Aquifer FM Qs at end of case 1-40
Study online at https://quizlet.com/_97gcn4
AQUIFER FM QS AT END OF CASE 1-40 QUESTIONS WITH VERY
CORRECT ANSWERS, 2024/2025
1. *Case 30: Question 1*
A 21-year-old G1P0 female present to clinic as a new patient to establish prenatal
care. Which statement represents something that would not be expected to be a
benefit of group prenatal care for this patient?
A. Decreases the likelihood of preterm delivery
B. Increases physician contact
C. Increases support network
D. Shared education between patients
E. Increases adherence to techniques for pain management during labor: The
correct Answer is E.
E. Increases adherence to techniques for pain management during labor
Clear, health literate communication about options for pain management are a benefit
of group prenatal care, not adherence to a particular pain management plan.
Answer choices A, B, C and D are benefits of group prenatal care.
Advantages of group prenatal visits: increase prenatal knowledge, labor preparedness,
support network, shared education between patients, and patient satisfaction
provide more time for prenatal education and anticipatory guidance improve
provider efficiency
preterm delivery less likely (more significant for African-American women) -preterm
birth is the number one cause for neonatal death in African-American infants increased
birth weight of preterm infants (a significant survival determinant) combat racial
disparities used for a variety of medical conditions, including diabetes and chronic
pain.
2. *Case 30: Question 2*
A 24-year-old G1P0 female at 38 weeks gestation presents to ED complaining of
strong lower abdominal contractions that are 10 minutes apart for the last hour.
Subsequent cervical examination demonstrates that she is 2cm dilated.
FHT are 140 and NST is non-reactive with early decelerations. What
is the most appropriate management of this patient?
, Aquifer FM Qs at end of case 1-40
Study online at https://quizlet.com/_97gcn4
A. Augment labor with Pitocin
B. C-section
C. Expectant management
D. Immediate vacuum delivery
E. Rupture membranes to increase labor: The correct answer is C.
C. Expectant management
Expectant management is the most appropriate management at this time. ** Patient is
currently not in active labor. Active labor is defined as cervical dilation > 6 cm in the
presence of contractions. Contractions are normally 3-5 minutes apart. Fetus is not in
distress at this time. Early decelerations are indicative of head compression and are not
especially concerning.
It is not generally advised to induce patients prior to 39 weeks if there are no
complications and fetus is not in distress.
C-section would not be indicated in this case because neither mother and baby are
stable and not in distress.
Immediate vacuum delivery is not indicated in this case. Vacuum delivery is indicated
only during the second stage of labor, which is the beginning of pushing to the delivery
of the baby.
3. *Case 30: Question 3*
The NST tracing attached is most consistent with:
A. Cord compression
B. Head compression
C. Uteroplacental insufficiency
D. Fetal bradycardia
E. Fetal tachycardia: The correct answer is B.
B. Head compression
The NST tracing shows early decelerations which indicate head compression. Early
decelerations coincide with the beginning and end of a contraction. It is the
characteristic "mirror image" of a contraction.
Cord compression is indicated by variable decelerations which are a decrease in fetal
heart rate that vary in timing, duration, and intensity. It often looks like the letter "V"
and does not necessarily correspond to contractions.
, Aquifer FM Qs at end of case 1-40
Study online at https://quizlet.com/_97gcn4
4. *Case 30: Question 4*
A 32-year-old female at 33 weeks and 5 days gestation (G2P1) presents to the
clinic with headache and RUQ abdominal pain. Blood pressure is 172/121 mmHg
on examination while seated. No visual changes noted. Edema is present in the
hands, bilaterally. Urine dipstick demonstrated 4+ protein. FHT are 117.
Which of the following is the most appropriate next step in the management of
this patient?
A. Twice-weekly non-stress testing
B. Daily aspirin
C. Expedited delivery of the premature fetus
D. Lisinopril
E. Strict bed rest until 37 weeks: The correct answer is C.
C. Expedited delivery of the premature fetus
Expedited delivery of the fetus is the best treatment for severe pre-eclampsia. (Note:
severe pre-eclampsia is not necessarily an indication for a C-section, however.)
6. *Case 31: Question 1*
Which of the following is not a risk factor for CAD?
A. Hypertension
B. Female sex
C. Smoking
D. Diabetes: The correct answer is B.
B. Female sex
Hypertension, smoking, and diabetes (along with elevated lipid levels, obesity, and
sedentary lifestyle) are modifiable risk factors for CAD.
Non-modifiable risk factors include older age (men>45 and women >55), family
history of CAD in a first-degree relative at a young age, and male sex.
7. *Case 31: Question 2*
A 56-year-old male presents for care at the ED complaining of dry cough for the
past three days. He notes that this problem started a few days after his family's
, Aquifer FM Qs at end of case 1-40
Study online at https://quizlet.com/_97gcn4
annual fish fry and barbecue and has been worsening since. He has no known past
medical history but mentions that he has not seen a doctor in years. He notes that
the cough is worse at night often waking him from sleep. He is unable to lie flat on
his back and has started using three to four pillows to sleep comfortably. He also
reports increased swelling in his legs that worsens throughout the day. He denies
having any chest pain or palpitations and also does not believe he has had any sick
contacts. He does not know his family history since he was adopted as a child. He
has not had any fevers, sweats, or chills. On exam, you observe a tachypneic,
obese man in mild distress. On chest auscultation, he has an S3, bilateral rales at
the lung bases, and 2+ pitting edema in the lower legs bilaterally. What is the most
likely diagnosis?
A. New onset heart failure
B. Pneumonia
C. Sleep apnea
D. Anxiety: The correct answer is A.
A. New onset heart failure
The patient's description of the cough (worse at night, unable to lie flat, wakes from
sleep), physical exam findings (obesity, rales in the lung bases, pitting edema), and
history (started after a fish fry/BBQ) point to CHF as the most likely diagnosis. A lack
of fever points away from pneumonia and a lack of description of snoring or pauses
during sleep points away from sleep apnea.
Anxiety would not cause the symptoms or physical exam findings described here.
8. *Case 31: Question 3*
A 56-year-old male presents for care at the ED complaining of dry cough for the
past three days. He notes that this problem started a few days after his family's
annual fish fry and barbecue and has been worsening since. He has no known past
medical history but mentions that he has not seen a doctor in years. He notes that
the cough is worse at night often waking him from sleep. He is unable to lie flat on
his back and has started using three to four pillows to sleep comfortably. He also
reports increased swelling in his legs that worsens throughout the day. He denies
having any chest pain or palpitations and also does not believe he has had any sick
contacts. He does not know his family history since he was adopted as a child. He
has not had any fevers, sweats, or chills. On exam, you observe a tachypneic,
obese man in mild distress. On chest auscultation, he has an S3, bilateral rales at
Study online at https://quizlet.com/_97gcn4
AQUIFER FM QS AT END OF CASE 1-40 QUESTIONS WITH VERY
CORRECT ANSWERS, 2024/2025
1. *Case 30: Question 1*
A 21-year-old G1P0 female present to clinic as a new patient to establish prenatal
care. Which statement represents something that would not be expected to be a
benefit of group prenatal care for this patient?
A. Decreases the likelihood of preterm delivery
B. Increases physician contact
C. Increases support network
D. Shared education between patients
E. Increases adherence to techniques for pain management during labor: The
correct Answer is E.
E. Increases adherence to techniques for pain management during labor
Clear, health literate communication about options for pain management are a benefit
of group prenatal care, not adherence to a particular pain management plan.
Answer choices A, B, C and D are benefits of group prenatal care.
Advantages of group prenatal visits: increase prenatal knowledge, labor preparedness,
support network, shared education between patients, and patient satisfaction
provide more time for prenatal education and anticipatory guidance improve
provider efficiency
preterm delivery less likely (more significant for African-American women) -preterm
birth is the number one cause for neonatal death in African-American infants increased
birth weight of preterm infants (a significant survival determinant) combat racial
disparities used for a variety of medical conditions, including diabetes and chronic
pain.
2. *Case 30: Question 2*
A 24-year-old G1P0 female at 38 weeks gestation presents to ED complaining of
strong lower abdominal contractions that are 10 minutes apart for the last hour.
Subsequent cervical examination demonstrates that she is 2cm dilated.
FHT are 140 and NST is non-reactive with early decelerations. What
is the most appropriate management of this patient?
, Aquifer FM Qs at end of case 1-40
Study online at https://quizlet.com/_97gcn4
A. Augment labor with Pitocin
B. C-section
C. Expectant management
D. Immediate vacuum delivery
E. Rupture membranes to increase labor: The correct answer is C.
C. Expectant management
Expectant management is the most appropriate management at this time. ** Patient is
currently not in active labor. Active labor is defined as cervical dilation > 6 cm in the
presence of contractions. Contractions are normally 3-5 minutes apart. Fetus is not in
distress at this time. Early decelerations are indicative of head compression and are not
especially concerning.
It is not generally advised to induce patients prior to 39 weeks if there are no
complications and fetus is not in distress.
C-section would not be indicated in this case because neither mother and baby are
stable and not in distress.
Immediate vacuum delivery is not indicated in this case. Vacuum delivery is indicated
only during the second stage of labor, which is the beginning of pushing to the delivery
of the baby.
3. *Case 30: Question 3*
The NST tracing attached is most consistent with:
A. Cord compression
B. Head compression
C. Uteroplacental insufficiency
D. Fetal bradycardia
E. Fetal tachycardia: The correct answer is B.
B. Head compression
The NST tracing shows early decelerations which indicate head compression. Early
decelerations coincide with the beginning and end of a contraction. It is the
characteristic "mirror image" of a contraction.
Cord compression is indicated by variable decelerations which are a decrease in fetal
heart rate that vary in timing, duration, and intensity. It often looks like the letter "V"
and does not necessarily correspond to contractions.
, Aquifer FM Qs at end of case 1-40
Study online at https://quizlet.com/_97gcn4
4. *Case 30: Question 4*
A 32-year-old female at 33 weeks and 5 days gestation (G2P1) presents to the
clinic with headache and RUQ abdominal pain. Blood pressure is 172/121 mmHg
on examination while seated. No visual changes noted. Edema is present in the
hands, bilaterally. Urine dipstick demonstrated 4+ protein. FHT are 117.
Which of the following is the most appropriate next step in the management of
this patient?
A. Twice-weekly non-stress testing
B. Daily aspirin
C. Expedited delivery of the premature fetus
D. Lisinopril
E. Strict bed rest until 37 weeks: The correct answer is C.
C. Expedited delivery of the premature fetus
Expedited delivery of the fetus is the best treatment for severe pre-eclampsia. (Note:
severe pre-eclampsia is not necessarily an indication for a C-section, however.)
6. *Case 31: Question 1*
Which of the following is not a risk factor for CAD?
A. Hypertension
B. Female sex
C. Smoking
D. Diabetes: The correct answer is B.
B. Female sex
Hypertension, smoking, and diabetes (along with elevated lipid levels, obesity, and
sedentary lifestyle) are modifiable risk factors for CAD.
Non-modifiable risk factors include older age (men>45 and women >55), family
history of CAD in a first-degree relative at a young age, and male sex.
7. *Case 31: Question 2*
A 56-year-old male presents for care at the ED complaining of dry cough for the
past three days. He notes that this problem started a few days after his family's
, Aquifer FM Qs at end of case 1-40
Study online at https://quizlet.com/_97gcn4
annual fish fry and barbecue and has been worsening since. He has no known past
medical history but mentions that he has not seen a doctor in years. He notes that
the cough is worse at night often waking him from sleep. He is unable to lie flat on
his back and has started using three to four pillows to sleep comfortably. He also
reports increased swelling in his legs that worsens throughout the day. He denies
having any chest pain or palpitations and also does not believe he has had any sick
contacts. He does not know his family history since he was adopted as a child. He
has not had any fevers, sweats, or chills. On exam, you observe a tachypneic,
obese man in mild distress. On chest auscultation, he has an S3, bilateral rales at
the lung bases, and 2+ pitting edema in the lower legs bilaterally. What is the most
likely diagnosis?
A. New onset heart failure
B. Pneumonia
C. Sleep apnea
D. Anxiety: The correct answer is A.
A. New onset heart failure
The patient's description of the cough (worse at night, unable to lie flat, wakes from
sleep), physical exam findings (obesity, rales in the lung bases, pitting edema), and
history (started after a fish fry/BBQ) point to CHF as the most likely diagnosis. A lack
of fever points away from pneumonia and a lack of description of snoring or pauses
during sleep points away from sleep apnea.
Anxiety would not cause the symptoms or physical exam findings described here.
8. *Case 31: Question 3*
A 56-year-old male presents for care at the ED complaining of dry cough for the
past three days. He notes that this problem started a few days after his family's
annual fish fry and barbecue and has been worsening since. He has no known past
medical history but mentions that he has not seen a doctor in years. He notes that
the cough is worse at night often waking him from sleep. He is unable to lie flat on
his back and has started using three to four pillows to sleep comfortably. He also
reports increased swelling in his legs that worsens throughout the day. He denies
having any chest pain or palpitations and also does not believe he has had any sick
contacts. He does not know his family history since he was adopted as a child. He
has not had any fevers, sweats, or chills. On exam, you observe a tachypneic,
obese man in mild distress. On chest auscultation, he has an S3, bilateral rales at
