NM702 Practice Test Questions with Verified
Correct Answers
1. How would you determine an EDB and current gestational age for a patient who
presents for initial prenatal care in the second trimester? What if the person was sure of
their LMP? What if they had no idea about LMP? What other ways could you
corroborate the EDB?
· Start by using the same history-taking approach we use during the first trimester.
· Asking the person their recollection of their last menstrual period, if they recorded it
anywhere, if any memory joggers would help them remember, etc.
· You would then use the same decision-making process that you used in the first trimester as
to whether a dating ultrasound is clinically superior to using menstrual-based dates.
· In other situations, menstrual history-taking is insufficient, and a dating ultrasound is
crucial.
· Regardless of the method, carefully begin the process of corroborating the dates through
multiple elements.
o Onset of pregnancy symptoms
o Date of any positive home pregnancy tests
o Date of quickening (first fetal movement the patient felt)
o Fundal height.
These data points may or may not be available, but it is clinically reassuring to know that
additional elements align and provide more support for the dates you've developed
Which fetal structures are used for dating ultrasounds in the second trimester
· The later in pregnancy that a dating ultrasound is preformed, the greater the amount of
uncertainty and error inherent in the calculation of the EDB
,· Be cautious changing EDB in the second trimester, once an EDB has been set in the first
trimester it is very rare to change it in the second trimester
-Biparietal Diameter (BPD)
-Head Circumference (HC)
-Abdominal Circumference (AC)
-Femur Length (FL)
Practice Scenario #1
· Sure LMP and regular, 28-day cycles
· LMP = January 5, 2021
· Using Naegele's Rule, EDB = October 11, 2021
· US measured CRL at 9 weeks 4 days and provided EDB = October 7, 2021
· Difference between menstrual date and US date = 4 days
-This is in the 9 - 13 6/7 weeks range when we change the date if the difference is more than
7 days
-Because the difference between LMP-based date and US date is less than the guidelines
range, DECISION: Use the LMP-based EDB (October 11, 2021)
Practice Scenario #2
· Naegele's Rule EDB = September 15, 2021
· US measured BPD/HC/AC/FL at 19 weeks 1 day and provided EDB = September 7,
2021
· Difference between menstrual date and US date = 8 days
,· This is in the 16 - 21 6/7 weeks range when we change the date if the difference is more
than 10 days
· Because the difference between the LMP-based date and US date is LESS than the
guideline range, DECISION: Use the later, LMP-based EDB (September 15, 2021).
Practice Scenario #3
· Naegele's Rule EDB = September 15, 2021
· US measured BPD/HC/AC/FL at 15 weeks 1 day and provided EDB = September 5,
2021
· Difference between menstrual date and US date = 10 days
· This is in the 14 - 15 6/7 weeks range when we change the date if the difference is more
than 7 days
· Because the difference between the LMP-based date and US date is MORE than the
guideline range, DECISION: Use the earlier, US-based EDB (September 5, 2021).
Why are earlier dating ultrasounds more accurate than later dating ultrasounds?
-All conceptuses begin at the same size, but fetal growth becomes more and more variable as
the pregnancy progresses
How would you decide whether to change a due date at different gestational ages in the
second trimester?
9-13 6/7 = more than 7 days
14-15 6/7 = more than 7 days
16-21 6/7 = more than 10 days
22-27 6/7 = more than 14 days
, Imagine a patient is unhappy with the EDB you have set. How will you respond?
· Explain that harm could result from using a less accurate EDB if complications were to
present later in pregnancy necessitating interventions such as induction of labor.
· Explore the patients' thoughts about the EDB and why they are unhappy about it. See if
there is something you could do to help them feel better about the situation. Get to the reason
they are feeling this way.
· The bottom line is that you should not change a due date unless it meets the guidelines, but
you will want to be supportive and kind, providing individualized and respectful education,
and listening carefully to the patient's concerns.
What do you expect for a second-trimester blood pressure compared with the person's
baseline: higher, lower, or unchanged? What is the physiologic reason?
· Throughout the second trimester, you should continue to expect blood pressure to be a bit
lower than the persons normal.
· The arteries continue to be relaxed and peripheral vascular resistance continues to be lower
than nonpregnant people so decreased blood pressure is normal until about 32 weeks’
gestation.
· At each visit, you'll not only look at the current BP, but you'll also look back at previous
visits' readings and any nonpregnant BPs available as a baseline.
1. How will you assess maternal weight gain in the second trimester? What factors will
you consider?
Clinicians find that several factors influence weight gain in the second trimester. Nausea and
vomiting are often gone or greatly diminished, leading to improved appetite and a broader
range of foods the person is interested in eating. In some people, this can cause a jump in
Correct Answers
1. How would you determine an EDB and current gestational age for a patient who
presents for initial prenatal care in the second trimester? What if the person was sure of
their LMP? What if they had no idea about LMP? What other ways could you
corroborate the EDB?
· Start by using the same history-taking approach we use during the first trimester.
· Asking the person their recollection of their last menstrual period, if they recorded it
anywhere, if any memory joggers would help them remember, etc.
· You would then use the same decision-making process that you used in the first trimester as
to whether a dating ultrasound is clinically superior to using menstrual-based dates.
· In other situations, menstrual history-taking is insufficient, and a dating ultrasound is
crucial.
· Regardless of the method, carefully begin the process of corroborating the dates through
multiple elements.
o Onset of pregnancy symptoms
o Date of any positive home pregnancy tests
o Date of quickening (first fetal movement the patient felt)
o Fundal height.
These data points may or may not be available, but it is clinically reassuring to know that
additional elements align and provide more support for the dates you've developed
Which fetal structures are used for dating ultrasounds in the second trimester
· The later in pregnancy that a dating ultrasound is preformed, the greater the amount of
uncertainty and error inherent in the calculation of the EDB
,· Be cautious changing EDB in the second trimester, once an EDB has been set in the first
trimester it is very rare to change it in the second trimester
-Biparietal Diameter (BPD)
-Head Circumference (HC)
-Abdominal Circumference (AC)
-Femur Length (FL)
Practice Scenario #1
· Sure LMP and regular, 28-day cycles
· LMP = January 5, 2021
· Using Naegele's Rule, EDB = October 11, 2021
· US measured CRL at 9 weeks 4 days and provided EDB = October 7, 2021
· Difference between menstrual date and US date = 4 days
-This is in the 9 - 13 6/7 weeks range when we change the date if the difference is more than
7 days
-Because the difference between LMP-based date and US date is less than the guidelines
range, DECISION: Use the LMP-based EDB (October 11, 2021)
Practice Scenario #2
· Naegele's Rule EDB = September 15, 2021
· US measured BPD/HC/AC/FL at 19 weeks 1 day and provided EDB = September 7,
2021
· Difference between menstrual date and US date = 8 days
,· This is in the 16 - 21 6/7 weeks range when we change the date if the difference is more
than 10 days
· Because the difference between the LMP-based date and US date is LESS than the
guideline range, DECISION: Use the later, LMP-based EDB (September 15, 2021).
Practice Scenario #3
· Naegele's Rule EDB = September 15, 2021
· US measured BPD/HC/AC/FL at 15 weeks 1 day and provided EDB = September 5,
2021
· Difference between menstrual date and US date = 10 days
· This is in the 14 - 15 6/7 weeks range when we change the date if the difference is more
than 7 days
· Because the difference between the LMP-based date and US date is MORE than the
guideline range, DECISION: Use the earlier, US-based EDB (September 5, 2021).
Why are earlier dating ultrasounds more accurate than later dating ultrasounds?
-All conceptuses begin at the same size, but fetal growth becomes more and more variable as
the pregnancy progresses
How would you decide whether to change a due date at different gestational ages in the
second trimester?
9-13 6/7 = more than 7 days
14-15 6/7 = more than 7 days
16-21 6/7 = more than 10 days
22-27 6/7 = more than 14 days
, Imagine a patient is unhappy with the EDB you have set. How will you respond?
· Explain that harm could result from using a less accurate EDB if complications were to
present later in pregnancy necessitating interventions such as induction of labor.
· Explore the patients' thoughts about the EDB and why they are unhappy about it. See if
there is something you could do to help them feel better about the situation. Get to the reason
they are feeling this way.
· The bottom line is that you should not change a due date unless it meets the guidelines, but
you will want to be supportive and kind, providing individualized and respectful education,
and listening carefully to the patient's concerns.
What do you expect for a second-trimester blood pressure compared with the person's
baseline: higher, lower, or unchanged? What is the physiologic reason?
· Throughout the second trimester, you should continue to expect blood pressure to be a bit
lower than the persons normal.
· The arteries continue to be relaxed and peripheral vascular resistance continues to be lower
than nonpregnant people so decreased blood pressure is normal until about 32 weeks’
gestation.
· At each visit, you'll not only look at the current BP, but you'll also look back at previous
visits' readings and any nonpregnant BPs available as a baseline.
1. How will you assess maternal weight gain in the second trimester? What factors will
you consider?
Clinicians find that several factors influence weight gain in the second trimester. Nausea and
vomiting are often gone or greatly diminished, leading to improved appetite and a broader
range of foods the person is interested in eating. In some people, this can cause a jump in
