AMCB Task Analysis Test Content
Questions With Correct Answers
Evaluate for signs of pregnancy - CORRECT ANSWER✔✔-Presumptive Signs
| | | | | | | | |
(Reported by Woman in History):
| | | |
- Amneorrhea in a woman who previously experienced regular cycles
| | | | | | | | |
- Breast or nipple tingling, tenderness, and/or enlargement
| | | | | | |
- Fatigue
|
- N/V
|
- Quickening (perception of FM)
| | | |
- Pigmentation changes (cholasma, linea nigra)
| | | | |
- Sustained elevated basal body temp (in absence of infection)
| | | | | | | | |
- Urinary frequency
| |
Probable signs (detected by physical exam or lab test):
| | | | | | | |
- Breast changes (expression of colostrum, enlargement of breasts and nipples)
| | | | | | | | | |
- Enlargement of abdomen
| | |
- Enlargement of uterus
| | |
- Changes noted on pelvic exam: ballottement, Chadwick's (bluish color),
| | | | | | | | | |
Goodell's (softening cervix), Hegar's (softening lower uterus), Piskacek's
| | | | | | | |
(asymmetric lateral bulge in uterus)| | | |
- Palpable fetal outline or movement
| | | | |
,- Palpation of uterine contractions
| | | |
- Positive pregnancy test
| | |
Positive signs: |
- Sonographic evidence
| |
- Audible FHTs
| |
Assess the woman's acceptance of pregnancy - CORRECT ANSWER✔✔-Ask open-
| | | | | | | | |
ended questions to ascertain her own questions, concerns, and plans for the
| | | | | | | | | | | |
current pregnancy and listen carefully to her responses
| | | | | | |
Determine woman's goals | |
Approx half of all pregnancies are unintended
| | | | | |
Orders and evaluates serial hCG levels when indicated - CORRECT ANSWER✔✔-
| | | | | | | | | |
Serial measurements of quantitative serum beta-hCG values repeated every 48-72
| | | | | | | | |
ho urs (often in conjunction with early US) to help determine presence and
| | | | | | | | | | | | | |
viability of an intrauterine pregnancy, rule out ectopic pregnancy, or follow
| | | | | | | | | | |
decline when a spontaneous abortion has occurred
| | | | | |
Serum values increase exponentially in early pregnancy, doubling approx every
| | | | | | | | | |
1.5-3 days in the first 5-6 weeks, then doubling every 3-3.5 days in weeks 7-8,
| | | | | | | | | | | | | | |
peaking at 8-10 weeks, then plateauing
| | | | |
,"discriminatory zone" at hCG of 1500-2000 (approx 91% of women with beta| | | | | | | | | | | |
higher than this range will have an intrauterine gestational sac visible if
| | | | | | | | | | | |
transvaginal US is performed | | |
Once hCG reaches 3500, 99% of pregnancies visible on US
| | | | | | | | |
Provides counseling and support for women experiencing early pregnancy loss -
| | | | | | | | | | |
CORRECT ANSWER✔✔-Expectant management: counsel to call provider if signs of
| | | | | | | | |
infection or heavy bleeding, discuss if wanting to collect POC for genetics with hx
| | | | | | | | | | | | | | |
of 2 or more miscarriages; follow up urine pregnancy test a week or more after to
| | | | | | | | | | | | | | |
confirm completion
| |
Medical management: Cytotec (800mcg vaginally with option to repeat dose in 7
| | | | | | | | | | | |
days if no response to first dose); success is 80-90% within 7 days in women who
| | | | | | | | | | | | | | | |
are up to 10 weeks gestational age at time of administration; counsel on expected
| | | | | | | | | | | | |
symptoms and warning signs; ensure access to emergency care if needed
| | | | | | | | | | |
Surgical management: may be advised for women who prefer this option, after
| | | | | | | | | | | |
failed expectant management, women greater than 10 weeks gestation, or if
| | | | | | | | | | |
woman has risk factors contraindicating medical management; risk factors include
| | | | | | | | |
|cervical trauma, uterine perforation, and intrauterine adhesions
| | | | | |
Evaluates historical, physical, and lab data to determine current gestational age
| | | | | | | | | | |
and due date - CORRECT ANSWER✔✔-Accurate calculation of gestational age is
| | | | | | | | | | |
necessary to appropriately select interventions for threatened preterm labor, to
| | | | | | | | | |
determine adequacy of fetal growth, and to time the initiation of fetal
| | | | | | | | | | | |
surveillance or IOL | |
, EDD by LMP: date of LMP used as baseline for an initial determination of
| | | | | | | | | | | | | |
gestational age and EDD (Naegele's rule: first day of LMP + 7 days - 3 months =
| | | | | | | | | | | | | | | | |
EDD)
EDD by Pregnancy Wheels and Apps: calculates EDD based on 280 days for
| | | | | | | | | | | | |
duration of gestation; may vary by 1-7 days for EDD
| | | | | | | | |
ART: date of insemination or embryo transfer used instead of LMP because
| | | | | | | | | | | |
precise due date can be calculated
| | | | |
First trimester US: calculation of gestational age and EDD based on US performed
| | | | | | | | | | | | |
before 13 6/7 weeks is the most accurate method for dating pregnancy; crown-
| | | | | | | | | | | |
rump length is most accurate
| | | |
Second trimester US: estimates fetal age based on composite measurements of
| | | | | | | | | | |
fetal head circumference, biparietal diameter, femur length; as well as woman's
| | | | | | | | | | |
abdominal circumference |
Less reliable methods: fundal measurement, onset of quickening, clinician's
| | | | | | | | |
notation of first detection of FHTs, client's s/s of pregnancy
| | | | | | | | |
Orders first-trimester US to establish or confirm gestational age - CORRECT
| | | | | | | | | | |
ANSWER✔✔-Most accurate first trimester ultrasound measurement for | | | | | | |
determining gestational age is crown-rump length measurement
| | | | | |
<8 6/7: change EDD if >5 days discrepancy between LMP and US dates to support
| | | | | | | | | | | | | | |
US dating
|
Questions With Correct Answers
Evaluate for signs of pregnancy - CORRECT ANSWER✔✔-Presumptive Signs
| | | | | | | | |
(Reported by Woman in History):
| | | |
- Amneorrhea in a woman who previously experienced regular cycles
| | | | | | | | |
- Breast or nipple tingling, tenderness, and/or enlargement
| | | | | | |
- Fatigue
|
- N/V
|
- Quickening (perception of FM)
| | | |
- Pigmentation changes (cholasma, linea nigra)
| | | | |
- Sustained elevated basal body temp (in absence of infection)
| | | | | | | | |
- Urinary frequency
| |
Probable signs (detected by physical exam or lab test):
| | | | | | | |
- Breast changes (expression of colostrum, enlargement of breasts and nipples)
| | | | | | | | | |
- Enlargement of abdomen
| | |
- Enlargement of uterus
| | |
- Changes noted on pelvic exam: ballottement, Chadwick's (bluish color),
| | | | | | | | | |
Goodell's (softening cervix), Hegar's (softening lower uterus), Piskacek's
| | | | | | | |
(asymmetric lateral bulge in uterus)| | | |
- Palpable fetal outline or movement
| | | | |
,- Palpation of uterine contractions
| | | |
- Positive pregnancy test
| | |
Positive signs: |
- Sonographic evidence
| |
- Audible FHTs
| |
Assess the woman's acceptance of pregnancy - CORRECT ANSWER✔✔-Ask open-
| | | | | | | | |
ended questions to ascertain her own questions, concerns, and plans for the
| | | | | | | | | | | |
current pregnancy and listen carefully to her responses
| | | | | | |
Determine woman's goals | |
Approx half of all pregnancies are unintended
| | | | | |
Orders and evaluates serial hCG levels when indicated - CORRECT ANSWER✔✔-
| | | | | | | | | |
Serial measurements of quantitative serum beta-hCG values repeated every 48-72
| | | | | | | | |
ho urs (often in conjunction with early US) to help determine presence and
| | | | | | | | | | | | | |
viability of an intrauterine pregnancy, rule out ectopic pregnancy, or follow
| | | | | | | | | | |
decline when a spontaneous abortion has occurred
| | | | | |
Serum values increase exponentially in early pregnancy, doubling approx every
| | | | | | | | | |
1.5-3 days in the first 5-6 weeks, then doubling every 3-3.5 days in weeks 7-8,
| | | | | | | | | | | | | | |
peaking at 8-10 weeks, then plateauing
| | | | |
,"discriminatory zone" at hCG of 1500-2000 (approx 91% of women with beta| | | | | | | | | | | |
higher than this range will have an intrauterine gestational sac visible if
| | | | | | | | | | | |
transvaginal US is performed | | |
Once hCG reaches 3500, 99% of pregnancies visible on US
| | | | | | | | |
Provides counseling and support for women experiencing early pregnancy loss -
| | | | | | | | | | |
CORRECT ANSWER✔✔-Expectant management: counsel to call provider if signs of
| | | | | | | | |
infection or heavy bleeding, discuss if wanting to collect POC for genetics with hx
| | | | | | | | | | | | | | |
of 2 or more miscarriages; follow up urine pregnancy test a week or more after to
| | | | | | | | | | | | | | |
confirm completion
| |
Medical management: Cytotec (800mcg vaginally with option to repeat dose in 7
| | | | | | | | | | | |
days if no response to first dose); success is 80-90% within 7 days in women who
| | | | | | | | | | | | | | | |
are up to 10 weeks gestational age at time of administration; counsel on expected
| | | | | | | | | | | | |
symptoms and warning signs; ensure access to emergency care if needed
| | | | | | | | | | |
Surgical management: may be advised for women who prefer this option, after
| | | | | | | | | | | |
failed expectant management, women greater than 10 weeks gestation, or if
| | | | | | | | | | |
woman has risk factors contraindicating medical management; risk factors include
| | | | | | | | |
|cervical trauma, uterine perforation, and intrauterine adhesions
| | | | | |
Evaluates historical, physical, and lab data to determine current gestational age
| | | | | | | | | | |
and due date - CORRECT ANSWER✔✔-Accurate calculation of gestational age is
| | | | | | | | | | |
necessary to appropriately select interventions for threatened preterm labor, to
| | | | | | | | | |
determine adequacy of fetal growth, and to time the initiation of fetal
| | | | | | | | | | | |
surveillance or IOL | |
, EDD by LMP: date of LMP used as baseline for an initial determination of
| | | | | | | | | | | | | |
gestational age and EDD (Naegele's rule: first day of LMP + 7 days - 3 months =
| | | | | | | | | | | | | | | | |
EDD)
EDD by Pregnancy Wheels and Apps: calculates EDD based on 280 days for
| | | | | | | | | | | | |
duration of gestation; may vary by 1-7 days for EDD
| | | | | | | | |
ART: date of insemination or embryo transfer used instead of LMP because
| | | | | | | | | | | |
precise due date can be calculated
| | | | |
First trimester US: calculation of gestational age and EDD based on US performed
| | | | | | | | | | | | |
before 13 6/7 weeks is the most accurate method for dating pregnancy; crown-
| | | | | | | | | | | |
rump length is most accurate
| | | |
Second trimester US: estimates fetal age based on composite measurements of
| | | | | | | | | | |
fetal head circumference, biparietal diameter, femur length; as well as woman's
| | | | | | | | | | |
abdominal circumference |
Less reliable methods: fundal measurement, onset of quickening, clinician's
| | | | | | | | |
notation of first detection of FHTs, client's s/s of pregnancy
| | | | | | | | |
Orders first-trimester US to establish or confirm gestational age - CORRECT
| | | | | | | | | | |
ANSWER✔✔-Most accurate first trimester ultrasound measurement for | | | | | | |
determining gestational age is crown-rump length measurement
| | | | | |
<8 6/7: change EDD if >5 days discrepancy between LMP and US dates to support
| | | | | | | | | | | | | | |
US dating
|
