Exam 2

Question 1 of 25

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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?

Select one of the following:

  • 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

Question 2 of 25

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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?

Select one of the following:

  • Normal

  • Higher than normal

  • Lower than normal

  • None of the above

Question 3 of 25

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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?

Select one of the following:

  • 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

Question 4 of 25

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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:

Select one of the following:

  • Midway between the umbilicus and the lower ribs

  • At the level of the umbilicus

  • From 33-35 cm

  • From 32-34 cm

Question 5 of 25

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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?

Select one of the following:

  • Placenta abruptio

  • Placental previa

  • Acute cervictitis

  • Molar pregnancy (hydatidiform mole)

Question 6 of 25

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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?

Select one of the following:

  • 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

Question 7 of 25

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A pelvic exam on a woman who is 12 weeks pregnant would reveal that her uterus is located at which of the following areas?

Select one of the following:

  • 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

Question 8 of 25

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A positive Coombs test on an Rh- pregnant woman means:

Select one of the following:

  • 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

Question 9 of 25

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Folic acid supplementation is recommended for women who are planning pregnancy in order to"

Select one of the following:

  • Prevent renal agenensis

  • Prevent anencephaly

  • Prevent kidney defects

  • Prevent heart defects

Question 10 of 25

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An Rh- pregnant woman with negative rubella titters should be vaccinated at what time period in her pregnancy?

Select one of the following:

  • She can be vaccinated at any time of her pregnancy

  • During the second trimester

  • During the third trimester

  • During the postpartum period

Question 11 of 25

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The majority of the serum alpha fetoprotein is produced by the:

Select one of the following:

  • Fetal liver

  • Mother's liver

  • Placenta

  • Fetal neural tube

Question 12 of 25

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HCG is produced by the:

Select one of the following:

  • Placenta

  • Hypothalamus

  • Anterior pituitary

  • Ovaries

Question 13 of 25

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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?

Select one of the following:

  • HELLP Syndrome

  • Preeclampsia

  • Eclampsia of pregnancy

  • Primary HTN

Question 14 of 25

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The positive signs of pregnancy include:

Select one of the following:

  • 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

Question 15 of 25

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Chadwick's sign is characterized by:

Select one of the following:

  • Softening of the cervix

  • Blue coloration of the cervix and the vagina

  • Softening of the uterine isthmus

  • Nausea and vomiting during the first trimester

Question 16 of 25

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Hegar's sign is considered a:

Select one of the following:

  • Positive sign of pregnancy

  • Probable sign of pregnancy

  • Presumptive sign of pregnancy

  • Problem in pregnancy

Question 17 of 25

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When palpating a women who is at 20 weeks gestation, the NP should be able to feel the uterine fundus at what level?

Select one of the following:

  • Just rising out of the level of the pubis symphysis

  • Between the pubis symphysis and the umbilicus

  • At the level of the umbilicus

  • Above the level of the umbilicus

Question 18 of 25

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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?

Select one of the following:

  • Placenta previa

  • Placenta abruptio

  • A molar pregnancy

  • An ectopic pregnancy

Question 19 of 25

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Which of the following is contraindicated in the care of pregnant women with placenta previa?

Select one of the following:

  • Echocardiogram

  • Intravaginal U/S

  • Abdominal U/S

  • Pelvic U/S

Question 20 of 25

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RhoGAM's mechanism of action is:

Select one of the following:

  • 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

Question 21 of 25

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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?

Select one of the following:

  • Clarithromycin (Biaxin)

  • Trimethoprim/sulfamethoxazole (Bactrim DS)

  • Ofloxacin (Floxin)

  • Penicillin (Pen VK)

Question 22 of 25

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Women who are pregnant in the winter months are commanded to have which of the following?

Select one 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

Question 23 of 25

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Which of the following conditions is a possible complication of severe eclampsia?

Select one of the following:

  • Placenta previa

  • Placenta abruptio

  • Erythroblastosis fetalis

  • Uterine rupture

Question 24 of 25

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All of the following are not recommended for the outpatient treatment of mild preeclampsia except:

Select one of the following:

  • 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

Question 25 of 25

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Normal weight gain for a healthy weight before pregnancy woman would be:

Select one of the following:

  • 35-45

  • 25-35

  • 28-40

  • 15-20

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Exam 2 Practice for Child rearing/bearing

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