©PREP4EXAMS@2024 [REAL-EXAM-DUMPS] Monday, July 29, 2024 12:15 PM
WHNP Basics! NCC study set 2024 Practice
Questions and Answers (100% Pass)
When would you see ++ ketones on a urine dip...What is going on with the mom? -
✔️✔️1. diabetes
2. hyperemesis gravidarum
"Ketones are chemicals that the body creates when it breaks down fat to use for energy.
The body does this when it doesn't have enough insulin to use glucose, the body's
normal source of energy. When ketones build up in the blood, they make it more acidic."
-google
Varney's Normal Lab Values in Pregnancy - ✔️✔️
1st trimester vag bleeding - ✔️✔️LQQSDAA questions and spec exam to determine
etiology of bleeding.
CBC, blood type (and antibody screen?) to know if hemodynamically stable and if Rh -
/needs Rhogam.
TVUS immediately, and if not immediately available, get a bHCG immediately and the
TVUS as soon as possible.
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,©PREP4EXAMS@2024 [REAL-EXAM-DUMPS] Monday, July 29, 2024 12:15 PM
Ensure to give pt warning signs of ectopic if pregnancy location is unknown and she is
going home.
If miscarriage, give edu re: B/R/A to expectant management vs Miso (vs D&C/aspiration
if available.)
How much Rhogam do I order for the person who is Rh neg and has 1st trimester
bleeding? Per AAFP:
"The dose of RhO(D) immune globulin is 50 mcg (250 IU) in women with bleeding
before 12 completed weeks' gestation."
TVUS Dx of early pregnancy loss, per Loren - ✔️✔️
Warning signs for COCs - ✔️✔️ACHES!
Abdominal pain (severe)
Chest pain (sharp, severe, SOB)
Headache (severe, dizzy, unilaeral)
Eye problem (scotomata, blurred vision, blind spots)
Severe leg pain (calf or thigh)
Warning signs for IUDs - ✔️✔️PAINS!
Period late/missed; abnormal spotting or bleeding
Abdominal pain
Infection- vaginal discharge
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,©PREP4EXAMS@2024 [REAL-EXAM-DUMPS] Monday, July 29, 2024 12:15 PM
Not feeling well- fever, aches, chills
String missing, shorter or longer
When to RTC after BCM initiation - ✔️✔️RTC 3 months for BCM supervision/BP check if
OCP, ring or patch
RTC 3 mos for wt, BP and repeat inj if Depo
RTC PRN in Nexplanon
RTC after first menses following insertion if IUD for thread check
Infertility work-up per Up to Date - ✔️✔️Minimal work up: "The minimal work-up includes
serum prolactin, thyroid-stimulating hormone (TSH), FSH, and assessment for
polycystic ovary syndrome (PCOS)."
"Diagnostic tests — In addition to the history and physical examination, the initial
diagnostic evaluation consists of:
●Semen analysis to detect male factor infertility.
●Documentation of normal ovulatory function. Women with regular menses
approximately every four weeks with moliminal symptoms are almost always ovulatory.
●A test to rule out tubal occlusion and assess the uterine cavity. We usually perform a
hysterosalpingogram (HSG), which evaluates both the uterus and tubes, but
laparoscopy with chromotubation combined with hysteroscopy may be more appropriate
in women suspected of having endometriosis. Dilute indigo carmine or methylene blue
can be used for the chromotubation dye. (See 'Role of laparoscopy' below.)
●A test or tests of ovarian reserve such as cycle day 3 follicle-stimulating hormone
(FSH) or estradiol, clomiphene citrate challenge test, anti-müllerian hormone (AMH), or
antral follicle count."
Women with periods q 28 days "with molimina symptoms prior to menses (breast
tenderness, bloating, fatigue, etc.) are most likely ovulatory. In women who do not
describe their cycles as such, laboratory assessment of ovulation should be performed.
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, ©PREP4EXAMS@2024 [REAL-EXAM-DUMPS] Monday, July 29, 2024 12:15 PM
Ovulation is most easily documented by a mid-luteal phase serum progesterone level,
which should be obtained approximately one week before the expected menses. For a
typical 28-day cycle, the test would be obtained on day 21. A progesterone level >3
ng/mL is evidence of recent ovulation
An alternative is to have the patient use an over-the-counter urinary ovulation prediction
kit. These kits detect luteinizing hormone (LH) and are highly effective for predicting the
timing of the LH surge that reliab
My hypothetical plan for a patient coming for infertility complaint - ✔️✔️Full physical- top
and bottoms off, spec
Expl recurrent preg loss to pt, work-up process, available tx depending on dx
Order Prolactin, TSH, a1c
Dirty catch today for GC/CT
Order blood draw for HIV, RPR
Consider advising pt to obtain OTC urine ovulation kit
If same male partner, advise pt to consider semen analysis and to RTC with partner for
exam and consult
Rx PO FA .4 mg (aka 400 mcg) daily
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