PRIMARY CARE OF CHILDBEARING
AND CHILDREARING FAMILIES
ADVANCED QUESTIONS AND ANSWERS
1. A 24-year-old primigravida at 28 weeks gestation presents with a blood pressure of 145/95
mmHg and 1+ proteinuria. Which is the most appropriate next step in management?
A. Immediate hospitalization and delivery
B. Start antihypertensive medication immediately
C. Order a 24-hour urine collection for protein and creatinine clearance
D. Schedule a follow-up visit in two weeks
Answer: C
Conceptual Explanation: Preeclampsia is diagnosed by new-onset hypertension after 20
weeks with proteinuria. A 24-hour urine collection is the gold standard to quantify protein
excretion.
2. Which of the following physical findings is a classic sign of developmental dysplasia of the
hip (DDH) in a 4-month-old infant?
A. Asymmetric thigh skin folds
,B. Positive Ortolani maneuver
C. Internal rotation of the femur
D. Presence of a sacral dimple
Answer: A
Conceptual Explanation: While Ortolani and Barlow are useful in newborns, as the infant
gets older, signs like asymmetric thigh folds and limited hip abduction become more
prominent markers for DDH.
3. According to the CDC immunization schedule, which vaccines should a 2-month-old infant
receive?
A. Rotavirus, DTaP, Hib, PCV13, IPV, HepB
B. MMR, Varicella, HepB
C. DTaP, MMR, Hib, Influenza
D. HepB, IPV, Varicella, Meningococcal
Answer: A
Conceptual Explanation: The 2-month visit typically includes the second dose of HepB
and the first doses of Rotavirus, DTaP, Hib, PCV13, and IPV.
4. A pregnant patient at 10 weeks gestation asks about the safety of using Ibuprofen for
headaches. What is the best advice?
A. It is safe throughout the entire pregnancy.
, B. It is preferred over Acetaminophen in the first trimester.
C. Avoid it, especially in the third trimester due to risk of premature closure of the ductus
arteriosus.
D. It should only be used if Acetaminophen causes a rash.
Answer: C
Conceptual Explanation: NSAIDs like Ibuprofen are generally avoided in pregnancy,
particularly after 20-30 weeks, to prevent premature closure of the ductus arteriosus and
oligohydramnios.
5. What is the primary diagnostic criterion for Gestational Diabetes Mellitus (GDM) using the
‘one-step’ 75g OGTT method?
A. Fasting blood glucose ≥ 126 mg/dL
B. Fasting blood glucose ≥ 92 mg/dL
C. 1-hour glucose ≥ 140 mg/dL
D. HbA1c ≥ 6.5%
Answer: B
Conceptual Explanation: According to ADA/IADPSG criteria, a fasting plasma glucose of
92 mg/dL or higher is diagnostic for GDM in the one-step method.
AND CHILDREARING FAMILIES
ADVANCED QUESTIONS AND ANSWERS
1. A 24-year-old primigravida at 28 weeks gestation presents with a blood pressure of 145/95
mmHg and 1+ proteinuria. Which is the most appropriate next step in management?
A. Immediate hospitalization and delivery
B. Start antihypertensive medication immediately
C. Order a 24-hour urine collection for protein and creatinine clearance
D. Schedule a follow-up visit in two weeks
Answer: C
Conceptual Explanation: Preeclampsia is diagnosed by new-onset hypertension after 20
weeks with proteinuria. A 24-hour urine collection is the gold standard to quantify protein
excretion.
2. Which of the following physical findings is a classic sign of developmental dysplasia of the
hip (DDH) in a 4-month-old infant?
A. Asymmetric thigh skin folds
,B. Positive Ortolani maneuver
C. Internal rotation of the femur
D. Presence of a sacral dimple
Answer: A
Conceptual Explanation: While Ortolani and Barlow are useful in newborns, as the infant
gets older, signs like asymmetric thigh folds and limited hip abduction become more
prominent markers for DDH.
3. According to the CDC immunization schedule, which vaccines should a 2-month-old infant
receive?
A. Rotavirus, DTaP, Hib, PCV13, IPV, HepB
B. MMR, Varicella, HepB
C. DTaP, MMR, Hib, Influenza
D. HepB, IPV, Varicella, Meningococcal
Answer: A
Conceptual Explanation: The 2-month visit typically includes the second dose of HepB
and the first doses of Rotavirus, DTaP, Hib, PCV13, and IPV.
4. A pregnant patient at 10 weeks gestation asks about the safety of using Ibuprofen for
headaches. What is the best advice?
A. It is safe throughout the entire pregnancy.
, B. It is preferred over Acetaminophen in the first trimester.
C. Avoid it, especially in the third trimester due to risk of premature closure of the ductus
arteriosus.
D. It should only be used if Acetaminophen causes a rash.
Answer: C
Conceptual Explanation: NSAIDs like Ibuprofen are generally avoided in pregnancy,
particularly after 20-30 weeks, to prevent premature closure of the ductus arteriosus and
oligohydramnios.
5. What is the primary diagnostic criterion for Gestational Diabetes Mellitus (GDM) using the
‘one-step’ 75g OGTT method?
A. Fasting blood glucose ≥ 126 mg/dL
B. Fasting blood glucose ≥ 92 mg/dL
C. 1-hour glucose ≥ 140 mg/dL
D. HbA1c ≥ 6.5%
Answer: B
Conceptual Explanation: According to ADA/IADPSG criteria, a fasting plasma glucose of
92 mg/dL or higher is diagnostic for GDM in the one-step method.
