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Williams Chapter 9 - Prenatal Care

Total questions: 33

Worksheet time: 17mins

Name
Class
Date
1.

A 32-year-old nulligravida patient with no prenatal care presents in labor. You realize lack of prenatal care increases her risk of a poor outcome. What is the increased risk of mortality for women who do not receive prenatal care as compared to women who do?

a)

Risk unchanged

b)

Twofold risk

c)

Fourfold risk

d)

Fivefold risk

2.

Which of the following is more common when women do not obtain prenatal care?

a)

Stillbirth

b)

Preterm birth

c)

Neonatal death

d)

All of the above

3.

Which possible cause of a "false-positive" B-hCG is most common?

a)

Malignancy

b)

Heterophilic antibodies

c)

Exogenous B-hCG use for weight loss

d)

B-hCG produced in the pituitary gland

4.

A 33-year old woman who presents for prenatal care is described as a G5P2113. From this information, you recognize she needs counseling regarding the risks of which of the following?

a)

Grand multiparity

b)

Advanced maternal age

c)

Recurrent preterm birth

d)

Recurrent pregnancy loss

5.

A 26-year-old G1 presents to your office for prenatal care at 12 weeks' gestation. She denies any past medical or surgical history, but does report smoking 1 pack of cigarettes every 2-3 days. Which of the following statements regarding her tobacco use in pregnancy is not yet proven?

a)

Smoking increases the risk of preterm birth

b)

Smoking increases the risk of placental abruption

c)

Use of a nicotine patch can improve perinatal outcomes

d)

Smoking cessation at any stage of pregnancy can improve perinatal outcomes

6.

A 24-year-old woman presents for prenatal care at 14 weeks gestation. During your initial interview she reports that for the last year she has consistently consumed 8-10 alcoholic beverages per day. Which of the following fetal abnormalities is she at increased risk of experiencing?

a)

Facial abnormalities

b)

Fetal growth restriction

c)

Central nervous system dysfunction

d)

All of the above

7.

What is the prevalence of domestic violence in pregnancy?

a)

< 0.5%

b)

0.5%

c)

1-2%

d)

4-8%

8.

For a routine low-risk woman with no complaints, which laboratory test should not be offered as part of her first prenatal visit?

a)

Hepatitis B testing

b)

Chlamydia screeing

c)

Blood type and screen

d)

Thyroid function testing

9.

A 29-year-old G2P1 at 8 weeks gestation presents for her first prenatal care visit. She is 64 inches tall and weights 160 pounds, making her body mass index 27kg/m^2. What amount of total weight gain should you recommend for her pregnancy

a)

0-10 pounds

b)

11-20 pounds

c)

15-25 pounds

d)

25-35 pounds

10.

For an obese woman, the risk of pre-eclampsia and cesarean delivery is lowest with what amount of gestational weight gain

a)

0-14 pounds

b)

11-20 pounds

c)

15-25 pounds

d)

25-35 pounds

11.

Among women with a normal BMI prior to pregnancy who have less than 25 pounds of gestational weight gain, which complication is increased?

a)

Pre-eclampsia

b)

Cesarean delivery

c)

Large-for-gestational age infant

d)

Small-for-gestational age infant

12.

There is substantial evidence that severe undernutrition during pregnancy can result in a higher rate of which of the following?

a)

Preterm birth

b)

Perinatal mortality

c)

Small-for-gestational-age infants

d)

All of the above

13.

For a woman with a normal pre-pregnancy BMI, approximately how many additional kilocalories per day are recommended in the three trimesters of pregnancy, respectively?

a)

0, 340, 450

b)

0, 250, 500

c)

100, 200, 300

d)

200, 300, 400

14.

Which food is the most complete source of nutrients for pregnancy women?

a)

Dairy

b)

Fruit

c)

Poultry

d)

Leafy vegetables

15.

Which mineral is least likely to be supplied in quantities sufficient for pregnancy when ingesting a normal diet?

a)

Iron

b)

Calcium

c)

Vitamin D

d)

Vitamin B6

16.

A 23-year-old G2P1 presents for her postpartum visit after delivering an infant with an encephalocele. You counsel that next time she should initiate 4mg of folic acid daily at least 4 weeks prior to conception. This will decrease her risk of a similar birth defect by what percentage?

a)

30%

b)

50%

c)

70%

d)

90%

17.

Which vitamin, when ingested in large quantities, causes a well-described constellation of birth defects?

a)

Vitamin A

b)

Vitamin C

c)

Vitamin B6

d)

Vitamin B12

18.

A 27-year-old woman at 16 weeks gestation reports a long history o regular aerobic exercise including cycling, running, swimming and low impact aerobics. Which of those activities do you recommend she forego during pregnancy?

a)

Cycling

b)

Running

c)

Swimming

d)

Low impact aerobics

19.

A 26-year-old woman, gravida 3, para 2, presents to your office at 18 weeks gestation. Her BMI is 40. Her history is negative. She is scheduled for a fetal anatomy ultrasonographic study. You discuss that her obesity places her at increased risk of congenital anomalies compared with a nonobese woman. The structural malformation with the highest attributable increased risk in this patient is

a)

anorectal atresia

b)

cardiac anomaly

c)

limb anomaly

d)

neural tube defect

e)

orofacial clefting

20.

A 38-year-old, G4P3, at 10 weeks gestation presents for her first prenatal visit. Her BMI is 30. She is health overall and would like to be able to start exercising during this pregnancy. You tell her that she can exercise 20-30 minutes daily during the pregnancy. The most appropriate way for her to monitor her level of exercise intensity is

a)

blood pressure

b)

calorie expenditure

c)

heart rate

d)

perceived exertion rate

e)

respiratory rate

21.

A 33-year-old Caucasian woman, G5P4, at 12 weeks gestation, presents to your office for a prenatal visit. Her bMI is 23. She is a resident of Florida and works as a gardener. She follows a vegetarian diet is adherent to prenatal vitamin use. The most important factor in this patient's history to support screening her for hypovitaminosis D is her

a)

BMI

b)

Caucasian ancestry

c)

Occupation

d)

State of residence

e)

Vegetarian diet

22.

A 28-year-old G1P0 presents for prepregnancy counseling. She had a spontaneous abortion at 12 weeks of gestation. Her medical history includes morbid obesity with a BMI of 42 and chronic HTN managed with labetalol. In addition to optimizing her health through labetalol therapy, weight loss, and exercise, you also advise her to start taking

a)

aspirin

b)

folic acid

c)

pyridoxine

d)

vitamin B12

e)

thiamine

23.

Which type of fish contains a level of methylmercury low enough to be safe for consumption during pregnancy?

a)

Shark

b)

Salmon

c)

Tile fish

d)

Sword fish

24.

A 28yo G2P1 presents for a prenatal appointment and reports that recently her toddler was screened for lead exposure and had an elevated level, though he did not require treatment. They resident in a home built in 1950. You draw a maternal lead level, which is 10µg/dL. What is the most appropriate level of intervention?

a)

No intervention

b)

Chelation therapy

c)

Relocate her family for the duration of the preganncy

d)

Identify the source of lead in her environment and remove it

25.

At least how much elemental iron should be given as a supplement daily to a pregnant woman?

a)

15mg

b)

27mg

c)

42mg

d)

60mg

26.

Maternal deficiency of vitamin D has been associated with which of the following complications in the offspring?

a)

anemia

b)

seizures

c)

jaundice

d)

congenital ricketts

27.

Air travel is not recommended after which gestational age

a)

14 weeks

b)

20 weeks

c)

30 weeks

d)

36 weeks

28.

Which of the following statements regarding vaccinations in pregnancy is true?

a)

All pregnancy women should be offered influenza vaccine during the appropriate season

b)

The Tdap vaccine should be given to all pregnancy women between 16 and 20 weeks gestation

c)

Varicella vaccine should be offered to all women who are exposed to chicken pox during pregnancy

d)

The MMR vaccine should be given to all pregnant women who are not immune

29.

When instructing a pregnancy woman on proper safety restraints when operating an automobile, which statement is true?

a)

A two point restraint system is ideal

b)

Airbags should be disabled in the third trimester

c)

The lap belt should be under her abdomen and across her thighs

d)

The shoulder belt should be across her chest above the level of her breasts

30.

Which of the following concerns regarding international air travel during the third trimester cannot be mitigated with frequent ambulation?

a)

Radiation exposure

b)

Venous thromboembolism

c)

Cabin air pressure changes

d)

Development of complications remote from health resources

31.

Sexual intercourse during pregnancy is associated with which of the following pregnancy complications

a)

Miscarriage

b)

Preterm birth

c)

Spontaneous rupture of membranes

d)

None of the above

32.

Which of the following is the only vaccine with proven fetal harm?

a)

Varicella

b)

Smallpox

c)

Hepatitis B

d)

MMR

33.

What is the recommended amount of caffeine consumption in pregnancy according to ACOG?

a)

0 mg/day

b)

<100mg/day

c)

<200mg/day

d)

<500mg/day