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Aquifer FM Qs at end of case 1-40 With Complete Solutions.
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Aquifer FM Qs at end of case 1-40 WithComplete Solutions.
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,*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 - Answers: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.
*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?
A. Augment labor with Pitocin
B. C-section
C. Expectant management
D. Immediate vacuum delivery
E. Rupture membranes to increase labor - Answers: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.
*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 - Answers: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.
*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 - Answers: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.)
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