PRIMARY CARE OF CHILDBEARING
AND CHILDREARING FAMILIES
COMPREHENSIVE EXAM
1. A 26-year-old primigravida at 28 weeks gestation presents for a routine check-up. Her
glucose challenge test (GCT) result is 155 mg/dL. What is the next most appropriate step in
management?
A. Diagnose gestational diabetes and start insulin
B. Advise the patient to monitor her blood glucose at home for one week
C. Repeat the glucose challenge test in two weeks
D. Perform a 3-hour oral glucose tolerance test (OGTT)
Answer: D
Conceptual Explanation: A 1-hour GCT result above 140 mg/dL is considered positive and
requires a follow-up 3-hour OGTT to confirm the diagnosis of gestational diabetes.
2. Which of the following findings is the most sensitive indicator of iron deficiency anemia in
a pregnant woman?
A. Serum ferritin level
,B. Serum iron level
C. Mean corpuscular volume (MCV)
D. Total iron-binding capacity (TIBC)
Answer: A
Conceptual Explanation: Serum ferritin is the most sensitive test for identifying iron
deficiency in pregnancy as it reflects actual iron stores before hemoglobin levels drop.
3. At which gestational age should a pregnant woman be screened for Group B Streptococcus
(GBS) colonization?
A. 24-28 weeks
B. 36-37 weeks
C. 28-32 weeks
D. 32-34 weeks
Answer: B
Conceptual Explanation: Universal screening for GBS colonization is recommended for all
pregnant women between 36 0/7 and 37 6/7 weeks of gestation.
4. A 4-month-old infant is brought in for a well-child visit. Which developmental milestone is
typically achieved by this age?
A. Sitting without support
B. Transferring objects from hand to hand
, C. Using a pincer grasp
D. Rolling from prone to supine
Answer: D
Conceptual Explanation: By 4 months, infants usually roll from stomach to back. Sitting
unsupported occurs around 6 months, and pincer grasp around 9 months.
5. In the management of a child with Croup, which clinical finding would most strongly
indicate the need for nebulized epinephrine?
A. Barking cough
B. Low-grade fever
C. Hoarseness
D. Stridor at rest
Answer: D
Conceptual Explanation: Stridor at rest indicates severe airway obstruction in a child
with Croup and necessitates immediate treatment with nebulized epinephrine and
corticosteroids.
6. A 14-year-old female presents with primary dysmenorrhea. Which medication is
considered the first-line treatment?
A. Combined oral contraceptives
B. Nonsteroidal anti-inflammatory drugs (NSAIDs)
AND CHILDREARING FAMILIES
COMPREHENSIVE EXAM
1. A 26-year-old primigravida at 28 weeks gestation presents for a routine check-up. Her
glucose challenge test (GCT) result is 155 mg/dL. What is the next most appropriate step in
management?
A. Diagnose gestational diabetes and start insulin
B. Advise the patient to monitor her blood glucose at home for one week
C. Repeat the glucose challenge test in two weeks
D. Perform a 3-hour oral glucose tolerance test (OGTT)
Answer: D
Conceptual Explanation: A 1-hour GCT result above 140 mg/dL is considered positive and
requires a follow-up 3-hour OGTT to confirm the diagnosis of gestational diabetes.
2. Which of the following findings is the most sensitive indicator of iron deficiency anemia in
a pregnant woman?
A. Serum ferritin level
,B. Serum iron level
C. Mean corpuscular volume (MCV)
D. Total iron-binding capacity (TIBC)
Answer: A
Conceptual Explanation: Serum ferritin is the most sensitive test for identifying iron
deficiency in pregnancy as it reflects actual iron stores before hemoglobin levels drop.
3. At which gestational age should a pregnant woman be screened for Group B Streptococcus
(GBS) colonization?
A. 24-28 weeks
B. 36-37 weeks
C. 28-32 weeks
D. 32-34 weeks
Answer: B
Conceptual Explanation: Universal screening for GBS colonization is recommended for all
pregnant women between 36 0/7 and 37 6/7 weeks of gestation.
4. A 4-month-old infant is brought in for a well-child visit. Which developmental milestone is
typically achieved by this age?
A. Sitting without support
B. Transferring objects from hand to hand
, C. Using a pincer grasp
D. Rolling from prone to supine
Answer: D
Conceptual Explanation: By 4 months, infants usually roll from stomach to back. Sitting
unsupported occurs around 6 months, and pincer grasp around 9 months.
5. In the management of a child with Croup, which clinical finding would most strongly
indicate the need for nebulized epinephrine?
A. Barking cough
B. Low-grade fever
C. Hoarseness
D. Stridor at rest
Answer: D
Conceptual Explanation: Stridor at rest indicates severe airway obstruction in a child
with Croup and necessitates immediate treatment with nebulized epinephrine and
corticosteroids.
6. A 14-year-old female presents with primary dysmenorrhea. Which medication is
considered the first-line treatment?
A. Combined oral contraceptives
B. Nonsteroidal anti-inflammatory drugs (NSAIDs)
