ANTEPARTUM CARE UNFOLDING REASONING | Anne
Jones 17-Year-Old | Complete Case Study | 2026/2027
Updated | Pass Guaranteed - A+ Graded
Aligned with 2026/2027 AWHONN Standards of Perinatal Nursing Care &
ACOG Practice Bulletins
[PART 1: Initial Presentation & History (Questions 1-12)]
Adolescent Pregnancy Intake, Risk Assessment, Psychosocial Evaluation, Initial Labs,
Dating/Gestational Age Determination, Confidentiality/Consent (Minor Status Legal
Considerations)
Q1. Anne Jones, a 17-year-old G1P0, presents to the prenatal clinic at 8 weeks
gestation by LMP. She is accompanied by her 18-year-old boyfriend. She lives with
her mother and two younger siblings. She dropped out of high school in 10th
grade and works part-time at a fast-food restaurant. Which factor in Anne's
history places her at the HIGHEST risk for adverse pregnancy outcomes?
A. Her age alone (17 years)
B. Her lack of high school diploma and limited financial resources
C. Her gravidity/parity status (G1P0)
D. Her living situation with extended family
Correct Answer: B. Her lack of high school diploma and limited financial
resources [CORRECT]
Rationale: While adolescent age increases risks (preterm birth, low birthweight,
preeclampsia, anemia), social determinants of health—particularly low educational
attainment, limited financial resources, and food insecurity—are the strongest
predictors of adverse outcomes in teen pregnancies. These factors compound
physiologic risks by creating barriers to consistent prenatal care, nutrition, and stress
,management. Option A is a risk factor but not the highest. Option C is normal for a
first pregnancy. Option D (living with family) can actually be protective if supportive.
Antepartum Nursing Principle: Social determinants often outweigh biological age
in predicting outcomes; comprehensive psychosocial assessment is essential at
intake. ACOG/AWHONN Reference: ACOG Committee Opinion: Health Disparities in
Pregnancy 2024; AWHONN Perinatal Nursing Standards. Unfolding Case Continuity:
Anne's socioeconomic status will guide referrals to WIC, school re-engagement
programs, and social work.
Q2. Anne's last menstrual period (LMP) was January 15, 2026. Using Naegele's
rule, what is her estimated date of delivery (EDD)?
A. October 8, 2026
B. October 22, 2026
C. November 12, 2026
D. October 15, 2026
Correct Answer: B. October 22, 2026 [CORRECT]
Rationale: Naegele's rule: EDD = LMP + 1 year - 3 months + 7 days. January 15,
2026 + 1 year = January 15, 2027. Minus 3 months = October 15, 2026. Plus 7 days =
October 22, 2026. Option A subtracts 7 days instead of adding. Option C adds 3
months instead of subtracting. Option D forgets to add the 7 days. Antepartum
Nursing Principle: Accurate EDD determination guides all subsequent screening,
testing, and intervention timing. ACOG/AWHONN Reference: ACOG Practice Bulletin:
Methods for Estimating Due Date 2017 (Reaffirmed 2024). Unfolding Case
Continuity: Anne's EDD of October 22, 2026, will be confirmed by first-trimester
ultrasound.
Q3. Anne is 17 years old and presents without a parent. She requests that her
pregnancy information not be shared with her mother. According to most state
laws and ACOG guidance, which statement about confidentiality for pregnant
minors is MOST accurate?
,A. All pregnant minors must have parental consent for prenatal care
B. Pregnant minors are generally considered emancipated for pregnancy-related care
and can consent to their own treatment; confidentiality should be maintained unless
specific state law requires otherwise
C. The provider must inform the parents because Anne is a minor
D. Anne cannot receive prenatal care without a parent present
Correct Answer: B. Pregnant minors are generally considered emancipated for
pregnancy-related care and can consent to their own treatment; confidentiality
should be maintained unless specific state law requires otherwise [CORRECT]
Rationale: Most states recognize pregnant minors as "emancipated" or "mature
minors" for pregnancy-related healthcare, allowing them to consent to prenatal care,
labor and delivery, and postpartum care. Confidentiality should be maintained to
encourage care-seeking, though providers should know their specific state laws.
Option A is incorrect for most states. Option C violates the therapeutic relationship.
Option D creates a barrier to essential care. Antepartum Nursing Principle:
Maintaining confidentiality for pregnant teens encourages engagement in prenatal
care and honest disclosure of risk factors. ACOG/AWHONN Reference: ACOG
Committee Opinion: Confidentiality in Adolescent Health Care 2024. Unfolding Case
Continuity: Anne's trust in confidentiality will be essential for honest disclosure of
substance use, IPV, and other sensitive topics.
Q4. During the initial psychosocial assessment, Anne discloses that her boyfriend
sometimes "gets angry and pushes her around" when they argue. She says it "only
happens when he's drunk." Which screening tool is MOST appropriate for formal
intimate partner violence (IPV) assessment in this adolescent population?
A. GAD-7 (Generalized Anxiety Disorder screening)
B. HITS (Hurt, Insult, Threaten, Scream) or ATS (Abuse Assessment Screen)
C. PHQ-9 (Patient Health Questionnaire)
D. CRAFFT (substance use screening)
Correct Answer: B. HITS (Hurt, Insult, Threaten, Scream) or ATS (Abuse
Assessment Screen) [CORRECT]
, Rationale: HITS and ATS are validated IPV screening tools appropriate for pregnant
adolescents. The HITS questionnaire asks about being Hurt, Insulted, Threatened, or
Screamed at—simple, direct language suitable for teens. GAD-7 (Option A) screens
for anxiety. PHQ-9 (Option C) screens for depression. CRAFFT (Option D) screens for
substance use—all important but not IPV-specific. Antepartum Nursing Principle:
Universal IPV screening with validated tools is standard of care; disclosure requires
safety planning and resource connection. ACOG/AWHONN Reference: ACOG
Committee Opinion: Intimate Partner Violence 2022 (Reaffirmed 2025). Unfolding
Case Continuity: Anne's IPV disclosure triggers mandatory safety planning and social
work referral.
Q5. Anne's initial laboratory studies are drawn. Her results show: Blood type O
negative, antibody screen negative, Rubella IgG non-immune, HIV negative, RPR
non-reactive, Hepatitis B surface antigen negative, Gonorrhea/Chlamydia
negative. Which intervention is REQUIRED based on these results?
A. Rh immunoglobulin (Rhogam) 300 mcg at 28 weeks gestation and postpartum if
baby is Rh positive
B. Rubella vaccination immediately during pregnancy
C. Hepatitis B immune globulin (HBIG) for Anne
D. Penicillin treatment for syphilis
Correct Answer: A. Rh immunoglobulin (Rhogam) 300 mcg at 28 weeks gestation
and postpartum if baby is Rh positive [CORRECT]
Rationale: Anne is Rh-negative with a negative antibody screen—she requires
Rhogam 300 mcg at 28 weeks and within 72 hours postpartum if the infant is Rh-
positive. Rubella vaccination (Option B) is contraindicated during pregnancy and
given postpartum. Hepatitis B surface antigen negative (Option C) means no HBIG is
needed. RPR non-reactive (Option D) means no syphilis treatment is indicated.
Antepartum Nursing Principle: Rh-negative status requires proactive Rhogam
administration to prevent alloimmunization; documentation of antibody status at
every pregnancy is essential. ACOG/AWHONN Reference: ACOG Practice Bulletin:
The Rh D Alloimmunization in Pregnancy 2024. Unfolding Case Continuity: Anne's
Jones 17-Year-Old | Complete Case Study | 2026/2027
Updated | Pass Guaranteed - A+ Graded
Aligned with 2026/2027 AWHONN Standards of Perinatal Nursing Care &
ACOG Practice Bulletins
[PART 1: Initial Presentation & History (Questions 1-12)]
Adolescent Pregnancy Intake, Risk Assessment, Psychosocial Evaluation, Initial Labs,
Dating/Gestational Age Determination, Confidentiality/Consent (Minor Status Legal
Considerations)
Q1. Anne Jones, a 17-year-old G1P0, presents to the prenatal clinic at 8 weeks
gestation by LMP. She is accompanied by her 18-year-old boyfriend. She lives with
her mother and two younger siblings. She dropped out of high school in 10th
grade and works part-time at a fast-food restaurant. Which factor in Anne's
history places her at the HIGHEST risk for adverse pregnancy outcomes?
A. Her age alone (17 years)
B. Her lack of high school diploma and limited financial resources
C. Her gravidity/parity status (G1P0)
D. Her living situation with extended family
Correct Answer: B. Her lack of high school diploma and limited financial
resources [CORRECT]
Rationale: While adolescent age increases risks (preterm birth, low birthweight,
preeclampsia, anemia), social determinants of health—particularly low educational
attainment, limited financial resources, and food insecurity—are the strongest
predictors of adverse outcomes in teen pregnancies. These factors compound
physiologic risks by creating barriers to consistent prenatal care, nutrition, and stress
,management. Option A is a risk factor but not the highest. Option C is normal for a
first pregnancy. Option D (living with family) can actually be protective if supportive.
Antepartum Nursing Principle: Social determinants often outweigh biological age
in predicting outcomes; comprehensive psychosocial assessment is essential at
intake. ACOG/AWHONN Reference: ACOG Committee Opinion: Health Disparities in
Pregnancy 2024; AWHONN Perinatal Nursing Standards. Unfolding Case Continuity:
Anne's socioeconomic status will guide referrals to WIC, school re-engagement
programs, and social work.
Q2. Anne's last menstrual period (LMP) was January 15, 2026. Using Naegele's
rule, what is her estimated date of delivery (EDD)?
A. October 8, 2026
B. October 22, 2026
C. November 12, 2026
D. October 15, 2026
Correct Answer: B. October 22, 2026 [CORRECT]
Rationale: Naegele's rule: EDD = LMP + 1 year - 3 months + 7 days. January 15,
2026 + 1 year = January 15, 2027. Minus 3 months = October 15, 2026. Plus 7 days =
October 22, 2026. Option A subtracts 7 days instead of adding. Option C adds 3
months instead of subtracting. Option D forgets to add the 7 days. Antepartum
Nursing Principle: Accurate EDD determination guides all subsequent screening,
testing, and intervention timing. ACOG/AWHONN Reference: ACOG Practice Bulletin:
Methods for Estimating Due Date 2017 (Reaffirmed 2024). Unfolding Case
Continuity: Anne's EDD of October 22, 2026, will be confirmed by first-trimester
ultrasound.
Q3. Anne is 17 years old and presents without a parent. She requests that her
pregnancy information not be shared with her mother. According to most state
laws and ACOG guidance, which statement about confidentiality for pregnant
minors is MOST accurate?
,A. All pregnant minors must have parental consent for prenatal care
B. Pregnant minors are generally considered emancipated for pregnancy-related care
and can consent to their own treatment; confidentiality should be maintained unless
specific state law requires otherwise
C. The provider must inform the parents because Anne is a minor
D. Anne cannot receive prenatal care without a parent present
Correct Answer: B. Pregnant minors are generally considered emancipated for
pregnancy-related care and can consent to their own treatment; confidentiality
should be maintained unless specific state law requires otherwise [CORRECT]
Rationale: Most states recognize pregnant minors as "emancipated" or "mature
minors" for pregnancy-related healthcare, allowing them to consent to prenatal care,
labor and delivery, and postpartum care. Confidentiality should be maintained to
encourage care-seeking, though providers should know their specific state laws.
Option A is incorrect for most states. Option C violates the therapeutic relationship.
Option D creates a barrier to essential care. Antepartum Nursing Principle:
Maintaining confidentiality for pregnant teens encourages engagement in prenatal
care and honest disclosure of risk factors. ACOG/AWHONN Reference: ACOG
Committee Opinion: Confidentiality in Adolescent Health Care 2024. Unfolding Case
Continuity: Anne's trust in confidentiality will be essential for honest disclosure of
substance use, IPV, and other sensitive topics.
Q4. During the initial psychosocial assessment, Anne discloses that her boyfriend
sometimes "gets angry and pushes her around" when they argue. She says it "only
happens when he's drunk." Which screening tool is MOST appropriate for formal
intimate partner violence (IPV) assessment in this adolescent population?
A. GAD-7 (Generalized Anxiety Disorder screening)
B. HITS (Hurt, Insult, Threaten, Scream) or ATS (Abuse Assessment Screen)
C. PHQ-9 (Patient Health Questionnaire)
D. CRAFFT (substance use screening)
Correct Answer: B. HITS (Hurt, Insult, Threaten, Scream) or ATS (Abuse
Assessment Screen) [CORRECT]
, Rationale: HITS and ATS are validated IPV screening tools appropriate for pregnant
adolescents. The HITS questionnaire asks about being Hurt, Insulted, Threatened, or
Screamed at—simple, direct language suitable for teens. GAD-7 (Option A) screens
for anxiety. PHQ-9 (Option C) screens for depression. CRAFFT (Option D) screens for
substance use—all important but not IPV-specific. Antepartum Nursing Principle:
Universal IPV screening with validated tools is standard of care; disclosure requires
safety planning and resource connection. ACOG/AWHONN Reference: ACOG
Committee Opinion: Intimate Partner Violence 2022 (Reaffirmed 2025). Unfolding
Case Continuity: Anne's IPV disclosure triggers mandatory safety planning and social
work referral.
Q5. Anne's initial laboratory studies are drawn. Her results show: Blood type O
negative, antibody screen negative, Rubella IgG non-immune, HIV negative, RPR
non-reactive, Hepatitis B surface antigen negative, Gonorrhea/Chlamydia
negative. Which intervention is REQUIRED based on these results?
A. Rh immunoglobulin (Rhogam) 300 mcg at 28 weeks gestation and postpartum if
baby is Rh positive
B. Rubella vaccination immediately during pregnancy
C. Hepatitis B immune globulin (HBIG) for Anne
D. Penicillin treatment for syphilis
Correct Answer: A. Rh immunoglobulin (Rhogam) 300 mcg at 28 weeks gestation
and postpartum if baby is Rh positive [CORRECT]
Rationale: Anne is Rh-negative with a negative antibody screen—she requires
Rhogam 300 mcg at 28 weeks and within 72 hours postpartum if the infant is Rh-
positive. Rubella vaccination (Option B) is contraindicated during pregnancy and
given postpartum. Hepatitis B surface antigen negative (Option C) means no HBIG is
needed. RPR non-reactive (Option D) means no syphilis treatment is indicated.
Antepartum Nursing Principle: Rh-negative status requires proactive Rhogam
administration to prevent alloimmunization; documentation of antibody status at
every pregnancy is essential. ACOG/AWHONN Reference: ACOG Practice Bulletin:
The Rh D Alloimmunization in Pregnancy 2024. Unfolding Case Continuity: Anne's
