While pregnancy is a time of great joy, it also brings common ailments that often lead patients to the pharmacy seeking self-care options. Pharmacists, guided by the principles taught in courses like Patient Care I and Patient Care 5, have a critical responsibility to ensure that any over-the-counter (OTC) product recommended is safe for both mother and developing child. This involves a cautious, evidence-based approach that prioritizes non-pharmacologic therapies first. This quiz will test your knowledge on the safe self-care management for common conditions during pregnancy.
1. What is the first-line and safest over-the-counter analgesic/antipyretic for use throughout all trimesters of pregnancy?
- a. Ibuprofen
- b. Naproxen
- c. Aspirin
- d. Acetaminophen
Answer: d. Acetaminophen
2. NSAIDs like ibuprofen should generally be avoided in pregnancy, especially in which trimester, due to the risk of premature closure of the ductus arteriosus?
- a. First trimester
- b. Second trimester
- c. Third trimester
- d. They are safe throughout pregnancy.
Answer: c. Third trimester
3. A pregnant patient complains of heartburn. What is the most appropriate initial recommendation?
- a. A high-dose proton pump inhibitor.
- b. An H2-receptor antagonist.
- c. Lifestyle and dietary modifications, followed by a calcium-containing antacid if needed.
- d. Bismuth subsalicylate.
Answer: c. Lifestyle modifications and a calcium-containing antacid if needed.
4. Which of the following is considered a first-line pharmacologic option for nausea and vomiting of pregnancy (“morning sickness”)?
- a. Ondansetron
- b. Pyridoxine (Vitamin B6) with or without doxylamine
- c. Meclizine
- d. Scopolamine
Answer: b. Pyridoxine (Vitamin B6) with or without doxylamine
5. A pregnant patient is seeking an OTC product for nasal congestion from a cold. Which of the following is the safest first-line recommendation?
- a. Oral pseudoephedrine
- b. Oral phenylephrine
- c. A saline nasal spray
- d. An oxymetazoline nasal spray for 7 days.
Answer: c. A saline nasal spray
6. The course “Reproductive Self-Care” is a specific learning module in which course?
- a. PHA5781 Patient Care I
- b. PHA5104 Sterile Compounding
- c. PHA5703 Pharmacy Law and Ethics
- d. PHA5878C Patient Care 3
Answer: a. PHA5781 Patient Care I
7. A pregnant patient needs to treat constipation. After lifestyle modifications fail, which class of laxatives is generally considered the safest initial choice?
- a. Stimulant laxatives (e.g., senna)
- b. Saline laxatives (e.g., magnesium citrate)
- c. Bulk-forming laxatives (e.g., psyllium)
- d. Mineral oil
Answer: c. Bulk-forming laxatives (e.g., psyllium)
8. Why are oral decongestants like pseudoephedrine generally avoided during the first trimester of pregnancy?
- a. They are not effective.
- b. Due to a potential small risk of gastroschisis.
- c. They cause severe drowsiness.
- d. They are too expensive.
Answer: b. Due to a potential small risk of gastroschisis.
9. Which OTC antihistamine has a long history of use in pregnancy and is often considered a preferred agent if needed?
- a. Fexofenadine
- b. Loratadine
- c. Cetirizine
- d. Chlorpheniramine
Answer: d. Chlorpheniramine
10. A pregnant patient should be counseled to take what supplement to prevent neural tube defects in the fetus?
- a. Iron
- b. Calcium
- c. Folic Acid
- d. Vitamin B12
Answer: c. Folic Acid
11. The management of women’s health is a topic within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
12. Which herbal supplement has some evidence for treating nausea in pregnancy?
- a. St. John’s Wort
- b. Black cohosh
- c. Ginger
- d. Echinacea
Answer: c. Ginger
13. A pregnant woman asks if she can take bismuth subsalicylate (Pepto-Bismol) for diarrhea. The pharmacist should advise against it because:
- a. It is not effective for diarrhea.
- b. The salicylate component carries risks similar to aspirin, especially in the third trimester.
- c. It causes severe constipation.
- d. It must be taken with food.
Answer: b. The salicylate component carries risks similar to aspirin, especially in the third trimester.
14. What is the first-line treatment for a cough during pregnancy?
- a. Dextromethorphan
- b. Guaifenesin
- c. Non-pharmacologic measures like honey, humidity, and hydration.
- d. Codeine-containing cough syrups.
Answer: c. Non-pharmacologic measures like honey, humidity, and hydration.
15. Counseling patients on self-care is a key objective for student pharmacists.
- a. True
- b. False
Answer: a. True
16. For a pregnant patient with allergies, which of the following is considered the safest first-line pharmacologic option?
- a. An oral decongestant
- b. An intranasal corticosteroid like budesonide (Category B)
- c. A first-generation antihistamine
- d. A systemic corticosteroid
Answer: b. An intranasal corticosteroid like budesonide (Category B)
17. The “Female Reproduction and Pregnancy” lecture is a topic within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
18. A key principle of OTC use in pregnancy is to:
- a. Always use combination products to treat multiple symptoms.
- b. Use the lowest effective dose for the shortest possible duration.
- c. Choose brand-name products over generics.
- d. Use herbal products because they are “natural” and therefore safe.
Answer: b. Use the lowest effective dose for the shortest possible duration.
19. Which of the following antacids is also a good source of supplemental calcium for a pregnant patient?
- a. Aluminum hydroxide
- b. Magnesium hydroxide
- c. Sodium bicarbonate
- d. Calcium carbonate
Answer: d. Calcium carbonate
20. An active learning session on women’s health is part of the Patient Care 5 course.
- a. True
- b. False
Answer: a. True
21. A pregnant patient wants to treat her acne. Which OTC ingredient is generally considered safe?
- a. Salicylic acid (in low concentrations, for limited use)
- b. Retinoids
- c. Hydroquinone
- d. Benzoyl peroxide (in low concentrations)
Answer: d. Benzoyl peroxide (in low concentrations)
22. A pregnant patient has diarrhea. The first-line management should focus on:
- a. Immediately starting loperamide.
- b. Oral rehydration and dietary modifications.
- c. Taking a prophylactic antibiotic.
- d. A saline laxative.
Answer: b. Oral rehydration and dietary modifications.
23. The pharmacist’s primary role in self-care during pregnancy is to:
- a. Recommend products that will provide the most symptom relief, regardless of safety.
- b. Help the patient select a safe and effective product while screening for any exclusions to self-care.
- c. Discourage the use of all OTC medications.
- d. Diagnose the patient’s condition.
Answer: b. Help the patient select a safe and effective product while screening for any exclusions to self-care.
24. An active learning session on women’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
25. Which OTC laxative is generally avoided in pregnancy due to the risk of causing uterine contractions?
- a. Docusate
- b. Psyllium
- c. Stimulant laxatives like senna or castor oil.
- d. Polyethylene glycol 3350
Answer: c. Stimulant laxatives like senna or castor oil.
26. A pregnant patient should be advised that smoking cessation:
- a. Is not necessary during pregnancy.
- b. Should only be attempted with medication.
- c. Is one of the most important things she can do for her and her baby’s health.
- d. Can be delayed until after delivery.
Answer: c. Is one of the most important things she can do for her and her baby’s health.
27. Dextromethorphan for cough is generally considered ____ during pregnancy.
- a. contraindicated
- b. high-risk
- c. low-risk
- d. the first-line treatment for all coughs
Answer: c. low-risk
28. An active learning session on women’s health is part of which course module?
- a. Module 3: Women’s Health
- b. Module 1: Diabetes Mellitus
- c. Module 4: Medication Safety
- d. Module 8: Men’s Health
Answer: a. Module 3: Women’s Health
29. A pregnant patient asks about an herbal tea for morning sickness. The best response from the pharmacist is:
- a. “All herbal teas are safe in pregnancy.”
- b. “You should not drink any herbal teas.”
- c. “The safety of many herbal ingredients in pregnancy is unknown, so it’s best to be cautious. Let’s talk about safer options like ginger or Vitamin B6.”
- d. “As long as it’s organic, it is safe.”
Answer: c. “The safety of many herbal ingredients in pregnancy is unknown, so it’s best to be cautious. Let’s talk about safer options like ginger or Vitamin B6.”
30. The “Introduction to Women’s Health” is a lecture within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
31. A patient complains of insomnia during pregnancy. The safest first approach is:
- a. Recommending diphenhydramine.
- b. Recommending melatonin.
- c. Counseling on sleep hygiene principles.
- d. Recommending a prescription hypnotic.
Answer: c. Counseling on sleep hygiene principles.
32. What is a key concern with using sodium bicarbonate as an antacid during pregnancy?
- a. It can cause fluid retention and affect blood pressure.
- b. It is not effective.
- c. It has a high risk of teratogenicity.
- d. It causes severe constipation.
Answer: a. It can cause fluid retention and affect blood pressure.
33. The old FDA pregnancy category for acetaminophen was:
- a. A
- b. B
- c. C
- d. X
Answer: b. B
34. A patient should always consult their OB/GYN or primary care provider before starting any new OTC medication or supplement during pregnancy.
- a. True
- b. False
Answer: a. True
35. Which of the following is NOT a good non-pharmacologic option for heartburn in pregnancy?
- a. Eating small, frequent meals.
- b. Avoiding spicy or fatty foods.
- c. Lying down immediately after eating.
- d. Not eating for 2-3 hours before bedtime.
Answer: c. Lying down immediately after eating.
36. A pregnant patient wants to treat her seasonal allergies. Which of the following has the most human data supporting its safety?
- a. Pseudoephedrine
- b. Phenylephrine
- c. Chlorpheniramine and loratadine
- d. Oxymetazoline nasal spray
Answer: c. Chlorpheniramine and loratadine
37. Docusate sodium is a stool softener that is:
- a. A first-line agent for treating established constipation.
- b. Generally considered safe for preventing straining during pregnancy.
- c. A potent stimulant laxative.
- d. Contraindicated in pregnancy.
Answer: b. Generally considered safe for preventing straining during pregnancy.
38. The lecture “Management of Women’s Health” is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
39. A pregnant patient asks about a hemorrhoid cream. Which ingredient is generally considered safe for external use?
- a. Hydrocortisone 1%
- b. Phenylephrine
- c. Pramoxine
- d. Witch hazel or other protectants
Answer: d. Witch hazel or other protectants
40. An active learning session covering women’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
41. The primary concern with high-dose aspirin use in the third trimester is:
- a. It can cause premature closure of the ductus arteriosus.
- b. It can prolong gestation and labor.
- c. It can increase bleeding risk for mother and infant.
- d. All of the above.
Answer: d. All of the above.
42. The “Reproductive Self-Care” module covers OTC use in pregnancy.
- a. True
- b. False
Answer: a. True
43. A pharmacist’s most important role in OTC use during pregnancy is:
- a. To promote patient safety by recommending evidence-based therapies and encouraging physician consultation.
- b. To sell the most expensive prenatal vitamin.
- c. To recommend a product for every complaint.
- d. To refuse to sell any OTC product to a pregnant person.
Answer: a. To promote patient safety by recommending evidence-based therapies and encouraging physician consultation.
44. Which of the following is a non-pharmacologic recommendation for leg cramps during pregnancy?
- a. Decreasing fluid intake.
- b. Stretching and adequate hydration.
- c. Taking an NSAID.
- d. Complete bed rest.
Answer: b. Stretching and adequate hydration.
45. A pregnant patient can safely receive which of the following vaccines?
- a. MMR (Measles, Mumps, Rubella)
- b. Varicella
- c. Inactivated influenza vaccine
- d. All vaccines are contraindicated.
Answer: c. Inactivated influenza vaccine
46. A patient asks for a recommendation for a prenatal vitamin. The pharmacist should ensure the product contains at least how much folic acid?
- a. 100 mcg
- b. 400-800 mcg
- c. 1000 mcg (1 mg)
- d. 5000 mcg (5 mg)
Answer: b. 400-800 mcg
47. The general principle for all medication use in pregnancy is:
- a. All medications are safe.
- b. No medications are safe.
- c. A careful risk versus benefit assessment must be made for every medication.
- d. Only brand-name drugs are safe.
Answer: c. A careful risk versus benefit assessment must be made for every medication.
48. An active learning session on women’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
49. Why is it important to ask a patient about all their medications, including herbals and supplements, during pregnancy?
- a. To identify potential teratogens or products with unknown safety profiles.
- b. To assess for drug interactions.
- c. To have a complete medication history.
- d. All of the above.
Answer: d. All of the above.
50. The ultimate goal of counseling on OTC use in pregnancy is to:
- a. Ensure the pregnant patient can safely and effectively manage minor ailments while minimizing any potential risk to the fetus.
- b. Prevent the patient from using any medication at all.
- c. Make a sale.
- d. Pass the final exam.
Answer: a. Ensure the pregnant patient can safely and effectively manage minor ailments while minimizing any potential risk to the fetus.