Pregnancy

Question 1

A 30 year old female is 25 weeks pregnant with twins. She has 5 living children. Four of the 5 children were born at 39 weeks gestation and one child was born at 27 weeks gestation. Two years ago she had a miscarriage at 10 weeks gesations. What is her GTPAL?

A. G=7, T=4, P=0, A= 1, L=5
B. G=7, T=4, P=1, A= 1, L=5
C. G=6, T=2, P=0, A= 1, L=5
D. G=6, T=2, P=2, A= 1, L=5

Answer 1

B. G=7, T=4, P=1, A= 1, L=5

Question 2

What does GTPAL indicate

Answer 2

G= Gravida = How many times the woman has been pregnant (includes current pregnancy) 
T = Term Births >37 weeks 
P = Preterm Births 20-37 weeks (alive or stillborn) 
A = Abortion (any pregancy loss before 20 weeks) 
L= living children

Question 3

What gestational age to women receive Rhogam?

Answer 3

Given to Rh- negative women

@ 26-28 weeks & another dose 72 post delivery

Question 4

Which immunizations can you have when pregnant?

Answer 4

Influenza

Tdapt - protect against pertussis w/ EACH pregnancy regardless of mothers vaccination status. between 27-36 weeks

Question 5

A patient is 32 weeks gestation, which assessment of fundal height would indicate restricted fetal growth? 
A. 29cm
B. 30cm
C. 31cm
D. 32cm

Answer 5

29cm

** Fundal height is roughly equal to the number of weeks gestation.

> 4cm–> large fetus, extra amniotic fluid, multiple preg
<4cm –> low amniotic fluid, growth restriction

Question 6

A 24-year old pregnant patient is found to have an elevated maternal serum alpha-fetoprotein (MSAFP) level of \_\_ at 16 weeks gestation. The NP knows that it may indicate:
A. Downs syndrome 
B. Normal Pregnancy 
C. Gestational Diabetes
D. Fetal neural tube defect

Answer 6

Fetal neural tube defect

Question 7

Where would locate the fundus on a 12 week pregnant patient?
A. Below the symphysis pubis
B. Between symphysis pubis and umbilicus
C. At the umbilicus (* 20 weeks)
D. Above the umbilicus

Answer 7

between symphysis pubis and umbilics

Question 8

what antihypertensive medication is safe to give in pregnancy for patients with preeclampsia?

Answer 8

Methylodpa

others: Labetalol, & Nifedipine

** AVOID ACE/ARBS

Question 9

what should you assess for if a pregnant woman is craving ice?

Answer 9

Iron deficiency Anemia

Question 10

What do you suspect if a pregnant woman is spotting with no pain?

Answer 10

Placenta previa

Question 11

Illicit drugs have significant detrimental effects on fetal development, pregnant women with addiction should be referred for treatment immediately and screened for

Answer 11

HIV & Hep C

Question 12

how do you calculate naegeles rules?

Answer 12

Add seven days to the first day of your LMP then subtract 3 months

Question 13

What would the treatment be for a UTI during pregnancy?

Answer 13

PCN
Cephalosporins (cipro)
Nitrofurantoin (macrobid) - contraindicated from 38-42 weeks gestation!

Tx: 10-14 days

NEVER quinolones or sulfa drugs during pregnancy

Question 14

A pregnant patient presents for routine 16-week prenatal visit. Her BP was 126/83 and is now 110/62, what accounts for the changes
A. Decrease in preload
B. Decrease in stroke volume
C. Decrease in cardiac output
D. Decreased systemic vascular resistance

Answer 14

A decreased systemic vascular resistance

Question 15

A 24yr old needs to be treated for scabies- what would the nurse practitioner say to the patient?
A. is safe to use in pregnant women, babies, children, and older adults.
B.Lotion and/or shampoo is not considered first-line therapy.
C.Needs to be repeated following 12 hour intervals
D. Can be used in patients with a hx of seizures.

Answer 15

• **the study question specifically mentions Kwell is safe in pregnancy. But from the 3P lecture the med is a discontinued medication in US & COP says not to administer in pregnancy.
• Permethrin 5% - safe in pregnancy and infants >2 months. (from COP)