TEST BANK FOR GYNECOLOGIC HEALTH CARE
PRENATAL AND POSTPARTUM CARE (4TH
EDITION) BY SCHUILING & LIKIS – ALL
CHAPTERS INCLUDED
This comprehensive test bank features highly detailed
multiple-choice questions, accurate answer keys, and in-
depth rationales tailored specifically to the 4th edition of
Schuiling & Likis's Gynecologic Health Care. Perfect for
nurse practitioner, nurse-midwife, and advanced practice
nursing students, it covers crucial clinical topics from
preconception counseling through postpartum
complications. Master your exams, save valuable study time,
and ensure top grades with this definitive, high-yield
preparation resource.
Question 1
A 26-year-old nulligravida presents for a preconception
counseling visit. She has a history of type 2 diabetes mellitus
managed with metformin. Her current hemoglobin A1c is 8.4%.
Which of the following is the most accurate information to provide
regarding her glycemic control?
A) An HbA1c of 8.4% is optimal for preventing structural
congenital anomalies.
B) Metformin should be immediately discontinued and replaced
with lifestyle modifications only.
,C) Optimizing glycemic control to an HbA1c < 6.5% before
conception significantly reduces the risk of congenital cardiac and
neural tube defects.
D) Glycemic control does not impact early embryonic
development, only third-trimester fetal growth.
Correct Answer: C
Rationale: Preconception hyperglycemia is directly linked to an
increased risk of congenital structural anomalies, particularly
cardiac defects and sacral agenesis. The clinical goal for patients
with pre-gestational diabetes is to safely achieve an HbA1c as
close to normal as possible (ideally < 6.5%) prior to conception to
minimize these teratogenic risks. Metformin may be continued or
transitioned to insulin depending on individual clinical dynamics,
but glycemic optimization is the paramount priority.
Question 2
A woman at 8 weeks gestation asks about the safety of exercising
during pregnancy. She was sedentary prior to becoming pregnant.
Which of the following recommendations is most appropriate
according to current ACOG guidelines?
A) Exercise is contraindicated for women who were completely
sedentary before pregnancy.
B) She can safely initiate a regular, moderate-intensity exercise
routine, starting with 15–20 minutes of walking daily and gradually
increasing to 30 minutes.
C) She should limit her heart rate to a maximum of 100 beats per
minute during any physical activity.
D) Supine exercises are highly encouraged during the second
and third trimesters to stabilize the pelvis.
,Correct Answer: B
Rationale: Current professional guidelines support the initiation of
moderate-intensity exercise in previously sedentary pregnant
women, provided there are no absolute medical contraindications.
Walking is an ideal low-impact activity. Setting strict arbitrary heart
rate caps (e.g., 100 or 140 bpm) is no longer clinically
recommended; instead, the "talk test" is preferred. Supine
exercises should be avoided after the first trimester to prevent
aortocaval compression and subsequent maternal hypotension.
Question 3
An Rh-negative unsensitized G2P1 presents at 28 weeks
gestation for her routine prenatal visit. Her antibody screen
remains negative. Which of the following management plans is
correct?
A) Administer Rho(D) immune globulin (RhoGAM) 300 mcg
intramuscularly at this visit.
B) Defer Rho(D) immune globulin administration until the
immediate postpartum period, regardless of the infant's blood
type.
C) Administer Rho(D) immune globulin only if the patient
experiences open abdominal trauma.
D) Perform an amniocentesis immediately to determine the fetal
Rh status before administering any biological products.
Correct Answer: A
Rationale: To prevent maternal alloimmunization, an Rh-negative,
unsensitized patient should routinely receive a prophylactic dose
of 300 mcg of Rho(D) immune globulin at 28 weeks gestation. A
second dose is administered within 72 hours of delivery if the
neonate is confirmed to be Rh-positive. Waiting until postpartum
, or only administering it after trauma leaves a critical window of
vulnerability for spontaneous transplacental fetomaternal
hemorrhage in the third trimester.
Question 4
A pregnant patient at 36 weeks gestation tests positive for Group
B Streptococcus (GBS) via routine rectovaginal screening. She
has no history of drug allergies. What is the standard protocol for
managing this finding?
A) Immediate initiation of oral amoxicillin for 7 days to eradicate
the colonization before labor.
B) Intravenous penicillin G administration initiated at the onset of
active labor or rupture of membranes, continued until delivery.
C) Scheduled cesarean delivery at 39 weeks to bypass the
colonized birth canal entirely.
D) Intravenous clindamycin administration starting immediately in
the outpatient clinic setting.
Correct Answer: B
Rationale: Routine rectovaginal screening for GBS is performed
between 36 0/7 and 37 6/7 weeks gestation. Antepartum oral
antibiotics do not effectively eradicate GBS colonization by the
time of delivery. Therefore, intrapartum intravenous antibiotic
prophylaxis (typically penicillin G or ampicillin) is indicated at the
onset of labor or rupture of membranes to minimize the risk of
early-onset neonatal GBS sepsis.
Question 5
During a routine prenatal visit at 32 weeks gestation, a patient
reports experiencing sudden, sharp, shooting pains in her lower
groin area when she changes positions in bed or stands up
PRENATAL AND POSTPARTUM CARE (4TH
EDITION) BY SCHUILING & LIKIS – ALL
CHAPTERS INCLUDED
This comprehensive test bank features highly detailed
multiple-choice questions, accurate answer keys, and in-
depth rationales tailored specifically to the 4th edition of
Schuiling & Likis's Gynecologic Health Care. Perfect for
nurse practitioner, nurse-midwife, and advanced practice
nursing students, it covers crucial clinical topics from
preconception counseling through postpartum
complications. Master your exams, save valuable study time,
and ensure top grades with this definitive, high-yield
preparation resource.
Question 1
A 26-year-old nulligravida presents for a preconception
counseling visit. She has a history of type 2 diabetes mellitus
managed with metformin. Her current hemoglobin A1c is 8.4%.
Which of the following is the most accurate information to provide
regarding her glycemic control?
A) An HbA1c of 8.4% is optimal for preventing structural
congenital anomalies.
B) Metformin should be immediately discontinued and replaced
with lifestyle modifications only.
,C) Optimizing glycemic control to an HbA1c < 6.5% before
conception significantly reduces the risk of congenital cardiac and
neural tube defects.
D) Glycemic control does not impact early embryonic
development, only third-trimester fetal growth.
Correct Answer: C
Rationale: Preconception hyperglycemia is directly linked to an
increased risk of congenital structural anomalies, particularly
cardiac defects and sacral agenesis. The clinical goal for patients
with pre-gestational diabetes is to safely achieve an HbA1c as
close to normal as possible (ideally < 6.5%) prior to conception to
minimize these teratogenic risks. Metformin may be continued or
transitioned to insulin depending on individual clinical dynamics,
but glycemic optimization is the paramount priority.
Question 2
A woman at 8 weeks gestation asks about the safety of exercising
during pregnancy. She was sedentary prior to becoming pregnant.
Which of the following recommendations is most appropriate
according to current ACOG guidelines?
A) Exercise is contraindicated for women who were completely
sedentary before pregnancy.
B) She can safely initiate a regular, moderate-intensity exercise
routine, starting with 15–20 minutes of walking daily and gradually
increasing to 30 minutes.
C) She should limit her heart rate to a maximum of 100 beats per
minute during any physical activity.
D) Supine exercises are highly encouraged during the second
and third trimesters to stabilize the pelvis.
,Correct Answer: B
Rationale: Current professional guidelines support the initiation of
moderate-intensity exercise in previously sedentary pregnant
women, provided there are no absolute medical contraindications.
Walking is an ideal low-impact activity. Setting strict arbitrary heart
rate caps (e.g., 100 or 140 bpm) is no longer clinically
recommended; instead, the "talk test" is preferred. Supine
exercises should be avoided after the first trimester to prevent
aortocaval compression and subsequent maternal hypotension.
Question 3
An Rh-negative unsensitized G2P1 presents at 28 weeks
gestation for her routine prenatal visit. Her antibody screen
remains negative. Which of the following management plans is
correct?
A) Administer Rho(D) immune globulin (RhoGAM) 300 mcg
intramuscularly at this visit.
B) Defer Rho(D) immune globulin administration until the
immediate postpartum period, regardless of the infant's blood
type.
C) Administer Rho(D) immune globulin only if the patient
experiences open abdominal trauma.
D) Perform an amniocentesis immediately to determine the fetal
Rh status before administering any biological products.
Correct Answer: A
Rationale: To prevent maternal alloimmunization, an Rh-negative,
unsensitized patient should routinely receive a prophylactic dose
of 300 mcg of Rho(D) immune globulin at 28 weeks gestation. A
second dose is administered within 72 hours of delivery if the
neonate is confirmed to be Rh-positive. Waiting until postpartum
, or only administering it after trauma leaves a critical window of
vulnerability for spontaneous transplacental fetomaternal
hemorrhage in the third trimester.
Question 4
A pregnant patient at 36 weeks gestation tests positive for Group
B Streptococcus (GBS) via routine rectovaginal screening. She
has no history of drug allergies. What is the standard protocol for
managing this finding?
A) Immediate initiation of oral amoxicillin for 7 days to eradicate
the colonization before labor.
B) Intravenous penicillin G administration initiated at the onset of
active labor or rupture of membranes, continued until delivery.
C) Scheduled cesarean delivery at 39 weeks to bypass the
colonized birth canal entirely.
D) Intravenous clindamycin administration starting immediately in
the outpatient clinic setting.
Correct Answer: B
Rationale: Routine rectovaginal screening for GBS is performed
between 36 0/7 and 37 6/7 weeks gestation. Antepartum oral
antibiotics do not effectively eradicate GBS colonization by the
time of delivery. Therefore, intrapartum intravenous antibiotic
prophylaxis (typically penicillin G or ampicillin) is indicated at the
onset of labor or rupture of membranes to minimize the risk of
early-onset neonatal GBS sepsis.
Question 5
During a routine prenatal visit at 32 weeks gestation, a patient
reports experiencing sudden, sharp, shooting pains in her lower
groin area when she changes positions in bed or stands up
