Deck 26: Obstetric Health Maintenance and Promotion: the Initial Prenatal Visit

Question 1

Current evidence demonstrates that the standard model of individual prenatal care visits:

A) Reduces rates of preterm delivery
B) Reduces rates of low birth weight infants
C) Allows for continuing risk assessment
D) All of the above

Answer 1

C

Question 2

Your patient comes for her first prenatal visit on March 4. She is sure of her last menstrual period (LMP) which was January 1, giving her an estimated gestational age of 9 weeks today. She is worried because she was taking oral contraceptives when she conceived. When reviewing her medical record you note that she was seen in the Emergency Department for nausea and vomiting and had an ultrasound done at that time where the crown-rump length (CRL) gave her a gestational age of 8 weeks (3 days different from her LMP date). On her bimanual exam at today's visit her uterine size is 10 weeks. Which of the following would you use to establish a best estimate of the delivery date (EDD).

A) Last menstrual period
B) Ultrasound
C) Uterine size

Answer 2

B

Question 3

Your patient comes for her first prenatal visit on May 13. She is sure of her last menstrual period (LMP), which was December 31. She states that she remembers getting her period because she was at a party that night and it was a normal period for her in flow and length. Her an estimated gestational age by LMP is 19 weeks today. When reviewing her medical record you note that she had a fetal survey ultrasound done on May 8 giving her a gestational age of 19 weeks (7 days different from her LMP date). On her abdominal exam at today's visit her uterine size is 20 weeks. Which of the following would you use to establish the best estimate of the delivery date (EDD)?

A) Last menstrual period
B) Ultrasound
C) Uterine size

Answer 3

A

Question 4

Your patient comes for her first prenatal visit on March 9 with her wife. They have been together in a mutually monogamous relationship for 5 years. She is sure of her last menstrual period (LMP), January 5, which was normal in flow and length, giving her an estimated gestational age of 9 weeks today. She and her partner are thrilled because she conceived with artificial insemination on their first and only try. When reviewing her medical record you note that she was seen in the Emergency Department on March 5 for vaginal spotting and had an ultrasound done at that time where the crown-rump length gave her a gestational age of 8 weeks (3 days different from her LMP date). On her bimanual exam at today's visit her uterine size is 10 weeks. Which of the following would you use to establish a best estimate of the delivery date?

A) Insemination
B) Last menstrual period
C) Ultrasound
D) Uterine size

Question 5

Which of the following puts a mother at increased risk during her pregnancy?

A) Body mass index of 42
B) Father of the baby is a twin
C) History of a urinary tract infection 5 years ago
D) Unplanned but wanted pregnancy
E) All of the above

Question 6

Which of the following would not be appropriate for inclusion on a prenatal problem list?

A) Declines genetic screening
B) History of depression
C) History of cholestasis of pregnancy
D) Low mean corpuscular volume (MCV)
E) Teen pregnancy

Question 7

Most pregnant women benefit from iron supplementation during pregnancy.

Question 8

Which of the following is not a part of routine screening for all pregnant women at the first prenatal visit (before 16 weeks):

A) Complete blood count with platelets
B) Glucose load test
C) Maternal blood type
D) Rubella immunity
E) Urine culture and sensitivity

Question 9

Your 26-year-old old patient comes in for her first prenatal visit at 15 weeks and is interested in genetic screening tests that are covered by her public insurance. What test(s) will you offer her?

A) Chorionic villus sampling (CVS)
B) Nuchal translucency (NT)
C) Noninvasive prenatal testing (NIPT)
D) Quadruple marker blood screen

Question 10

Your patient is a low-risk primagravida and is seeing you for her first prenatal visit at 11weeks. She has had no problems at today's visit. According to routine scheduling guidelines when should she return to see you?

A) 2 weeks
B) 4 weeks
C) 6 weeks
D) 8 weeks