APEA Pregnancy

APEA Pregnancy

Question:

What is the standard instrument used to auscultate fetal heart tones?

 

StethoscopeDoppler  CorrectPre-natal monitorUltrasound

 

Explanation:

The Doppler fetal rate monitor is the standard instrument used for this measurement, and can detect the fetal rate (FHR) as early as 10 weeks gestation.

Question:

During pregnancy, what sound may be auscultated at the second or third intercostal space at the sternal border due to increased blood flow through the vessels?

 

Diastolic murmur  IncorrectSystolic murmurVenous hum  CorrectBruit

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Explanation:

A venous hum, or continuous mammary souffle that occurs during pregnancy is due to increased blood flow through normal vessels. The mammary souffle is commonly heard during late pregnancy or lactation. It is heard loudest in the second or third intercostal space at the sternal border, and is typically both systolic and diastolic, though only the systolic component may be audible. APEA Pregnancy.

Question:

If regular uterine contractions occur prior to 37 weeks gestation, this could be:

 

a normal finding.  Incorrectpreterm labor.  Correctpreeclampsia.supine hypotensive syndrome.

 

Explanation:

Before 37 weeks, regular uterine contractions with or without pain and bleeding are abnormal, suggesting preterm labor.

Question:

Weight gain should be monitored during pregnancy. For a pregnant woman whose BMI is 18.5 – 24.9, the total weight gain should be:

 

11-20 pounds.15-25 pounds.25-35 pounds  Correct28-40 pounds.

 

Explanation:

Weight gain should be closely monitored during pregnancy, as both excessive and inadequate weight gain are associated with poor birth outcomes. The pregnant woman who has a BMI of <18.5, should gain 28 – 40 pounds; BMI 18.5-24.9 should gain 25 – 35 pounds; BMI 25-29.9 should gain 15 – 25 pounds; and the obese pregnant woman should gain 11 – 20 pounds APEA Pregnancy.

Question:

During pregnancy, a palpable softening of the cervical isthmus is noted. This finding is:

 

Hegar’s sign.  CorrectChadwick’s sign.striae gravidarum.linea nigra.

 

Explanation:

Hegar’s sign is the palpable softening of the cervical isthmus, the portion of the uterus that narrows into the cervix. Increased vascularity throughout the pelvis during pregnancy gives the vagina a bluish color, known as Chadwick’s sign. As the skin over the abdomen stretches to accommodate the fetus, purplish striae gravidarum (“stretch marks”) may appear. Linea nigra is a brownish black pigmented vertical stripe along the midline skin of the abdomen.

Question:

As tension on the abdominal wall increases with advancing pregnancy, the rectus abdominis muscles may separate at the midline of the abdomen. This finding is termed:

 

striae gravidarum.linea nigra.adnexae.diastasis recti.  Correct

 

Explanation:

As tension on the abdominal wall increases with advancing pregnancy, the rectus abdominis muscles may separate at the midline: this is diastasis recti. If diastasis is severe, especially in multiparous women, only a layer of skin, fascia, and peritoneum may cover the anterior uterine wall, and fetal parts may be palpable through this muscular gap. APEA Pregnancy.

Question:

Facial edema in a pregnant woman after 20 weeks gestation, could be:

 

a normal finding.suggestive of preeclampsia.  Correctrenal failure.  Incorrectheart failure.

 

Explanation:

Facial edema in a pregnant woman after 20 gestational weeks may reflect preeclampsia and should be investigated.

Question:

Weight gain should be monitored during pregnancy. For a pregnant woman whose BMI is < 18.5, the total weight gain should be:

 

11-20 pounds.15-25 pounds.25-35 pounds28-40 pounds.  Correct

 

Explanation:

Weight gain should be closely monitored during pregnancy, as both excessive and inadequate weight gain are associated with poor birth outcomes. The pregnant woman who has a BMI of <18.5, should gain 28 – 40 pounds; BMI 18.5-24.9 should gain 25 – 35 pounds; BMI 25-29.9 should gain 15 – 25 pounds; and the obese pregnant woman should gain 11 – 20 pounds.

Question:

Murmurs audible during pregnancy may suggest:

 

preeclampsia.hypertension.  Incorrectanemia.  Correctpulmonary embolus.

 

Explanation:

Murmurs audible during pregnancy may suggest anemia. However, benign systolic murmurs can be heard in pregnant women after the first trimester.

Question:

What is the importance of prenatal care?

 

Determines gestational age Estimates expected date of deliveryOptimizes health and minimizes risk for mother and fetus  CorrectObtain family history

 

Explanation:

Prenatal care focuses on optimizing health and minimizing risk for the mother and fetus. Goals of the initial prenatal visit are to confirm the pregnancy, assess the health of the mother and risks of complications, and counsel the mother about expectations for the pregnancy. APEA Pregnancy.

Question:

During pregnancy, which hormone promotes endometrial growth that supports the early embryo?

 

Progesterone  IncorrectHuman chorionic gonadotropin (HCG)Estrogen  CorrectHuman placental lactogen

 

Explanation:

Estrogen promotes endometrial growth that supports the early embryo. This hormone appears to stimulate prolactin output in the anterior lobe of the pituitary gland, which readies breast tissue for lactation. Estrogen also contributes to the hypercoagulable state that puts pregnant women at higher risk for thromboembolic events.

Question:

B/P readings greater than 140 mm HG systolic and greater than 90 mm HG diastolic prior to pregnancy, before 20 weeks gestation, or beyond 12 weeks postpartum is:

 

gestational hypertension.preeclampsia.chronic hypertension.  Correctprimary hypertension.  Incorrect

 

Explanation:

Chronic hypertension occurs when systolic BP (SBP) >140 mm Hg or diastolic BP (DBP) >90 mm Hg documented prior to pregnancy, before 20 weeks, or beyond 12 weeks postpartum. Gestational hypertension refers to elevated blood pressure detected after 20 weeks gestation in the absence of proteinuria. Pre-eclampsia occurs in a woman who was previously normotensive but now has new onset hypertension with either proteinuria or end-organ damage. APEA Pregnancy. Primary hypertension, formerly known as essential hypertension, is a disorder which is associated with elevated blood pressure and an unidentifiable cause.

Question:

Pregnant women should avoid unpasteurized dairy products, such as soft cheese, raw eggs, and delicatessen meats because of the risk of:

 

ingesting large amounts of mercury.ingestion large amounts of vitamin A.contracting toxoplasmosis.  Correctcontracting botulism.   Incorrect

 

Explanation:

Pregnant patients should avoid unpasteurized dairy products, soft cheeses, raw eggs, and delicatessen meats due to the risk of Listeria, Salmonella, and toxoplasmosis.

Question:

When performing a pelvic exam on a pregnant woman, a larger speculum may be needed because of:

 

increased vascularity of the vagina.vaginal wall relaxation.  Correctincreased vascularity of the cervical structures.swelling in the vaginal cavity.

 

Explanation:

Because of vaginal wall relaxation, a larger than usual speculum may be needed.

Question:

During pregnancy, which hormone is produced by the placenta and supports progesterone synthesis in the corpus luteum?

 

ProgesteroneHuman chorionic gonadotropin (HCG)  CorrectEstrogenHuman placental lactogen

 

Explanation:

Human chorionic gonadotropin (HCG) is produced by the placenta and supports progesterone synthesis in the corpus luteum, effectively preventing the early embryo from being lost to menstruation. APEA Pregnancy.

Question:

When performing the first Leopold maneuver on a pregnant woman, if the fetal buttocks and head are easily palpated at the fundus, the fetus is said to be in:

 

vertical lie.  Correcttransverse lie.face presentation.vertex presentation.  Incorrect

 

Explanation:

The top of the uterus (fundus) is palpated to establish which end of the fetus (fetal pole) is in the upper part of the uterus. If either the head or buttocks (Breech) of the fetus is in the fundus, then the fetus is in vertical lie. Otherwise the fetus is most likely in transverse lie. If the cephalic prominence is on the same side as the small parts, then the fetus is in vertex presentation. If the cephalic prominence is on the same side as the back , then the head is extended and the fetus is in face presentation.

Question:

During the vaginal examination of a pregnant woman in her first trimester, an adnexal mass with tenderness is palpated. This finding could be consistent with:

 

multiple gestation.a fibroid tumor.  Incorrectan ectopic pregnancy.  Correcta false pregnancy.

 

Explanation:

Adnexal tenderness or masses identified early in gestation require ultrasound evaluation to rule out ectopic pregnancy. An enlarged uterus may indicate multiple gestation or a fibroid tumor.

Question:

Normal changes in the breast and nipples during pregnancy include all of the following except:

 

a marked venous pattern on the breast.darkened nipples.mastitis.  Correctdarkened areola.

 

Explanation:

Normal changes include a marked venous pattern, darkened nipples and areolae, and prominent Montgomery’s glands. APEA Pregnancy. Mastitis is inflammation of the breast tissue and can be seen during or after pregnancy but it is not a normal change during pregnancy.

Question:

During pregnancy, a patient’s fundal height measured 26 centimeters. This would suggest that the gestational age was:

 

13 weeks.26 weeks.  Correct30 weeks.36 weeks.

 

Explanation:

Uterine fundal height measured in centimeters correlates with gestational age between 18 and 34 weeks. Fundal height is measured in centimeters from symphysis pubis to top of uterus. This is know as McDonald’s rule.

Question:

When should an oral glucose tolerance test be performed during pregnancy?

 

Initially, when the pregnancy is confirmed8 weeks24 weeks  Correct30 weeks

 

Explanation:

The oral glucose tolerance test is used to screen pregnant women for gestational diabetes between 24 and 28 weeks of pregnancy. It may also be used when the disease is suspected, even though fasting blood glucose level is normal.

Question:

Inflamed and overgrown gingiva during pregnancy is:

 

a common finding during pregnancy.  Correctsuggestive of anemia.suggestive of periodontal disease.indicative of poor nutrition.

 

Explanation:

Gingival inflammation and swelling is common during pregnancy because of hormonal shifts that occur. Consequently, meticulous oral hygiene is important in pregnant women.

Question:

When performing the third Leopold maneuver on a pregnant woman, the fetal head is the presenting part. This finding is referred to as the:

 

vertical lie.transverse lie.face presentation.vertex presentation.  Correct

 

Explanation:

When performing the third Leopold maneuver on a pregnant woman, the fetal head is the presenting part. This finding is referred to as the vertex or cephalic presentation. Additionally, if the cephalic prominence is on the same side as the small parts, then the fetus is in vertex presentation. If the cephalic prominence is on the same side as the back , then the head is extended and the fetus is in face presentation. The top of the uterus (fundus) is palpated to establish which end of the fetus (fetal pole) is in the upper part of the uterus. If either the head or buttocks (Breech) of the fetus is in the fundus, then the fetus is in vertical lie. Otherwise the fetus is most likely in transverse lie.

Question:

Inaudible fetal heart tones (FHT) may indicate:

 

extra amniotic fluid.  Incorrectsevere fetal morbidity.earlier gestation than expected.  Correctintrauterine growth restriction.

 

Explanation:

Lack of audible fetal heart tones (FHT) may indicate earlier gestation than expected, fetal demise, false pregnancy, or observer error; inability to locate the FHT should always be investigated with ultrasound.

Question:

Which one of the following symptoms would be seen in a 39 week gestational age patient who was suspected of having HELLP syndrome?

 

Decreased liver enzymes, low platelet count, and nauseaVomiting, flu – like symptoms, and platelet count < 100,000  CorrectFlu – like symptoms, low platelet count, and decreased liver enzymesHypotensive, malaise, and elevated platelet count > 100,000  Incorrect

 

Explanation:

HELLP syndrome is a life-threatening pregnancy complication usually considered to be a variant of pre-eclampsia. Both conditions usually occur during the later stages of pregnancy, or sometimes after childbirth. Its characteristics: H (hemolysis), EL (elevated liver enzymes) and LP (low platelet count).

Question:

The cervical opening or shortening noted during a bimanual examination prior to 37 weeks gestation, may indicate:

 

ectopic pregnancy.preterm labor.  Correctleiomyomata.cervical erosion.

 

Explanation:

The cervical opening or shortening noted during a bimanual examination prior to 37 weeks, may indicate preterm labor. APEA Pregnancy.

Question:

Weight gain should be monitored during pregnancy. For a pregnant woman whose BMI is 25 – 29.9, the total weight gain should be:

 

11-20 pounds.15-25 pounds.  Correct25-35 pounds28-40 pounds.

 

Explanation:

Weight gain should be closely monitored during pregnancy, as both excessive and inadequate weight gain are associated with poor birth outcomes. The pregnant woman who has a BMI of <18.5, should gain 28 – 40 pounds; BMI 18.5-24.9 should gain 25 – 35 pounds; BMI 25-29.9 should gain 15 – 25 pounds; and the obese pregnant woman should gain 11 – 20 pounds.

Question:

During pregnancy, as the skin over the abdomen stretches to accommodate the fetus, this purplish mark may appear. This finding is:

 

Hegar’s sign.Chadwick’s sign.striae gravidarum.  Correctlinea nigra.

 

Explanation:

As the skin over the abdomen stretches to accommodate the fetus, purplish striae gravidarum (“stretch marks”) may appear. Linea nigra is a brownish black pigmented vertical stripe along the midline skin. Hegar’s sign is the palpable softening of the cervical isthmus, the portion of the uterus that narrows into the cervix. Increased vascularity throughout the pelvis during pregnancy gives the vagina a bluish color, known as Chadwick’s sign. APEA Pregnancy.

Question:

During pregnancy, dyspnea accompanied by increased respiratory rate, cough, rales, or respiratory distress raises concerns of:

 

preeclampsia.hypertension.peripartum cardiomyopathy.  Correctcocaine use.

 

Explanation:

Dyspnea accompanied by increased respiratory rate, cough, rales, or respiratory distress raises concerns of possible infection, asthma, pulmonary embolus, or peripartum cardiomyopathy.

Question:

When should a vaginal swab for Group B streptococcus be obtained in a pregnant woman?

 

Initially, when the pregnancy is confirmed12-18 weeks24-30 weeks35 -37 weeks  Correct

 

Explanation:

A vaginal swab for group B streptococcus between 35 to 37 weeks gestation. Group B streptococcus can normally be found in 15%-45% of all healthy adult women. It can commonly be found in the intestine, vagina, and rectal area. Most women who are carriers will not have any symptoms. However, under certain circumstances, infection of both the mother and/or the newborn can develop.

Question:

Which substance used during pregnancy accounts for one third of all low-birth-weight infants, placental abruption, and preterm labor?

 

Illicit drugsAlcoholTobacco  CorrectPrescription drugs

 

Explanation:

Tobacco use accounts for a third of all low-birth-weight babies and many other poor pregnancy outcomes, including placental abruption and preterm labor.

Question:

Normal findings of the vaginal wall of a pregnant woman, include all of the following except:

 

bluish color.deep rugae.leukorrhea.lochia.  Correct

 

Explanation:

Normal findings of the vaginal wall of pregnant women include bluish color, deep rugae, and increased milky white discharge, or leukorrhea. Lochia is a term given to the substance that is discharged from the uterus, through the vagina after childbirth. It consists of blood, mucus and placental tissue.

Question:

During pregnancy, which hormone is responsible for increasing insulin resistance and hyperglycemia associated with gestational diabetes?

 

ProgesteroneHuman chorionic gonadotropin (HCG)EstrogenHuman placental lactogen  Correct

 

Explanation:

Human placental lactogen and other hormones have been implicated in the insulin resistance and hyperglycemia associated with gestational diabetes (GDM).

Question:

To estimate the expected date of delivery (EDD) using Naegele’s rule, if the last menses was March 3, 2014, the EDD would be:

 

December 7, 2014.January 10, 2015.January 7, 2015.December 10, 2014.  Correct

 

Explanation:

The expected date of delivery is 40 weeks from the first date of the LMP. Using Naegele’s rule, the EDD can be estimated by taking the LMP, adding 7 days, subtracting 3 months, and adding 1 year.

Question:

During pregnancy, which hormone results in increased blood viscosity?

 

Human chorionic gonadotropin (HCG)  IncorrectEstrogenProgesteroneErythropoietin  Correct

 

Explanation:

Erythropoietin increases during pregnancy, which raises erythrocyte mass resulting in increased blood viscosity. APEA Pregnancy.

Question:

In the third trimester of pregnancy, which position affords the greatest comfort by reducing the weight of the uterus on the abdominal vessels?

 

Left side lying  IncorrectRight side lyingSupineSemi-sitting with knees bent  Correct

 

Explanation:

In later trimesters, the semi-sitting position with the knees bent, affords greater comfort by reducing the weight of the gravid uterus on the abdominal vessels. By contrast, the supine position causes the uterus to overlie the vertebral column and compress the descending aorta and inferior vena cava.

Question:

Ingestion of large sea-going fish, such as tuna, swordfish and shark should be avoided in pregnant women, because they contain large amounts of:

 

Vitamin AMercury  CorrectIronToxoplasmosis

 

Explanation:

Ingestion of large sea-going fish including shark, swordfish, mackerel, and tuna, should be minimized due to their concentration of mercury and possible effects on the neurologic development in the fetus.

Question:

When might fundal height in a pregnant woman most accurately predict gestational age?

 

10 weeks gestation14 weeks gestation18 weeks gestation  Correct40 weeks gestation  Incorrect

 

Explanation:

Uterine fundal height measured in centimeters correlates with gestational age between 18 and 34 weeks. Fundal height is measured in centimeters from symphysis pubis to top of uterus. This is know as McDonald’s rule. APEA Pregnancy.

Question:

If fetal movement cannot be perceived after 24 weeks gestation, all of the following may be considered except:

 

fetal demise.false pregnancy.an error in calculating gestational age.a normal finding.  Correct

 

Explanation:

If fetal movement cannot be perceived after 24 weeks, consider error in calculating gestational age, fetal death or severe morbidity, or false pregnancy. Confirm fetal health and gestational age with an ultrasound.

Question:

During pregnancy, if fundal height is 4 centimeters smaller than expected, consider:

 

large for gestational age infantextra amniotic fluiduterine leiomyomaintrauterine growth restriction.  Correct

 

Explanation:

If fundal height is 4 centimeters or larger than expected, consider multiple gestation, a large fetus, extra amniotic fluid, or uterine leiomyoma. If fundal height is 4 centimeters or smaller than expected, consider low level of amniotic fluid, missed abortion, intrauterine growth restriction, or fetal anomaly. All of these conditions should be investigated by ultrasound.

Question:

During pregnancy, the Leopold maneuvers assist in determining all of the following except:

 

fetal position within the maternal abdomen.readiness for vaginal birth.adequacy of fetal growth.  Incorrectcervical effacement.  Correct

 

Explanation:

Leopold maneuvers are used to determine the fetal position within the maternal abdomen beginning in the second trimester; accuracy is greatest after 36 weeks gestation. These exam findings can help ascertain the adequacy of fetal growth and the readiness for vaginal birth. Since these maneuvers are performed on the maternal abdomen, cervical effacement is not included with these maneuvers. To determine cervical effacement, a vaginal exam would be performed.

Question:

Irregular brownish patches around the forehead, cheeks, nose, and jaw noted during pregnancy are:

 

pallor.nevi.chloasma.  Correcthirsutism.

 

Explanation:

Irregular brownish patches around the forehead, cheeks, nose, and jaw noted during pregnancy are known as chloasma (or melasma) or the “mask of pregnancy”. This is considered a normal finding.

Question:

Symptoms on initial assessment of a pregnant woman with preeclampsia are: blood pressure 158/100; urinary output 50 ml./hour; lungs clear upon auscultation; +1 urine protein on dipstick; and edema of the hands, ankles, and feet. On assessment an hour later, which one of the following symptoms would indicate worsening of preeclampsia?

 

Blood pressure 158/104Urinary output of 20 ml/ hour  CorrectReflexes 2+Platelet count of 150,000

 

Explanation:

The decrease in urine output is an indication of a decrease in glomerular filtration rate (GFR), which indicates a loss of renal perfusion. There is not a significant rise in blood pressure, the reflexes are normal at 2+, and the platelet count is normal, though at the lower end. The assessment finding of greatest is the decreased urine output. APEA Pregnancy.

Question:

During pregnancy, which hormone is secreted by the corpus luteum and placenta to promote ligamentous laxity in the sacroiliac joint and pubic symphysis for passage of the fetus?

 

Human chorionic gonadotropin (HCG)EstrogenHuman placental lactogenRelaxin  Correct

 

Explanation:

Relaxin is secreted by the corpus luteum and placenta, promoting ligamentous laxity in the sacroiliac joints and pubic symphysis in preparation for birth.

Question:

During the last trimester of pregnancy, the supine position causes the uterus to overlie the vertebral column and compress the descending aorta and inferior venal cava. This position causes the patient to become faint and dizzy resulting in:

 

a hypertensive crisis.supine hypotensive syndrome.  Correctpreeclampsia.gestational hypertension.

 

Explanation:

Compression interferes with venous return from the lower extremities and pelvic vessels, causing the patient to feel dizzy and faint. This is known as the supine hypotensive syndrome.

Question:

Which substance used during pregnancy accounts for the leading cause of preventable intellectual disability?

 

Illicit drugsAlcohol  CorrectTobaccoPrescription drugs

 

Explanation:

Fetal alcohol syndrome, the neurodevelopmental sequela of alcohol exposure during fetal development, is the leading cause of preventable intellectual disability in the United States.

Question:

A five percent weight loss during the first trimester due to vomiting would be considered:

 

normal weight loss.mild weight loss.moderate weight loss.excessive weight loss.  Correct

 

Explanation:

Weight loss in excess of 5% of pre-pregnancy weight is considered excessive, representing hyperemesis gravidarum, and may lead to adverse pregnancy outcomes.

Question:

Increased vascularity throughout the pelvis during pregnancy gives the vagina a bluish color. This sign is:

 

Hegar’s sign.Chadwick’s sign.  CorrectQuickening sign.Leopold’s sign.

 

Explanation:

Increased vascularity throughout the pelvis during pregnancy gives the vagina a bluish color, known as Chadwick’s sign. Vaginal walls appear deeply rugated due to thicker mucosa, loosening of connective tissue, and hypertrophy of smooth muscle cells. Hegar’s sign is the palpable softening of the cervical isthmus, the portion of the uterus that narrows into the cervix. The other choices are not related to this finding. APEA Pregnancy.

Question:

Weight gain should be monitored during pregnancy. For a pregnant woman whose BMI is = 30, the total weight gain should be:

 

11-20 pounds.  Correct15-25 pounds.25-35 pounds28-40 pounds.

 

Explanation:

Weight gain should be closely monitored during pregnancy, as both excessive and inadequate weight gain are associated with poor birth outcomes. The pregnant woman who has a BMI of <18.5, should gain 28 – 40 pounds; BMI 18.5-24.9 should gain 25 – 35 pounds; BMI 25-29.9 should gain 15 – 25 pounds; and the obese pregnant woman should gain 11 – 20 pounds.

Question:

In pregnant women, between 10 to 18 weeks gestation, fetal heart tones (FHT) can be auscultated along the:

 

woman’s back.woman’s upper left quadrant.  Incorrectmidline of the woman’s lower abdomen.  Correctupper left quadrant.

 

Explanation:

From 10 to 18 weeks gestation, the fetal heart tones (FHT) are located along the midline of the lower abdomen. After that time, the FHT are best heard over the back or chest and depends on fetal position.

Question:

When performing the third Leopold maneuver on a pregnant woman, the cephalic prominence is on the same side as the back. This finding is referred to as the:

 

vertical lie.transverse lie.  Incorrectface presentation.  Correctvertex presentation.

 

Explanation:

When performing the third Leopold maneuver on a pregnant woman, the cephalic prominence is on the same side as the back then the head is extended and the fetus is in face presentation. Additionally, if the cephalic prominence is on the same side as the small parts, then the fetus is in vertex presentation. The top of the uterus (fundus) is palpated to establish which end of the fetus (fetal pole) is in the upper part of the uterus. If either the head or buttocks (Breech) of the fetus is in the fundus, then the fetus is in vertical lie. Otherwise the fetus is most likely in transverse lie. APEA Pregnancy.

Question:

Hypertension that occurs after 20 weeks gestation in the absence of proteinuria is:

 

gestational hypertension.  Correctpreeclampsia.chronic hypertension.primary hypertension.

 

Explanation:

Chronic hypertension occurs when systolic BP (SBP) >140 mm Hg or diastolic BP (DBP) >90 mm Hg documented prior to pregnancy, before 20 weeks, or beyond 12 weeks postpartum. Gestational hypertension refers to elevated blood pressure detected after 20 weeks gestation in the absence of proteinuria. Pre-eclampsia occurs in a woman who was previously normotensive but now has new onset hypertension with either proteinuria or end-organ damage. Primary hypertension, formerly known as essential hypertension, is a disorder which is associated with elevated blood pressure and an unidentifiable cause.

Question:

During pregnancy, if fundal height is 4 centimeters larger than expected, consider all of the following except:

 

large for gestational age infantextra amniotic fluiduterine leiomyomafetal anomaly  Correct

 

Explanation:

If fundal height is 4 centimeters or larger than expected, consider multiple gestation, a large fetus, extra amniotic fluid, or uterine leiomyoma. If fundal height is 4 centimeters or smaller than expected, consider low level of amniotic fluid, missed abortion, intrauterine growth restriction, or fetal anomaly. All of these conditions should be investigated by ultrasound.

Question:

During pregnancy, which hormone increases tidal volume and alveolar minute ventilation, lowers esophageal sphincter tone, and relaxes tone in the uterus and bladder?

 

Progesterone  CorrectHuman chorionic gonadotropin (HCG)EstrogenHuman placental lactogen

 

Explanation:

Progesterone affects numerous body systems. Rising progesterone leads to increased tidal volume and alveolar minute ventilation, though respiratory rate remains constant; respiratory alkalosis and subjective shortness of breath result from these changes. Lower esophageal sphincter tone results from rising levels of estradiol and progesterone, contributing to gastroesophageal reflux. Progesterone relaxes tone in the ureters and bladder, causing hydronephrosis and an increased risk of bacteriuria.

Question:

The normal fetal heart rate (FHR) range is:

 

60-90 beats per minute.90-110 beats per minute.120-160 beats per minute.  Correct140-180 beats per minute.

 

Explanation:

The FHR ranges between 120 and 160 beats per minute (BPM). A heart rate of 60 to 90 BPM is usually maternal but an adequate FHR should be confirmed.

Question:

New onset hypertension with proteinuria or end-organ damage is:

 

gestational hypertension.preeclampsia.  Correctchronic hypertension.primary hypertension.

 

Explanation:

Chronic hypertension occurs when systolic BP (SBP) >140 mm Hg or diastolic BP (DBP) >90 mm Hg documented prior to pregnancy, before 20 weeks, or beyond 12 weeks postpartum. Gestational hypertension refers to elevated blood pressure detected after 20 weeks gestation in the absence of proteinuria. APEA Pregnancy. Pre-eclampsia occurs in a woman who was previously normotensive but now has new onset hypertension with either proteinuria or end-organ damage. Primary hypertension, formerly known as essential hypertension, is a disorder which is associated with elevated blood pressure and an unidentifiable cause.

Question:

A form of milk produced by the mammary glands during late pregnancy is referred to as:

 

witch’s milk.colostrum.  Correctbreast milk.lactating milk.

 

Explanation:

A form of milk produced by the mammary glands during late pregnancy is referred to as colostrum.

Question:

When examining the pregnant patient, conjunctival pallor may indicate:

 

leukemia.anemia.  Correctpreeclampsia.hypertension.

 

Explanation:

In pregnant women, conjunctival pallor may indicate anemia.

Question:

When performing the first Leopold maneuver on a pregnant woman, if the fetal buttocks and head are not easily palpated at the fundus, the fetus is said to be in:

 

vertical lie.transverse lie.  Correctface presentation.vertex presentation.

 

Explanation:

The top of the uterus (fundus) is palpated to establish which end of the fetus (fetal pole) is in the upper part of the uterus. If either the head or buttocks (Breech) of the fetus is in the fundus, then the fetus is in vertical lie. Otherwise the fetus is most likely in transverse lie. If the cephalic prominence is on the same side as the small parts, then the fetus is in vertex presentation. If the cephalic prominence is on the same side as the back , then the head is extended and the fetus is in face presentation.

Question:

After 24 weeks gestation, auscultation of more than one fetal heart tone (FHT) in different locations with varying rates suggests: APEA Pregnancy.

 

decelerations.fetal distress.intrauterine growth restriction.multiple gestation.  Correct

 

Explanation:

After 24 weeks’ gestation, auscultation of more than one FHT in different locations with varying rates suggests multiple gestation.

Question:

During pregnancy, a brownish black pigmented vertical stripe along the midline of the abdomen may appear. This finding is:

 

Hegar’s sign.Chadwick’s sign.striae gravidarum.linea nigra.  Correct

 

Explanation:

Linea nigra is a brownish black pigmented vertical stripe along the midline skin of the abdomen. As the skin over the abdomen stretches to accommodate the fetus, purplish striae gravidarum (“stretch marks”) may appear. Hegar’s sign is the palpable softening of the cervical isthmus, the portion of the uterus that narrows into the cervix. Increased vascularity throughout the pelvis during pregnancy gives the vagina a bluish color, known as Chadwick’s sign.

Question:

During the examination of a pregnant woman, knee and ankle deep tendon reflexes appear hyperreflexic. This finding could be suggestive of:

 

hypertension.gestational diabetes.preeclampsia.  Correctan embolus.

 

Explanation:

During the examination of a pregnant woman, knee and ankle deep tendon reflexes appear hyperreflexic. This finding could be suggestive of preeclampsia.

Question:

Upon cervical examination of the pregnant woman, cervical erosion, erythema, and irritation are noted. These findings could be suggestive of:

 

cervical cancer.a non-pregnant state.cervicitis.  Correctbacterial vaginosis.

 

Explanation:

Cervical erosion, erythema, discharge, or irritation might suggest cervicitis and warrants investigation for sexually transmitted infections (STIs). A pink cervix suggests a non-pregnant state. APEA Pregnancy.

 

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