A 27-year-old female was evaluated one week ago for vaginal bleeding. She reported a
history of normal menses until "a month or two ago." She is not sure when it started, but
she had been spotting/bleeding almost continuously for the last 3-4 weeks. She is sexually
active and is not using contraception. She denied abdominal pain, fever, or any other
symptoms. Pelvic ultrasound two weeks ago revealed a gestational sac in the uterus but no
heartbeat appreciated. A quantitative hCG was 15,000 IU/L. Today her repeat quantitative
hCG is 49,000 IU/L. The nurse practitioner informs the patient that she:
Likely has a molar pregnancy and needs additional radiographic testing.
Could have an ectopic pregnancy and needs to have another ultrasound today.
Appears to have had a spontaneous abortion and will need dilation and evacuation.
Most likely has an intrauterine pregnancy that will be confirmed by ultrasound in a few w -
ANSWER Most likely has an intrauterine pregnancy that will be confirmed by
ultrasound in a few weeks.
When counseling a breastfeeding woman about alcohol use during lactation, you inform the
woman about all of the following except:
Alcohol use inhibits the letdown reflex.
Alcohol use decreases milk production.
Infant intoxication can be seen with the mother ingesting as little as 5?10 ounces of wine or
its equivalent during a 2-hour time period.
Alcohol will readily pass into breast milk due to its low molecular weight. -
ANSWER Infant intoxication can be seen with the mother ingesting as little as 5-10
ounces of wine or its equivalent during a 2-hour time period.
1
,The NP sees a 27-year-old mother who is breastfeeding a 4-month-old infant. The mother is
diagnosed with acute bacterial rhinosinusitis and requires antimicrobial therapy. Which of
the following is the most appropriate choice?
Oral clindamycin
Oral amoxicillin-clavulanate
Oral cefixime
Oral doxycycline - ANSWER Oral amoxicillin-clavulanate
Amoxicillin-clavulanate is a preferred antimicrobial for the treatment of -
ANSWER Acute Bacterial rhinosinusitis
You see a 27-year-old woman in her second trimester who is diagnosed with prenatal
depression. In counseling her about the use of an SSRI during pregnancy and its possible
effect on the fetus or infant, you consider that studies to date reveal that:
In exposed neonates, increased rates of irritability have been reported.
The drugs have a negative effect on intellectual development.
A clear teratogenic pattern has been identified.
There is an increased rate of sudden unexpected infant death (SUID) in exposed offspring. -
ANSWER In exposed neonates, increased rates of irritability have been reported.
According to Hale's lactation risk categories, a drug that has been studied in a limited
number of breastfeeding women without an increase in adverse effects in the infant is given
category:
QID: 3677926
Mark For Review
L1.
L2.
L3.
2
, L4. - ANSWER L2
In caring for an acutely symptomatic woman with lactation-associated mastitis, you advise
her to:
Continue to nurse only on the unaffected side.
Pump the breasts and discard the milk from the affected side.
Continue to nurse the baby as much as the mother tolerates.
Initiate a course of antimicrobials. - ANSWER Continue to nurse the baby as much as
the mother tolerates.
Clinical presentation of a woman with ectopic pregnancy is likely to include:
Uterine size greater than normal for gestational age.
Protracted amenorrhea.
Nausea and vomiting.
Low serum hCG level for gestational age. - ANSWER Low serum hCG level for
gestational age.
A 25-year-old G3, P2, Ab0 woman with gestational age of 37 weeks presents with painless
vaginal bleeding, having soaked 3 pads in the past 2 hours. Examination reveals a soft,
relaxed uterus consistent with gestational age. The most likely diagnosis is:
Hemorrhagic cervicitis.
Placental abruption.
Membrane rupture.
Placenta previa. - ANSWER Placenta previa.
3
history of normal menses until "a month or two ago." She is not sure when it started, but
she had been spotting/bleeding almost continuously for the last 3-4 weeks. She is sexually
active and is not using contraception. She denied abdominal pain, fever, or any other
symptoms. Pelvic ultrasound two weeks ago revealed a gestational sac in the uterus but no
heartbeat appreciated. A quantitative hCG was 15,000 IU/L. Today her repeat quantitative
hCG is 49,000 IU/L. The nurse practitioner informs the patient that she:
Likely has a molar pregnancy and needs additional radiographic testing.
Could have an ectopic pregnancy and needs to have another ultrasound today.
Appears to have had a spontaneous abortion and will need dilation and evacuation.
Most likely has an intrauterine pregnancy that will be confirmed by ultrasound in a few w -
ANSWER Most likely has an intrauterine pregnancy that will be confirmed by
ultrasound in a few weeks.
When counseling a breastfeeding woman about alcohol use during lactation, you inform the
woman about all of the following except:
Alcohol use inhibits the letdown reflex.
Alcohol use decreases milk production.
Infant intoxication can be seen with the mother ingesting as little as 5?10 ounces of wine or
its equivalent during a 2-hour time period.
Alcohol will readily pass into breast milk due to its low molecular weight. -
ANSWER Infant intoxication can be seen with the mother ingesting as little as 5-10
ounces of wine or its equivalent during a 2-hour time period.
1
,The NP sees a 27-year-old mother who is breastfeeding a 4-month-old infant. The mother is
diagnosed with acute bacterial rhinosinusitis and requires antimicrobial therapy. Which of
the following is the most appropriate choice?
Oral clindamycin
Oral amoxicillin-clavulanate
Oral cefixime
Oral doxycycline - ANSWER Oral amoxicillin-clavulanate
Amoxicillin-clavulanate is a preferred antimicrobial for the treatment of -
ANSWER Acute Bacterial rhinosinusitis
You see a 27-year-old woman in her second trimester who is diagnosed with prenatal
depression. In counseling her about the use of an SSRI during pregnancy and its possible
effect on the fetus or infant, you consider that studies to date reveal that:
In exposed neonates, increased rates of irritability have been reported.
The drugs have a negative effect on intellectual development.
A clear teratogenic pattern has been identified.
There is an increased rate of sudden unexpected infant death (SUID) in exposed offspring. -
ANSWER In exposed neonates, increased rates of irritability have been reported.
According to Hale's lactation risk categories, a drug that has been studied in a limited
number of breastfeeding women without an increase in adverse effects in the infant is given
category:
QID: 3677926
Mark For Review
L1.
L2.
L3.
2
, L4. - ANSWER L2
In caring for an acutely symptomatic woman with lactation-associated mastitis, you advise
her to:
Continue to nurse only on the unaffected side.
Pump the breasts and discard the milk from the affected side.
Continue to nurse the baby as much as the mother tolerates.
Initiate a course of antimicrobials. - ANSWER Continue to nurse the baby as much as
the mother tolerates.
Clinical presentation of a woman with ectopic pregnancy is likely to include:
Uterine size greater than normal for gestational age.
Protracted amenorrhea.
Nausea and vomiting.
Low serum hCG level for gestational age. - ANSWER Low serum hCG level for
gestational age.
A 25-year-old G3, P2, Ab0 woman with gestational age of 37 weeks presents with painless
vaginal bleeding, having soaked 3 pads in the past 2 hours. Examination reveals a soft,
relaxed uterus consistent with gestational age. The most likely diagnosis is:
Hemorrhagic cervicitis.
Placental abruption.
Membrane rupture.
Placenta previa. - ANSWER Placenta previa.
3
