WOMEN'S HEALTH FNP REVIEW FULL PACK
SOLUTION
1.A 35-year-old primigravida who is at 18 weeks gestation is expecting twins. What would you would
expect her alpha fetoprotein (AFP) values to be?
Normal
Higher than normal
Lower than normal
None of the above
(correct answer)Higher than normal
Alpha fetoprotein (AFP) is produced in the fetal and maternal liver. Higher levels of AFP are commonly
seen in multiple gestations due to the growing liver in each fetus, which cumulatively lead to higher AFP
levels.
2.You note the following result on a routine urinalysis of a 37-year-old primigravida who is at 30 weeks
gestation. Leukocyte = trace, nitrite = negative, protein = 2+, blood = negative. Her weight has increased
by 5 lbs during the past week. Which of the following is most likely?
HELLP syndrome
Pregnancy-induced hypertension (preeclampsia)
Eclampsia of pregnancy
Primary hypertension
(correct answer)Pregnancy-induced hypertension (preeclampsia)
,This patient is manifesting two symptoms (edema) weight gain and proteinuria of the classic triad of
symptoms of preeclampsia: hypertension, edema (weight gain), and proteinuria.
3.A 32 year old primagravida tells the FNP that she is having back aches and would like to take an NSAID
she used to take. The FNP has previously advised her to avoid all NSAIDs during her pregnancy, but also
knows to tell the patient that the greatest risk is during:
First Trimester
Before 31 weeks
After 31 weeks
Episodes of hypertension
(correct answer)After 31 weeks
The FNP knows this is because NSAIDs may cause premature closure of the ductus arteriosus (in the
fetus).
In the fetus- the ductus arteriosus is a normal blood vessel that connects two major arteries — the aorta
and the pulmonary artery — that carry blood away from the heart. The lungs are not used while a fetus
is in the womb because the fetus gets oxygen directly from the mother's placenta.
4.A 35-year-old smoker is being evaluated for birth control choices. The patient has a history of pelvic
inflammatory disease (PID) along with an embolic episode after her last pregnancy. Which of the
following methods of birth control would you recommend?
Condoms and the vaginal sponge (Today Sponge)
Estrogen patches
Intrauterine device (IUD)
, Depo-Provera (depot medroxyprogesterone)
(correct answer)Condoms and the vaginal sponge (Today Sponge)
Contraindications for hormonal contraception include migraine headaches; cigarette smoking or obesity
in women older than 35 years;
history of thromboembolic disease;
hypertension or vascular disease if older than 35 years of age;
systemic lupus erythematosus with vascular disease, nephritis, or antiphospholipid antibodies;
hypertriglyceridemia;
coronary artery disease; congestive heart failure; and strokes.
Contraindications Levonorgestrel IUD:
Hypersensitivity to levonorgestrel;
pregnancy or suspected pregnancy;
postcoital contraception; congenital or acquired uterine anomaly, including fibroids that distort the
uterine cavity and would be incompatible with correct IUD placement;
acute pelvic inflammatory disease or history of pelvic inflammatory disease (unless there has been a
subsequent intrauterine pregnancy);
postpartum endometritis or infected abortion within past 3 months;
known or suspected uterine or cervical malignancy; untreated acute cervicitis or vaginitis (including
bacterial vaginosis, known chlamydial or gonococcal cervical infection) or other lower genital tract
infections until infection is controlled;
conditions which increase susceptibility to pelvic infections; unremoved IUD; uterine bleeding of
unknown etiology; acute hepatic disease or hepatic tumors (benign or malignant);
current or history of known or suspected breast cancer or other hormone-sensitive cancer.
Canadian labeling: Additional contraindications: Bacterial endocarditis; recent trophoblastic disease
while human chorionic gonadotropin (hCG) hormone levels are elevated; cervical dysplasia; known
immunodeficiency or hematologic malignancy
SOLUTION
1.A 35-year-old primigravida who is at 18 weeks gestation is expecting twins. What would you would
expect her alpha fetoprotein (AFP) values to be?
Normal
Higher than normal
Lower than normal
None of the above
(correct answer)Higher than normal
Alpha fetoprotein (AFP) is produced in the fetal and maternal liver. Higher levels of AFP are commonly
seen in multiple gestations due to the growing liver in each fetus, which cumulatively lead to higher AFP
levels.
2.You note the following result on a routine urinalysis of a 37-year-old primigravida who is at 30 weeks
gestation. Leukocyte = trace, nitrite = negative, protein = 2+, blood = negative. Her weight has increased
by 5 lbs during the past week. Which of the following is most likely?
HELLP syndrome
Pregnancy-induced hypertension (preeclampsia)
Eclampsia of pregnancy
Primary hypertension
(correct answer)Pregnancy-induced hypertension (preeclampsia)
,This patient is manifesting two symptoms (edema) weight gain and proteinuria of the classic triad of
symptoms of preeclampsia: hypertension, edema (weight gain), and proteinuria.
3.A 32 year old primagravida tells the FNP that she is having back aches and would like to take an NSAID
she used to take. The FNP has previously advised her to avoid all NSAIDs during her pregnancy, but also
knows to tell the patient that the greatest risk is during:
First Trimester
Before 31 weeks
After 31 weeks
Episodes of hypertension
(correct answer)After 31 weeks
The FNP knows this is because NSAIDs may cause premature closure of the ductus arteriosus (in the
fetus).
In the fetus- the ductus arteriosus is a normal blood vessel that connects two major arteries — the aorta
and the pulmonary artery — that carry blood away from the heart. The lungs are not used while a fetus
is in the womb because the fetus gets oxygen directly from the mother's placenta.
4.A 35-year-old smoker is being evaluated for birth control choices. The patient has a history of pelvic
inflammatory disease (PID) along with an embolic episode after her last pregnancy. Which of the
following methods of birth control would you recommend?
Condoms and the vaginal sponge (Today Sponge)
Estrogen patches
Intrauterine device (IUD)
, Depo-Provera (depot medroxyprogesterone)
(correct answer)Condoms and the vaginal sponge (Today Sponge)
Contraindications for hormonal contraception include migraine headaches; cigarette smoking or obesity
in women older than 35 years;
history of thromboembolic disease;
hypertension or vascular disease if older than 35 years of age;
systemic lupus erythematosus with vascular disease, nephritis, or antiphospholipid antibodies;
hypertriglyceridemia;
coronary artery disease; congestive heart failure; and strokes.
Contraindications Levonorgestrel IUD:
Hypersensitivity to levonorgestrel;
pregnancy or suspected pregnancy;
postcoital contraception; congenital or acquired uterine anomaly, including fibroids that distort the
uterine cavity and would be incompatible with correct IUD placement;
acute pelvic inflammatory disease or history of pelvic inflammatory disease (unless there has been a
subsequent intrauterine pregnancy);
postpartum endometritis or infected abortion within past 3 months;
known or suspected uterine or cervical malignancy; untreated acute cervicitis or vaginitis (including
bacterial vaginosis, known chlamydial or gonococcal cervical infection) or other lower genital tract
infections until infection is controlled;
conditions which increase susceptibility to pelvic infections; unremoved IUD; uterine bleeding of
unknown etiology; acute hepatic disease or hepatic tumors (benign or malignant);
current or history of known or suspected breast cancer or other hormone-sensitive cancer.
Canadian labeling: Additional contraindications: Bacterial endocarditis; recent trophoblastic disease
while human chorionic gonadotropin (hCG) hormone levels are elevated; cervical dysplasia; known
immunodeficiency or hematologic malignancy
