Prenatal Care — MCQs

A 24-year-old woman comes to the clinic because her period is 4 weeks late, and she is experiencing fatigue and morning nausea. She had her last period almost 8 weeks ago. She is gravida 0 para 0 with previously regular menses and an unremarkable medical history. She had her menarche at the age of 13 years. She has a single sexual partner and does not use contraception. At presentation, her vital signs are within normal limits. Gynecological examination reveals breast and uterine enlargement. There is also cyanosis and softening in the cervical and vaginal regions. Which of the following statements is correct?

A 34-year-old gravida 2 para 1 woman at 16 weeks gestation presents for prenatal care. Her prenatal course has been uncomplicated. She takes no medications besides her prenatal vitamin which she takes every day, and she has been compliant with routine prenatal care. She has a 7-year-old daughter who is healthy. The results of her recent quadruple screen are listed below: AFP: Low hCG: Low Estriol: Low Inhibin-A: Normal Which of the following is the most appropriate next step to confirm the diagnosis?

A 40-year-old pregnant woman, G4 P3, visits your office at week 30 of gestation. She is very excited about her pregnancy and wants to be the healthiest she can be in preparation for labor and for her baby. What vaccination should she receive at this visit?

A 24-year-old primigravida at 28 weeks gestation presents to the office stating that she “can’t feel her baby kicking anymore.” She also noticed mild-to-moderate vaginal bleeding. A prenatal visit a few days ago confirmed the fetal cardiac activity by Doppler. The medical history is significant for GERD, hypertension, and SLE. The temperature is 36.78°C (98.2°F), the blood pressure is 125/80 mm Hg, the pulse is 70/min, and the respiratory rate is 14/min. Which of the following is the next best step in evaluation?

A 53-year-old woman comes to the physician for evaluation of a 5-month history of painful sexual intercourse. She also reports vaginal dryness and occasional spotting. She has no pain with urination. She has hypertension, type 2 diabetes mellitus, and hypercholesterolemia. Her last menstrual period was 8 months ago. She is sexually active with her husband and has two children. Current medications include ramipril, metformin, atorvastatin, and aspirin. Her temperature is 37°C (98.6°F), pulse is 85/min, and blood pressure is 140/82 mm Hg. Pelvic examination shows decreasing labial fat pad, receding pubic hair, and clear vaginal discharge. Which of the following is the most appropriate pharmacotherapy?

A 15-year-old girl comes to the physician for a routine health maintenance examination. She recently became sexually active with her boyfriend and requests a prescription for an oral contraception. She lives with her parents. She has smoked half a pack of cigarettes daily for the past 2 years. Physical examination shows no abnormalities. A urine pregnancy test is negative. Which of the following is the most appropriate response?

A 21-year-old woman comes to the physician because she had a positive pregnancy test at home. For the past 3 weeks, she has had nausea and increased urinary frequency. She also had three episodes of non-bloody vomiting. She attends college and is on the varsity soccer team. She runs 45 minutes daily and lifts weights for strength training for 1 hour three times per week. She also reports that she wants to renew her ski pass for the upcoming winter season. Her vital signs are within normal limits. Physical examination shows no abnormalities. Which of the following is the most appropriate recommendation?

A 24-year-old woman visits her physician to seek preconception advice. She is recently married and plans to have a child soon. Menses occur at regular 28-day intervals and last 5 days. She has sexual intercourse only with her husband and, at this time, they consistently use condoms for birth control. The patient consumes a well-balanced diet with moderate intake of meat and dairy products. She has no history of serious illness and takes no medications currently. She does not smoke or drink alcohol. The patient’s history reveals no birth defects or severe genetic abnormalities in the family. Physical examination shows no abnormalities. Pelvic examination indicates a normal vagina, cervix, uterus, and adnexa. To decrease the likelihood of fetal neural-tube defects in her future pregnancy, which of the following is the most appropriate recommendation for initiation of folic acid supplementation?

An otherwise healthy 15-year-old girl is brought to the physician for evaluation of severe acne that involves her face, chest, and back. It has not improved with her current combination therapy of oral cephalexin and topical benzoyl peroxide. She is sexually active with one male partner, and they use condoms consistently. Facial scarring and numerous comedones are present, with sebaceous skin lesions on her face, chest, and back. Which of the following is indicated prior to initiating the appropriate treatment in this patient?

A 33-year-old pregnant woman in the 28th week of gestation presents to the emergency department for evaluation of bilateral edema of her legs. It seems to worsen at the end of the day and has lasted for the past 3 weeks. History reveals that this is her 3rd pregnancy. Vital signs include: blood pressure 120/80 mm Hg, heart rate 74/min, respiratory rate 18/min, and temperature 36.6°C (98.0°F). Body mass index is 36 kg/m2. Physical examination reveals bilateral leg edema with engorged surface veins. A photograph of the patient’s legs is shown. Which of the following is the best initial management of the patient?