Module 3 Unit A Practice Quiz Flashcards
Which of these is a positive sign of pregnancy i.e. it cannot be anything else other than pregnancy?
a) visualizing the fetus on ultrasound
b) positive pregnancy test
c) nausea and vomiting
d) maternal sensation of fetal movement
visualizing the fetus on ultrasound
Palpating an enlarged uterus is:
a probable sign of pregnancy
[Probably pregnancy (especially if skilled examiner) but could be due to other causes such as uterine fibroids.]
A person has a positive urine pregnancy test at home. Why is that a probable, rather than positive, sign of pregnancy?
Because the human chorionic gonadotropin (hCG) that the test identifies could, in rare cases, be due to something other than pregnancy.
What do urine and serum pregnancy tests identify?
beta subunit of human chorionic gonadotropin
Which beta hCG change would the clinician expect with a healthy pregnancy at 5 weeks’ gestation?
Levels should double every 2 days
[Generally, by 4 weeks gestation in a healthy pregnancy, hCG doubles approximately every 2-3 days and continues this pattern until it reaches 100,000 mIU/mL (usually between about 7 and 10 weeks of pregnancy) at which time the level plateaus and then begins to decline.]
Which are more common with pregnancy tests: false positive tests or false negative tests?
False negative tests
[False negatives are much more common, especially when the test is done too early after conception.
False positives are uncommon. They can occur if the test is expired, recent miscarriage, or there is a tumor secreting hCG.]
What “age” do clinicians most commonly use when describing the dating and progress of pregnancy?
Menstrual age
A patient presents for the first prenatal visit and tells the midwife/WHNP that the last period was “about 8 or 9 weeks ago,” but doesn’t remember the exact date. The most appropriate next step for the midwife/WHNP to take is to:
ask about events surrounding the last period as a memory jogger
[Although the other options may be a reasonable approach depending on the circumstances, the first step would be to illicit more information. Many patients can recall their last cycle if their memory is jogged.]
While asking about the last menstrual period (LMP) for the purposes of dating pregnancy, it is most important to ask which of the following?
a) if the LMP was normal
b) if the person had intercourse during the last period
c) age at menarche (first period)
if the LMP was normal
[Although the age of menarche and timing of intercourse may be helpful information to address other matters related to the patient, none of these would be the most useful information in dating the pregnancy.
Remember from module 2, that implantation bleeding can occur around the time in which a patient might anticipate menses, Therefore, it is important to establish when the last normal cycle occurred (flow, duration, and the presence of pre-menstural symptoms etc.).]
A newly pregnant person reports a certain last menstrual period that started 10 weeks ago. Their cycles are regular, 26 days long, with 5 days of bleeding each cycle. The best way to date this pregnancy is:
Subtract 2 days from the EDB determined by Naegele’s Rule.
The preferred way to assess uterine size in the first trimester is:
bimanual exam
The clinician assesses a pregnant person’s uterus and determines that it is approximately the size of a grapefruit. Assuming the pregnant person’s uterus was an average size prior to pregnancy, what is the most likely gestational age?
10-12 weeks
[Here are some rough similarities:
-6 weeks: small orange or small pear
-8 weeks: navel orange
-10-12 weeks: grapefruit]
Which of these factors is likely to affect the clinician’s assessment of uterine size in the first trimester? [select all that apply]
a) the person has uterine fibroids
b) this pregnancy is a twin gestation
c) the person was treated for chlamydia last year
d) the person is a cystic fibrosis carrier
e) this is the person’s 5th baby
a,b,& e (the person has uterine fibroids, this pregnancy is a twin gestation, this is the person’s 5th baby)
[Several factors can make uterine size assessment less accurate. These include:
-Individuals whose non-pregnant uterus is larger than expected i.e. uterine fibroids and having had several previous pregnancies.
-Multiple gestations
-Maternal abdominal adipose tissue
-A maternal full bladder]
A dating ultrasound showed a pregnancy at 7 weeks 1 day. The estimated date of birth from that ultrasound differed by 2 days from her LMP-based date. How should the midwife/WHNP proceed?
Use the LMP-based date
A pregnant person reports a last normal menstrual period that started July 16.
By Naegele’s rule, the EDB is April 23.
An ultrasound done when the person would have been 12 weeks pregnant by LMP showed ultrasound measurements of 10 weeks, 3 days pregnant with an EDB of May 6.
According to ACOG guidelines, what should the clinician set as the EDB?
May 6
