A second triple screen on a 35-year old primigravida reveals abnormally low levels of alpha fetoprotien and estriol and high levels of HCG. Which of the following interventions is the best choice for this patient?
Order and ultrasound
Ordera a CT scan of the abdomen
Order a 24-hour urine protein clearance
Assess for a history of illicit drug or alcohol use
A 36-year old primigravida who is at 28 weeks of gestations expecting twins. What would you expect her alpha-alpha-fetoprotien values to be?
Higher than normal
Lower than normal
None of the above
A multigravida who is at 28 weeks of gestation has a fundal height of 29 cm. Which of the following is the best recommendation for this patient?
Advise the mother that her pregnancy is progressing well
Order an ultrasound of the uterus
Refer her to an obstetrician for an amniocentesis
Recommend bed rest with bathroom privileges
A multigravida who is 34 weeks gestation want to know at what level her uterine fundus should be. The best answer is to tell the mother that her fundus is:
Midway between the umbilicus and the lower ribs
At the level of the umbilicus
From 33-35 cm
From 32-34 cm
A 28-year old multipara who is 32 weeks of gestation presents to your office complaining of sudden onset of small amount of bright red vaginal bleeding. She has had several episodes and appears anxious. On exam, her uterus is soft to palpation. Which of the following is most likely?
Molar pregnancy (hydatidiform mole)
A 30-year-old primigravida is diagnosed with a possible threatened abortion. The result of the urine pregnancy test is positive. Which of the following is TRUE regarding threatened abortion?
Vaginal bleeding and cramping are present, but the cervix remains closed
Vaginal bleeding and cramping are present along with a dilated cervix
The fetus and the plant are expelled
The products of conception and the placenta remain inside the uterus along with a dilated cervix
A pelvic exam on a woman who is 12 weeks pregnant would reveal that her uterus is located at which of the following areas?
Between the umbilicus and the suprapubic bone
Just rising above the suprapubic bone
Between the suprapubic bone and the xiphoid process
Between the umbilicus and the xiphoid process
A positive Coombs test on an Rh- pregnant woman means:
The mother has autoantibodies against Rh+ RBCs
The fetus has autoantibodies against maternal RBCs
The mother does not have Rh factor against fetal RBCs
The fetus does not have RBC autoantibodies
Folic acid supplementation is recommended for women who are planning pregnancy in order to"
Prevent renal agenensis
Prevent kidney defects
Prevent heart defects
An Rh- pregnant woman with negative rubella titters should be vaccinated at what time period in her pregnancy?
She can be vaccinated at any time of her pregnancy
During the second trimester
During the third trimester
During the postpartum period
The majority of the serum alpha fetoprotein is produced by the:
Fetal neural tube
HCG is produced by the:
You note the following routine urinalysis on a 37-year-old primagravida who is at 30 weeks gestation. Leukocytes=trace, nitrate=negative, protein=+2, blood=negative. Her weight has increase by 5ls during the past week. Which of the following is most likely?
Eclampsia of pregnancy
The positive signs of pregnancy include:
Palpation of the fetus and auscultation of the FHTs by the nurse practitioner
Palpation of the fetus and positive quantitative serum pregnancy test
FHTs and a + quantitative serum pregnancy test
FHTs and feeling movement of the baby by the mother
Chadwick's sign is characterized by:
Softening of the cervix
Blue coloration of the cervix and the vagina
Softening of the uterine isthmus
Nausea and vomiting during the first trimester
Hegar's sign is considered a:
Positive sign of pregnancy
Probable sign of pregnancy
Presumptive sign of pregnancy
Problem in pregnancy
When palpating a women who is at 20 weeks gestation, the NP should be able to feel the uterine fundus at what level?
Just rising out of the level of the pubis symphysis
Between the pubis symphysis and the umbilicus
Above the level of the umbilicus
A 38-year-old multigravida who is at 32 weeks gestation calls the FNP complaining of bright red vaginal bleeding. There is no watery d/c. She ocomplains that her uterus feels hard and very painful. Which of the following conditions is most likely?
A molar pregnancy
An ectopic pregnancy
Which of the following is contraindicated in the care of pregnant women with placenta previa?
RhoGAM's mechanism of action is:
The destruction of Rh+ fetal RBCs that are present in the mother's circulation
The destruction of maternal antibodies against Rh+ fetal RBCs
The stimulation of maternal antibodies so that there is a decreased risk of hemolysis
The destruction of maternal antibodies against fetal RBCs
A women at 32 weeks gestations a + throat culture for strep pyogenes. She denies allergies but gets very nauseated with erythromycin. Which of the following is the best choice for this pregnant patient?
Trimethoprim/sulfamethoxazole (Bactrim DS)
Penicillin (Pen VK)
Women who are pregnant in the winter months are commanded to have which of the following?
Increased intake of Vitamin C and foals
Vaccination against the influenza virus
Increased caloric intake of fruits and vegetables
Heavier winter clothes to avoid chilling the fetus
Which of the following conditions is a possible complication of severe eclampsia?
All of the following are not recommended for the outpatient treatment of mild preeclampsia except:
Severe sodium restriction
Restrict fluid intake to less than 1 liter/day
Aldomet (methyldopa) 250 mg PO BID
Bed rest on the left side with bathroom privleges
Normal weight gain for a healthy weight before pregnancy woman would be: