Women's Health APEA Final Exam Prep questions with correct answers
and rationales 2026/2027 version A+ Graded
1. A pregnant patient at 10 weeks' gestation presents for the initial prenatal visit. Which
laboratory test is routinely included in the initial prenatal evaluation?
A. Troponin
B. Blood type and Rh factor
C. Serum lithium level
D. Amylase only
Correct Answer: B
Rationale: Initial prenatal evaluation commonly includes blood type, Rh status, CBC, infectious
disease screening, and other routine prenatal tests.
2. A pregnant patient is Rh-negative and the fetus may be Rh-positive. Which medication is
used to prevent Rh isoimmunization?
A. Oxytocin
B. Rho(D) immune globulin
C. Methotrexate
D. Misoprostol
Correct Answer: B
Rationale: Rho(D) immune globulin prevents maternal sensitization to Rh-positive fetal red
blood cells.
3. Which finding is most concerning in a pregnant patient with hypertension?
A. Mild ankle edema at the end of the day
B. Severe headache and visual disturbances
C. Increased appetite
D. Mild urinary frequency
Correct Answer: B
Rationale: Severe headache and visual changes may indicate severe preeclampsia and require
immediate evaluation.
,4. A pregnant patient has a blood pressure of 168/112 mmHg, severe headache, and
proteinuria. What is the priority concern?
A. Normal physiologic pregnancy changes
B. Severe preeclampsia
C. Mild anemia
D. Round ligament pain
Correct Answer: B
Rationale: Severe hypertension with neurologic symptoms and proteinuria is concerning for
severe preeclampsia.
5. Which medication is commonly used for seizure prophylaxis in severe preeclampsia?
A. Magnesium sulfate
B. Warfarin
C. Lithium
D. Methimazole
Correct Answer: A
Rationale: Magnesium sulfate is used to prevent seizures in patients with severe preeclampsia.
6. A patient receiving magnesium sulfate has absent deep tendon reflexes and a respiratory
rate of 8/min. What is the priority action?
A. Continue the infusion.
B. Stop the magnesium infusion and notify the provider.
C. Administer additional magnesium.
D. Encourage ambulation.
Correct Answer: B
Rationale: Loss of reflexes and respiratory depression suggest magnesium toxicity.
7. Which medication is the antidote for magnesium toxicity?
,A. Calcium gluconate
B. Naloxone
C. Vitamin K
D. Protamine sulfate
Correct Answer: A
Rationale: Calcium gluconate is used to counteract the effects of magnesium toxicity.
8. A pregnant patient at 32 weeks reports painless bright-red vaginal bleeding. Which
condition should be suspected?
A. Placenta previa
B. Abruptio placentae
C. Ectopic pregnancy
D. Endometriosis
Correct Answer: A
Rationale: Painless, bright-red bleeding in the later stages of pregnancy is characteristic of
placenta previa.
9. A pregnant patient presents with painful vaginal bleeding, a rigid tender uterus, and
fetal distress. Which condition is most likely?
A. Placenta previa
B. Abruptio placentae
C. Normal bloody show
D. Cervical insufficiency
Correct Answer: B
Rationale: Painful bleeding with uterine tenderness and fetal compromise suggests placental
abruption.
10. A patient with suspected placenta previa should avoid:
A. Ultrasound evaluation
B. Digital vaginal examination until placenta location is confirmed
, C. Maternal vital signs
D. Fetal monitoring
Correct Answer: B
Rationale: A digital vaginal examination may worsen bleeding if the placenta covers the
cervical opening.
11. Which symptom is most concerning for an ectopic pregnancy?
A. Mild nausea in early pregnancy
B. Unilateral pelvic pain with shoulder pain and dizziness
C. Increased urinary frequency
D. Mild breast tenderness
Correct Answer: B
Rationale: Unilateral pelvic pain, referred shoulder pain, and dizziness may indicate ruptured
ectopic pregnancy and internal bleeding.
12. A hemodynamically stable patient with an early, unruptured ectopic pregnancy may be
treated with:
A. Methotrexate
B. Oxytocin
C. Rho(D) immune globulin only
D. Magnesium sulfate
Correct Answer: A
Rationale: Methotrexate may be used for selected stable patients with an appropriately
diagnosed unruptured ectopic pregnancy.
13. Which laboratory finding is expected in iron-deficiency anemia during pregnancy?
A. Increased ferritin
B. Low hemoglobin and low ferritin
C. Increased hemoglobin
D. Increased platelet count only
and rationales 2026/2027 version A+ Graded
1. A pregnant patient at 10 weeks' gestation presents for the initial prenatal visit. Which
laboratory test is routinely included in the initial prenatal evaluation?
A. Troponin
B. Blood type and Rh factor
C. Serum lithium level
D. Amylase only
Correct Answer: B
Rationale: Initial prenatal evaluation commonly includes blood type, Rh status, CBC, infectious
disease screening, and other routine prenatal tests.
2. A pregnant patient is Rh-negative and the fetus may be Rh-positive. Which medication is
used to prevent Rh isoimmunization?
A. Oxytocin
B. Rho(D) immune globulin
C. Methotrexate
D. Misoprostol
Correct Answer: B
Rationale: Rho(D) immune globulin prevents maternal sensitization to Rh-positive fetal red
blood cells.
3. Which finding is most concerning in a pregnant patient with hypertension?
A. Mild ankle edema at the end of the day
B. Severe headache and visual disturbances
C. Increased appetite
D. Mild urinary frequency
Correct Answer: B
Rationale: Severe headache and visual changes may indicate severe preeclampsia and require
immediate evaluation.
,4. A pregnant patient has a blood pressure of 168/112 mmHg, severe headache, and
proteinuria. What is the priority concern?
A. Normal physiologic pregnancy changes
B. Severe preeclampsia
C. Mild anemia
D. Round ligament pain
Correct Answer: B
Rationale: Severe hypertension with neurologic symptoms and proteinuria is concerning for
severe preeclampsia.
5. Which medication is commonly used for seizure prophylaxis in severe preeclampsia?
A. Magnesium sulfate
B. Warfarin
C. Lithium
D. Methimazole
Correct Answer: A
Rationale: Magnesium sulfate is used to prevent seizures in patients with severe preeclampsia.
6. A patient receiving magnesium sulfate has absent deep tendon reflexes and a respiratory
rate of 8/min. What is the priority action?
A. Continue the infusion.
B. Stop the magnesium infusion and notify the provider.
C. Administer additional magnesium.
D. Encourage ambulation.
Correct Answer: B
Rationale: Loss of reflexes and respiratory depression suggest magnesium toxicity.
7. Which medication is the antidote for magnesium toxicity?
,A. Calcium gluconate
B. Naloxone
C. Vitamin K
D. Protamine sulfate
Correct Answer: A
Rationale: Calcium gluconate is used to counteract the effects of magnesium toxicity.
8. A pregnant patient at 32 weeks reports painless bright-red vaginal bleeding. Which
condition should be suspected?
A. Placenta previa
B. Abruptio placentae
C. Ectopic pregnancy
D. Endometriosis
Correct Answer: A
Rationale: Painless, bright-red bleeding in the later stages of pregnancy is characteristic of
placenta previa.
9. A pregnant patient presents with painful vaginal bleeding, a rigid tender uterus, and
fetal distress. Which condition is most likely?
A. Placenta previa
B. Abruptio placentae
C. Normal bloody show
D. Cervical insufficiency
Correct Answer: B
Rationale: Painful bleeding with uterine tenderness and fetal compromise suggests placental
abruption.
10. A patient with suspected placenta previa should avoid:
A. Ultrasound evaluation
B. Digital vaginal examination until placenta location is confirmed
, C. Maternal vital signs
D. Fetal monitoring
Correct Answer: B
Rationale: A digital vaginal examination may worsen bleeding if the placenta covers the
cervical opening.
11. Which symptom is most concerning for an ectopic pregnancy?
A. Mild nausea in early pregnancy
B. Unilateral pelvic pain with shoulder pain and dizziness
C. Increased urinary frequency
D. Mild breast tenderness
Correct Answer: B
Rationale: Unilateral pelvic pain, referred shoulder pain, and dizziness may indicate ruptured
ectopic pregnancy and internal bleeding.
12. A hemodynamically stable patient with an early, unruptured ectopic pregnancy may be
treated with:
A. Methotrexate
B. Oxytocin
C. Rho(D) immune globulin only
D. Magnesium sulfate
Correct Answer: A
Rationale: Methotrexate may be used for selected stable patients with an appropriately
diagnosed unruptured ectopic pregnancy.
13. Which laboratory finding is expected in iron-deficiency anemia during pregnancy?
A. Increased ferritin
B. Low hemoglobin and low ferritin
C. Increased hemoglobin
D. Increased platelet count only
