LEIK CERTIFICATION EVALUATION 2026
STUDY GUIDE QUESTIONS AND ANSWERS
◉ A second triple screen on a 35-year-old primigravida reveals
abnormally low levels of the alpha fetoprotein and estriol and high
levels of human chorionic gonadotropin. Which of the following
interventions is the best choice?
A) Order an ultrasound
B) Order a computed tomography (CT) scan of the abdomen
C) Order a 24-hour urine for protein clearance
D) Assess for a history of illicit drug or alcohol use
Answer: A) Order an ultrasound
Abnormally low levels of alpha fetoprotein and estriol and high
levels of human chorionic gonadotropin are abnormal during
pregnancy. An ultrasound should be ordered to further evaluate the
fetus for characteristics of Down syndrome and/or fetal demise.
◉ A 35-year-old primigravida who is at 28 weeks of gestation is
expecting twins. What would you would expect her alpha
fetoprotein (AFP) values to be?
A) Normal
,B) Higher than normal
C) Lower than normal
D) None of the above
Answer: B) Higher than normal
Alpha fetoprotein is produced in the fetal and maternal liver. Higher
levels of alpha fetoprotein are commonly seen in multiple gestations
due to the growing fetuses and enlargement of the livers.
◉ Fetal TORCH infections can cause microcephaly, mental
retardation, hepatospleno- megaly, and intrauterine growth
retardation. The acronym TORCH stands for:
A) Toxoplasma gondii, other infections, rubella, cytomegalovirus,
and herpes
B) Toxic shock syndrome, ocular infections, rubella,
cytomegalovirus, and herpes
zoster
C) Tetanus, ophthalmic infections, roseola, cancer, and head
abnormalities
D) Toxins, other infections, roseola, candidiasis, and head
abnormalities
Answer: A) Toxoplasmagondii, other infections, rubella,
cytomegalovirus, and herpes
,The acronym TORCH stands for
Toxoplasma gondii,
Other infections,
Rubella,
Cytomegalovirus, and
Herpes.
Although several of the conditions listed in the other answer options
can also cause fetal problems, they are not included in the TORCH
acronym.
◉ Human papilloma virus (HPV) infection of the larynx has been
associated with:
A) Laryngeal neoplasia
B) Esophageal stricture
C) Cervical cancer
D) Metaplasia of esophageal squamous cells
Answer: A) Laryngeal neoplasia
HPV infection of the larynx has been associated with laryngeal
neoplasia; HPV infection of the cervix is associated with cervical
cancer.
, ◉ A multigravida who is at 28 weeks of gestation has a fundal height
of 29 cm. Which of the following is the best recommendation for this
patient?
A) Advise the mother that her pregnancy is progressing well
B) Order an ultrasound of the uterus
C) Refer her to an obstetrician for an amniocentesis
D) Recommend bed rest with bathroom privileges
Answer: A) Advise the mother that her pregnancy is progressing
well
From 20-35 weeks' gestation, fundal height should equal weeks
gestation. If greater than 2 cm within the gestational week of
pregnancy, further testing should be performed to evaluate fetal
growth
◉ A multigravida who is at 34 weeks of gestation wants to know at
what level her uterine fundus should be. The best answer is to
advise the mother that her fundus is:
A) Midway between the umbilicus and the lower ribs
B) At the level of the umbilicus
C) From 33 to 35 cm
D) From 32 to 34 cm
Answer: C) From 33 to 35 cm
STUDY GUIDE QUESTIONS AND ANSWERS
◉ A second triple screen on a 35-year-old primigravida reveals
abnormally low levels of the alpha fetoprotein and estriol and high
levels of human chorionic gonadotropin. Which of the following
interventions is the best choice?
A) Order an ultrasound
B) Order a computed tomography (CT) scan of the abdomen
C) Order a 24-hour urine for protein clearance
D) Assess for a history of illicit drug or alcohol use
Answer: A) Order an ultrasound
Abnormally low levels of alpha fetoprotein and estriol and high
levels of human chorionic gonadotropin are abnormal during
pregnancy. An ultrasound should be ordered to further evaluate the
fetus for characteristics of Down syndrome and/or fetal demise.
◉ A 35-year-old primigravida who is at 28 weeks of gestation is
expecting twins. What would you would expect her alpha
fetoprotein (AFP) values to be?
A) Normal
,B) Higher than normal
C) Lower than normal
D) None of the above
Answer: B) Higher than normal
Alpha fetoprotein is produced in the fetal and maternal liver. Higher
levels of alpha fetoprotein are commonly seen in multiple gestations
due to the growing fetuses and enlargement of the livers.
◉ Fetal TORCH infections can cause microcephaly, mental
retardation, hepatospleno- megaly, and intrauterine growth
retardation. The acronym TORCH stands for:
A) Toxoplasma gondii, other infections, rubella, cytomegalovirus,
and herpes
B) Toxic shock syndrome, ocular infections, rubella,
cytomegalovirus, and herpes
zoster
C) Tetanus, ophthalmic infections, roseola, cancer, and head
abnormalities
D) Toxins, other infections, roseola, candidiasis, and head
abnormalities
Answer: A) Toxoplasmagondii, other infections, rubella,
cytomegalovirus, and herpes
,The acronym TORCH stands for
Toxoplasma gondii,
Other infections,
Rubella,
Cytomegalovirus, and
Herpes.
Although several of the conditions listed in the other answer options
can also cause fetal problems, they are not included in the TORCH
acronym.
◉ Human papilloma virus (HPV) infection of the larynx has been
associated with:
A) Laryngeal neoplasia
B) Esophageal stricture
C) Cervical cancer
D) Metaplasia of esophageal squamous cells
Answer: A) Laryngeal neoplasia
HPV infection of the larynx has been associated with laryngeal
neoplasia; HPV infection of the cervix is associated with cervical
cancer.
, ◉ A multigravida who is at 28 weeks of gestation has a fundal height
of 29 cm. Which of the following is the best recommendation for this
patient?
A) Advise the mother that her pregnancy is progressing well
B) Order an ultrasound of the uterus
C) Refer her to an obstetrician for an amniocentesis
D) Recommend bed rest with bathroom privileges
Answer: A) Advise the mother that her pregnancy is progressing
well
From 20-35 weeks' gestation, fundal height should equal weeks
gestation. If greater than 2 cm within the gestational week of
pregnancy, further testing should be performed to evaluate fetal
growth
◉ A multigravida who is at 34 weeks of gestation wants to know at
what level her uterine fundus should be. The best answer is to
advise the mother that her fundus is:
A) Midway between the umbilicus and the lower ribs
B) At the level of the umbilicus
C) From 33 to 35 cm
D) From 32 to 34 cm
Answer: C) From 33 to 35 cm
