Week 1 Poll Qs

Question 1

Which of the following statements is correct regarding folic acid?

a) Folic acid is recommended once pregnancy is confirmed.
b) Folic acid is not required within North America as many foods have additional fortification which is enough during pregnancy.
c) Folic acid supplementation during preconception and pregnancy helps prevent neural tube defects.
d) Folic acid supplementation dosing is standard regardless of risk factors.

Answer 1

c) Folic acid supplementation during preconception and pregnancy helps prevent neural tube defects.

Ex: 3 months before you conceive or ppl of child-bearing age

Question 2

Which is the earliest biochemical marker of pregnancy?

a) Estrogen
b) Progesterone
c) Human chorionic gonadotropin (hCG)
d) Placental lactogen

Answer 2

c) Human chorionic gonadotropin (hCG)

Pregnancy tests based on recognition of hCG – urine and serum

Question 3

Most clients give birth within how many days of their estimated due date?

a) 3 days before 3 days after
b) 7 days before to 7 days after
c) 14 days before to 14 days after
d) 21 days before to 21 days after

Answer 3

b) 7 days before to 7 days after

Question 4

Simon is pregnant for the third time. Their first pregnancy resulted in a spontaneous abortion at 9 weeks. They delivered their second pregnancy at 39 weeks. Which is correct?

a) G2T1P0A1L2
b) G3T1P1A0L1
c) G3T1P0A0L1
d) G3T1P0A1L1

Answer 4

d) G3T1P0A1L1

Question 5

What is the recommended weight gain during pregnancy (singleton) for someone with a BMI of 21?

a) 15-20 pounds
b) 25-35 pounds
c) 30-45 pounds
d) 15 pounds per trimester

Answer 5

b) 25-35 pounds

Question 6

Morgan reports nausea and vomiting. Nausea and vomiting is a _ sign of pregnancy.

a) presumptive
b) probable
c) positive

Answer 6

a) presumptive

Question 7

This is Morgan’s 2nd pregnancy. Her 1st pregnancy ended in a spontaneous abortion at 8 weeks. Which statement is correct?

a) G2T0P1A0L0
b) G1T0P1A1L0
c) G2T0P1A0L0
d) G2T0P0A1L0

Answer 7

d) G2T0P0A1L0

Question 8

True or false: Morgan is a primigravida.

G2T0P0A1L0

Answer 8

False since she’s been pregnant before

Question 9

True or false: Morgan is a primipara

G2T0P0A1L0

Answer 9

False

Primipara means a pregnancy went past 20 weeks, but her previous one didn’t. Thus, she is a nullipara.

Question 10

Morgan denies having bad rubella or the rubella vaccine. Which of the following would be an appropriate action based on this information?

a) Administer the rubella vaccine
b) Take a blood sample to assess the rubella titer
c) Tell the client that rubella has little effects on the fetal so the risk is minimal
d) Have the client call her mother to inquire is she had measles as a child

Answer 10

b) Take a blood sample to assess the rubella titer

~ Vaccinate her after pregnancy

Question 11

Which of the following would indicate a need for further follow-up related to the potential development of erythroblastosis fetalis?

a) Blood type O
b) RH negative
c) Blood type A
d) RH positive

Answer 11

b) RH negative

Question 12

At 26 weeks gestation, how many cm should the fundal height be?

a) 20cm at the umbilicus
b) 22cm +/- 4cm
c) 26cm +/- 2cm
d) 26 cm +/- 4cm

Answer 12

c) 26cm +/- 2cm

Question 13

At 26 weeks gestation, the expected FHR is:

a) not detected by doppler
b) 60-100 BPM
c) 80-120 BPM
d) 110-160 BPM

Answer 13

d) 110-160 BPM

Question 14

Why is folate or folic acid of particular concern in the preconception period?

Answer 14

It decreases congenital heart disease, limb defects and cleft lip (pallet)

Question 15

What is the recommended dose of folic acid in clients that are low risk? What about those at high risk and highest risk?

Answer 15

Low risk = 0.4mg/daily

High risk of having a child w/ neural tube defects (ex: they have diabetes, fam hx, epilepsy) = 1mg in pregnancy then 0.4mg after 1st trimester

Highest risk = previous pregnancy w/ neural defect = 4mg

Question 16

What are some factors that can influence the accuracy of the results? (5)

Answer 16

1) Brain tumours can increase hCG levels which may give a false positive reading, even for men.
2) If you’re very hydrated (diluting levels)
3) Taking a pregnancy test too early may give you a false negative since the hCG levels are not as high as they should be (should be 7-10 days after)
4) Timing of day
5) Meds (anticonvulsants, tranquilizers)

Question 17

Why is it important to make an accurate assessment of the estimated due date? (3)

Answer 17

If it’s accurate, we can track the development of the fetus and determine if it is on track.

It gives the family time to prepare just in case there is something wrong.

Genetic screening is time-sensitive, thus, it’s important to know the accurate assessment of the EDB.

Question 18

What are some limitations with Nägele’s rule?

Answer 18

Accuracy is impacted if ppl don’t know when their last period was, ppl w/ longer cycles or ppl w/ irregular periods.

Question 19

How accurate are fetal ultrasounds for dating?

Answer 19

Dating ultrasounds are accurate in early pregnancy (it may be a few days off).

Question 20

Note the drop in fundal height from week 36 to 40. Why do you think the fundal height dropped at week 40?

Answer 20

At 40 weeks, it dropped b/c the baby is descending in preparation for labour.