism 
C)  Hyperthyroidism 
D)  Fibroid tumor C

Question 3

Estimated date of delivery is calculated by:

Accepted Answer

A)  Adding 7 days to the date of the last menstrual period and subtracting 3 months 
B)  Adding 9 months to the date of the last menstrual period 
C)  Most accurately by ultrasound examination 
D)  A and C 
A)  Adding 7 days to the date of the last menstrual period and subtracting 3 months 
B)  Adding 9 months to the date of the last menstrual period 
C)  Most accurately by ultrasound examination 
D)  A and C A

Question 4

A pregnant patient at 5 weeks gestation reports a slight amount of vaginal bleeding. The clinician should obtain the following laboratory test:

Accepted Answer

A)  Serial human chorionic gonadotropin levels over the next several days 
B)  Measurement of estrogen levels 
C)  Cervical mucus analysis 
D)  Pap smear for sexually transmitted infection 
A)  Serial human chorionic gonadotropin levels over the next several days 
B)  Measurement of estrogen levels 
C)  Cervical mucus analysis 
D)  Pap smear for sexually transmitted infection

Question 5

A diagnosis of hyperemesis gravidarum is associated with:

Accepted Answer

A)  Multiparity 
B)  Low body weight 
C)  Increased body weight 
D)  Food allergies 
A)  Multiparity 
B)  Low body weight 
C)  Increased body weight 
D)  Food allergies

Question 6

A pregnant patient at 6 months gestation who is 37 years old complains of urinary frequency, thirst, increased appetite, and candida vaginitis that is refractory to treatment. The patient has a history of vaginal delivery of a 10-pound neonate 3 years ago. On physical examination, vital signs are: temperature 98.6°F, pulse 88 beats/min, respirations 18 breaths/min, blood pressure 120/70. Heart has a regular rate and rhythm at 88 beats/min, no S3, no murmurs. Lungs are clear to auscultation. Abdominal examination is negative. Uterus fundus is above the umbilicus. Ankles: no edema. Dorsalis pedis pulses +2/4 bilaterally. Urine dipstick is negative for protein, + for glucose and + for ketones. The clinician should consider all of the following except:

Accepted Answer

A)  Obtain a 3-hour glucose tolerance test 
B)  Order an HbA1c blood test 
C)  Obtain a fasting serum glucose 
D)  Review family history of diabetes, including gestational diabetes mellitus 
A)  Obtain a 3-hour glucose tolerance test 
B)  Order an HbA1c blood test 
C)  Obtain a fasting serum glucose 
D)  Review family history of diabetes, including gestational diabetes mellitus

Question 7

If radiological studies are needed to evaluate intra-abdominal conditions during pregnancy, it is important for the clinician to recognize that a(n) _______________ exposes a fetus to ionizing radiation.

Accepted Answer

A)  Ultrasound 
B)  Computed tomography scan 
C)  Magnetic resonance imaging 
D)  Doppler equipment 
A)  Ultrasound 
B)  Computed tomography scan 
C)  Magnetic resonance imaging 
D)  Doppler equipment

Question 8

Your pregnant patient complains of back pain. When inquiring about the pain, the clinician should use the PQRST method. This includes asking the patient about:

Accepted Answer

A)  Radiation 
B)  Severity 
C)  Timing 
D)  All of the above 
A)  Radiation 
B)  Severity 
C)  Timing 
D)  All of the above

Question 9

A pregnant patient complains of nasal stuffiness and rapid breathing. The clinician should recognize that:

Accepted Answer

A)  Elevated progesterone directly stimulates the central respiratory center in pregnancy to enhance loss of CO2 
B)  Elevated estrogen and progesterone levels cause nasal edema 
C)  Elevated estrogen and progesterone cause nasal turbinate enlargement 
D)  All of the above 
A)  Elevated progesterone directly stimulates the central respiratory center in pregnancy to enhance loss of CO2 
B)  Elevated estrogen and progesterone levels cause nasal edema 
C)  Elevated estrogen and progesterone cause nasal turbinate enlargement 
D)  All of the above

Question 10

A pregnant patient at 12 weeks gestation complains of yellow vaginal discharge. Laboratory tests reveal bacterial vaginosis. The clinician should recognize that bacterial vaginosis is:

Accepted Answer

A)  A normal finding in pregnancy 
B)  Associated with preterm labor and delivery 
C)  Diagnosed by a nitrazine test 
D)  Often accompanied by vaginal bleeding 
A)  A normal finding in pregnancy 
B)  Associated with preterm labor and delivery 
C)  Diagnosed by a nitrazine test 
D)  Often accompanied by vaginal bleeding

Question 11

Which of the following statements is true regarding gestational blood pressures?

Accepted Answer

A)  Pre-eclampsia is diagnosed in pregnant women who have a blood pressure greater than 130/80 mm Hg in the third trimester. 
B)  Pre-eclampsia can occur even if the blood pressure is within the accepted normal range. 
C)  Gestational hypertension is defined as a rise in systolic blood pressure of 15 mm Hg and a diastolic blood pressure rise of 30 mm Hg. 
D)  Gestational hypertension is diagnosed if the patient has proteinuria and ankle edema, regardless of blood pressure measures. 
A)  Pre-eclampsia is diagnosed in pregnant women who have a blood pressure greater than 130/80 mm Hg in the third trimester. 
B)  Pre-eclampsia can occur even if the blood pressure is within the accepted normal range. 
C)  Gestational hypertension is defined as a rise in systolic blood pressure of 15 mm Hg and a diastolic blood pressure rise of 30 mm Hg. 
D)  Gestational hypertension is diagnosed if the patient has proteinuria and ankle edema, regardless of blood pressure measures.

Question 12

In a pregnant woman, a glucose screening test should be done at:

Accepted Answer

A)  24 weeks 
B)  20 weeks 
C)  16 weeks 
D)  10 weeks 
A)  24 weeks 
B)  20 weeks 
C)  16 weeks 
D)  10 weeks

Question 13

Your pregnant patient complains of hemorrhoids. On physical examination, vital signs are: temperature 98.6°F, pulse 80 beats/min, respirations 14 breaths/min, blood pressure 110/60. The heart has a regular rate and rhythm, no S3, no murmurs. Lungs are clear to auscultation. Abdominal examination is negative. Uterus fundus is at the umbilicus. Ankles show +1/4 bilateral ankle nonpitting edema. Dorsalis pedis pulses + 2/4 bilaterally. Rectal exam: + external hemorrhoid. Urine dipstick is negative for protein. The clinician should:

Accepted Answer

A)  Explain to the patient to lie in a left lateral recumbent position at night 
B)  Refer the patient to an obstetric physician for a diuretic prescription 
C)  Obtain 24-hour urine for protein 
D)  Obtain HbA1c and fasting serum glucose 
A)  Explain to the patient to lie in a left lateral recumbent position at night 
B)  Refer the patient to an obstetric physician for a diuretic prescription 
C)  Obtain 24-hour urine for protein 
D)  Obtain HbA1c and fasting serum glucose

Question 14

As you assess a pregnant patient, you suspect false small-for-dates presentation. You should recognize that a possible cause for this is:

Accepted Answer

A)  Error in date of last menstrual period 
B)  Fetus in transverse lie 
C)  Error in calculation of fundal height 
D)  All of the above 
A)  Error in date of last menstrual period 
B)  Fetus in transverse lie 
C)  Error in calculation of fundal height 
D)  All of the above

Question 15

Your pregnant patient at 8 months gestation complains of bilateral ankle swelling and no other symptoms. Which of the following findings require further investigation?

Accepted Answer

A)  Ankle swelling that is noticed at the end of the day after standing for a prolonged time 
B)  Weight gain of approximately 1 pound per week 
C)  A systolic rise of 30 mm Hg or diastolic rise of 15 mm Hg over the patient's baseline blood pressure 
D)  Uterine fundus above the umbilicus 
A)  Ankle swelling that is noticed at the end of the day after standing for a prolonged time 
B)  Weight gain of approximately 1 pound per week 
C)  A systolic rise of 30 mm Hg or diastolic rise of 15 mm Hg over the patient's baseline blood pressure 
D)  Uterine fundus above the umbilicus

Question 16

A pregnant patient complains of urinary frequency. She denies fever, dysuria, back pain, or hematuria. Urine dipstick is negative for leukocytes, protein, or blood. The clinician should:

Accepted Answer

A)  Explain to the patient that the uterus places pressure on the bladder during pregnancy 
B)  Advise the patient she needs urine culture and sensitivity 
C)  Obtain a glucose tolerance test 
D)  Obtain 24-hour urine for protein 
A)  Explain to the patient that the uterus places pressure on the bladder during pregnancy 
B)  Advise the patient she needs urine culture and sensitivity 
C)  Obtain a glucose tolerance test 
D)  Obtain 24-hour urine for protein

Question 17

The normal fetal heart rate is:

Accepted Answer

A)  70 to 100 beats/minute 
B)  100 to 110 beats/minute 
C)  110 to 120 beats/minute 
D)  120 to 160 beats/minute 
A)  70 to 100 beats/minute 
B)  100 to 110 beats/minute 
C)  110 to 120 beats/minute 
D)  120 to 160 beats/minute

Question 18

An ultrasound should be performed on all pregnant women at:

Accepted Answer

A)  5 to 6 weeks 
B)  10 to 12 weeks 
C)  16 to 20 weeks 
D)  None of the above 
A)  5 to 6 weeks 
B)  10 to 12 weeks 
C)  16 to 20 weeks 
D)  None of the above

Question 19

A pregnant patient complains of severe fatigue and exercise intolerance. Laboratory tests that should be investigated include:

Accepted Answer

A)  Complete blood count 
B)  Thyroid-stimulating hormone 
C)  T4 
D)  All of the above 
A)  Complete blood count 
B)  Thyroid-stimulating hormone 
C)  T4 
D)  All of the above

Question 20

Your pregnant patient is at 28 weeks gestation and complains of pain that radiates from the wrist into the fingers in the right hand. She is a computer programmer and uses a keyboard daily for 6 hours or more. The clinician should:

Accepted Answer

A)  Ask the person to place dorsal surfaces of hands together to check for Phalen's test 
B)  Teach the patient that carpal tunnel syndrome is common during the last trimester 
C)  Tap the patient's right wrist to try to elicit tingling in the fingers for Tinel's sign 
D)  All of the above 
A)  Ask the person to place dorsal surfaces of hands together to check for Phalen's test 
B)  Teach the patient that carpal tunnel syndrome is common during the last trimester 
C)  Tap the patient's right wrist to try to elicit tingling in the fingers for Tinel's sign 
D)  All of the above

The fundus of a pregnant woman is located just above the symphysis pubis. This indicates a pregnancy of:

A pregnant woman with hyperemesis gravidarum should be checked for:

Estimated date of delivery is calculated by:

A pregnant patient at 5 weeks gestation reports a slight amount of vaginal bleeding. The clinician should obtain the following laboratory test:

A diagnosis of hyperemesis gravidarum is associated with:

If radiological studies are needed to evaluate intra-abdominal conditions during pregnancy, it is important for the clinician to recognize that a(n) _______________ exposes a fetus to ionizing radiation.

Your pregnant patient complains of back pain. When inquiring about the pain, the clinician should use the PQRST method. This includes asking the patient about:

A pregnant patient complains of nasal stuffiness and rapid breathing. The clinician should recognize that:

A pregnant patient at 12 weeks gestation complains of yellow vaginal discharge. Laboratory tests reveal bacterial vaginosis. The clinician should recognize that bacterial vaginosis is:

Which of the following statements is true regarding gestational blood pressures?

In a pregnant woman, a glucose screening test should be done at:

As you assess a pregnant patient, you suspect false small-for-dates presentation. You should recognize that a possible cause for this is:

Your pregnant patient at 8 months gestation complains of bilateral ankle swelling and no other symptoms. Which of the following findings require further investigation?

A pregnant patient complains of urinary frequency. She denies fever, dysuria, back pain, or hematuria. Urine dipstick is negative for leukocytes, protein, or blood. The clinician should:

The normal fetal heart rate is:

An ultrasound should be performed on all pregnant women at:

A pregnant patient complains of severe fatigue and exercise intolerance. Laboratory tests that should be investigated include:

Your pregnant patient is at 28 weeks gestation and complains of pain that radiates from the wrist into the fingers in the right hand. She is a computer programmer and uses a keyboard daily for 6 hours or more. The clinician should:

Assessment and Clinical Decision Making: an Overview

Genomic Assessment: Interpreting Findings and Formulating Differential Diagnosis

Skin

Head, Face, and Neck

The Eye

Ear, Nose, Mouth, and Throat

Cardiac and Peripheral Vascular Systems

Respiratory System

Breasts

Abdomen

Genitourinary System

Male Reproductive System

Female Reproductive System

Musculoskeletal System

Neurological System

Nonspecific Complaints

Psychiatric Mental Health

Pediatric Patients

Assessment of the Transgender or Gender Diverse Adult

Older Patients

Persons With Disabilities

Filters

Exam 19: Pregnant Patients

The fundus of a pregnant woman is located just above the symphysis pubis. This indicates a pregnancy of:

A pregnant woman with hyperemesis gravidarum should be checked for:

Estimated date of delivery is calculated by:

A pregnant patient at 5 weeks gestation reports a slight amount of vaginal bleeding. The clinician should obtain the following laboratory test:

A diagnosis of hyperemesis gravidarum is associated with:

If radiological studies are needed to evaluate intra-abdominal conditions during pregnancy, it is important for the clinician to recognize that a(n) _______________ exposes a fetus to ionizing radiation.

Your pregnant patient complains of back pain. When inquiring about the pain, the clinician should use the PQRST method. This includes asking the patient about:

A pregnant patient complains of nasal stuffiness and rapid breathing. The clinician should recognize that:

A pregnant patient at 12 weeks gestation complains of yellow vaginal discharge. Laboratory tests reveal bacterial vaginosis. The clinician should recognize that bacterial vaginosis is:

Which of the following statements is true regarding gestational blood pressures?

In a pregnant woman, a glucose screening test should be done at:

As you assess a pregnant patient, you suspect false small-for-dates presentation. You should recognize that a possible cause for this is:

Your pregnant patient at 8 months gestation complains of bilateral ankle swelling and no other symptoms. Which of the following findings require further investigation?

A pregnant patient complains of urinary frequency. She denies fever, dysuria, back pain, or hematuria. Urine dipstick is negative for leukocytes, protein, or blood. The clinician should:

The normal fetal heart rate is:

An ultrasound should be performed on all pregnant women at:

A pregnant patient complains of severe fatigue and exercise intolerance. Laboratory tests that should be investigated include:

Your pregnant patient is at 28 weeks gestation and complains of pain that radiates from the wrist into the fingers in the right hand. She is a computer programmer and uses a keyboard daily for 6 hours or more. The clinician should:

Assessment and Clinical Decision Making: an Overview

Genomic Assessment: Interpreting Findings and Formulating Differential Diagnosis

Skin

Head, Face, and Neck

The Eye

Ear, Nose, Mouth, and Throat

Cardiac and Peripheral Vascular Systems

Respiratory System

Breasts

Abdomen

Genitourinary System

Male Reproductive System

Female Reproductive System

Musculoskeletal System

Neurological System

Nonspecific Complaints

Psychiatric Mental Health

Pediatric Patients

Assessment of the Transgender or Gender Diverse Adult

Older Patients

Persons With Disabilities

Filters