MCQ Quiz-Pregnancy

MCQ Quiz: Pregnancy

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Pregnancy is a transformative period involving profound physiological changes and unique healthcare needs. Providing care during this time requires specialized knowledge of appropriate pharmacotherapy, management of pregnancy-related conditions, and the importance of prenatal care. c

1. The presumptive signs of pregnancy are those that are:

  • Diagnostic of pregnancy, such as a fetal heartbeat.
  • Subjective and could be caused by other conditions, such as amenorrhea or nausea.
  • Objective signs noted by the examiner, such as uterine enlargement.
  • Confirmed only by ultrasound.


Answer: Subjective and could be caused by other conditions, such as amenorrhea or nausea.

2. Which hormone is detected in urine pregnancy tests and is considered a key marker of pregnancy?

  • Luteinizing Hormone (LH)
  • Follicle-Stimulating Hormone (FSH)
  • Progesterone
  • Human Chorionic Gonadotropin (hCG)


Answer: Human Chorionic Gonadotropin (hCG)

3. Daily supplementation with which of the following is critical in the periconceptional period to prevent neural tube defects?

  • Iron
  • Vitamin D
  • Folic Acid
  • Calcium


Answer: Folic Acid

4. The period of organogenesis, when the fetus is most susceptible to teratogens, occurs during which stage of pregnancy?

  • The first trimester
  • The second trimester
  • The third trimester
  • The last month of pregnancy


Answer: The first trimester

5. What is the first-line non-pharmacologic recommendation for a pregnant patient experiencing nausea and vomiting (“morning sickness”)?

  • Eating large, infrequent meals.
  • Lying down immediately after eating.
  • Consuming small, frequent meals and avoiding trigger foods.
  • Drinking large amounts of liquid with meals.


Answer: Consuming small, frequent meals and avoiding trigger foods.

6. The first-line pharmacologic treatment for nausea and vomiting of pregnancy is typically a combination of:

  • Ondansetron and metoclopramide
  • Promethazine and prochlorperazine
  • Doxylamine and pyridoxine (Vitamin B6)
  • Scopolamine and meclizine


Answer: Doxylamine and pyridoxine (Vitamin B6)

7. A pregnant patient complains of heartburn (GERD). Which of the following is an appropriate initial recommendation?

  • Lying flat after meals
  • An H2-receptor antagonist like famotidine or an antacid
  • A high-dose proton pump inhibitor
  • An oral promotility agent


Answer: An H2-receptor antagonist like famotidine or an antacid

8. Gestational Diabetes Mellitus (GDM) is a condition of glucose intolerance that first appears during pregnancy. What is the preferred first-line treatment?

  • Oral glyburide
  • Diet and exercise
  • High-dose metformin
  • Sliding-scale regular insulin


Answer: Diet and exercise

9. Which class of antihypertensive medications is generally contraindicated in pregnancy due to its teratogenic potential?

  • Beta-blockers like labetalol
  • ACE inhibitors and ARBs
  • Calcium channel blockers like nifedipine
  • Alpha-agonists like methyldopa


Answer: ACE inhibitors and ARBs

10. A pregnant patient is diagnosed with a urinary tract infection (UTI). Which antibiotic is generally considered safe and effective for an uncomplicated UTI in the second trimester?

  • Doxycycline
  • Ciprofloxacin
  • Nitrofurantoin or a cephalosporin
  • Trimethoprim/sulfamethoxazole


Answer: Nitrofurantoin or a cephalosporin

11. What is the primary purpose of administering Rho(D) immune globulin (RhoGAM) to an Rh-negative mother?

  • To treat anemia in the mother
  • To prevent the mother from developing antibodies against an Rh-positive fetus
  • To treat hypertension
  • To prevent gestational diabetes


Answer: To prevent the mother from developing antibodies against an Rh-positive fetus

12. Preeclampsia is a serious pregnancy complication characterized by:

  • Low blood pressure and proteinuria
  • New-onset hypertension and proteinuria after 20 weeks of gestation
  • High blood glucose and ketones in the urine
  • A severe skin rash and itching


Answer: New-onset hypertension and proteinuria after 20 weeks of gestation

13. The definitive treatment for severe preeclampsia or eclampsia is:

  • Administration of high-dose aspirin
  • A continuous infusion of labetalol
  • Delivery of the baby and placenta
  • Bed rest for the remainder of the pregnancy


Answer: Delivery of the baby and placenta

14. Which medication is used for seizure prophylaxis in patients with severe preeclampsia?

  • Phenytoin
  • Lorazepam
  • Magnesium sulfate
  • Phenobarbital


Answer: Magnesium sulfate

15. A pregnant patient experiencing constipation should first be advised to try which of the following?

  • A stimulant laxative like senna
  • Increasing dietary fiber and fluid intake
  • A daily mineral oil enema
  • An osmotic laxative like lactulose


Answer: Increasing dietary fiber and fluid intake

16. Which of the following vaccines is routinely recommended during every pregnancy, typically between 27 and 36 weeks?

  • Measles, Mumps, Rubella (MMR)
  • Tetanus, diphtheria, and acellular pertussis (Tdap)
  • Varicella (chickenpox)
  • Human Papillomavirus (HPV)


Answer: Tetanus, diphtheria, and acellular pertussis (Tdap)

17. A pregnant patient with hypothyroidism should be managed carefully because:

  • The maternal dose of levothyroxine often needs to be increased during pregnancy
  • Pregnancy cures hypothyroidism
  • The maternal dose of levothyroxine needs to be decreased
  • Levothyroxine is contraindicated in pregnancy


Answer: The maternal dose of levothyroxine often needs to be increased during pregnancy

18. What is a key role for the pharmacist in caring for a pregnant patient?

  • To advise the patient to stop all their medications
  • To assess the safety of medications and provide evidence-based recommendations
  • To diagnose new conditions during pregnancy
  • To deliver the baby


Answer: To assess the safety of medications and provide evidence-based recommendations

19. Which of the following is a common physiological change during pregnancy that can affect drug pharmacokinetics?

  • Decreased renal blood flow
  • Increased gastrointestinal motility
  • Increased plasma volume and increased renal clearance
  • Decreased cardiac output


Answer: Increased plasma volume and increased renal clearance

20. A pregnant patient has a deep vein thrombosis (DVT). Which anticoagulant is the preferred treatment?

  • Warfarin
  • Low-molecular-weight heparin (LMWH)
  • Rivaroxaban
  • Dabigatran


Answer: Low-molecular-weight heparin (LMWH)

21. Naegele’s rule is a method used to estimate:

  • The date of delivery
  • The risk of preeclampsia
  • The baby’s weight
  • The mother’s expected weight gain


Answer: The date of delivery

22. Which of the following live virus vaccines is contraindicated in pregnancy?

  • Inactivated influenza vaccine
  • Tdap vaccine
  • Measles, Mumps, Rubella (MMR) vaccine
  • Rho(D) immune globulin


Answer: Measles, Mumps, Rubella (MMR) vaccine

23. Iron-deficiency anemia is common in pregnancy. A key counseling point for a patient starting oral iron supplementation is:

  • To take it with a large glass of milk to improve absorption
  • That it may cause constipation and dark stools
  • That it should only be taken at bedtime
  • To take it with an antacid to prevent stomach upset


Answer: That it may cause constipation and dark stools

24. The FDA’s previous pregnancy risk category “X” indicated that:

  • The drug was safe to use at any point in pregnancy
  • Human and animal studies showed fetal abnormalities and the risk clearly outweighed any benefit
  • No studies had been conducted in humans or animals
  • The drug was only risky during the third trimester


Answer: Human and animal studies showed fetal abnormalities and the risk clearly outweighed any benefit

25. The current FDA labeling standard for medications used in pregnancy is the:

  • A, B, C, D, X category system
  • Pregnancy and Lactation Labeling Rule (PLLR)
  • Black Box Warning system
  • MedWatch program


Answer: Pregnancy and Lactation Labeling Rule (PLLR)

26. For a pregnant patient with chronic hypertension, which antihypertensive is a reasonable first-line choice?

  • Lisinopril
  • Losartan
  • Labetalol or methyldopa
  • Atenolol


Answer: Labetalol or methyldopa

27. A pregnant patient asks if it is safe to consume caffeine. What is the general recommendation?

  • All caffeine should be strictly avoided.
  • Unlimited caffeine consumption is safe.
  • Moderate consumption (e.g., <200 mg/day) is generally considered safe.
  • Only caffeinated teas are safe.


Answer: Moderate consumption (e.g., <200 mg/day) is generally considered safe.

28. Why is it important to treat asymptomatic bacteriuria in a pregnant patient?

  • To prevent the progression to pyelonephritis and reduce the risk of preterm labor
  • It is not necessary to treat it
  • To prevent the development of hypertension
  • To cure the patient’s nausea


Answer: To prevent the progression to pyelonephritis and reduce the risk of preterm labor

29. Tocolytic agents, such as terbutaline or magnesium sulfate, are used in pregnancy to:

  • Induce labor
  • Suppress preterm labor
  • Treat preeclampsia
  • Lower blood glucose


Answer: Suppress preterm labor

30. Corticosteroids like betamethasone are given to mothers at risk for preterm delivery to:

  • Stop the contractions
  • Prevent maternal infection
  • Enhance fetal lung maturity
  • Lower the mother’s blood pressure


Answer: Enhance fetal lung maturity

31. The HELLP syndrome is a severe variant of preeclampsia. What does the “H” stand for?

  • Hemolysis
  • Hypertension
  • Hemorrhage
  • Hyperglycemia


Answer: Hemolysis

32. Which of the following is a common integumentary (skin) change during pregnancy?

  • Vitiligo
  • Psoriasis
  • Striae gravidarum (stretch marks)
  • Alopecia (hair loss)


Answer: Striae gravidarum (stretch marks)

33. The recommended weight gain during pregnancy for a person with a normal pre-pregnancy BMI is approximately:

  • 5-10 pounds
  • 15-25 pounds
  • 25-35 pounds
  • 40-50 pounds


Answer: 25-35 pounds

34. A pharmacist’s role in pregnancy care includes:

  • Counseling on appropriate vitamin and mineral supplementation
  • Identifying and advising on medications that are unsafe during pregnancy
  • Providing education on managing common discomforts
  • All of the above


Answer: All of the above

35. A pregnant patient is found to have a Group B Streptococcus (GBS) colonization. What is the standard management?

  • Treatment with oral antibiotics for the remainder of the pregnancy
  • Intrapartum antibiotic prophylaxis (usually penicillin) during labor
  • No treatment is necessary
  • Immediate delivery via C-section


Answer: Intrapartum antibiotic prophylaxis (usually penicillin) during labor

36. A key component of the first prenatal visit is:

  • A detailed medical and family history
  • A physical exam and baseline lab work
  • An estimation of the gestational age and due date
  • All of the above


Answer: All of the above

37. Which of the following is considered a teratogen and should be strictly avoided during pregnancy?

  • Acetaminophen
  • Isotretinoin
  • Prenatal vitamins
  • Doxylamine


Answer: Isotretinoin

38. The increased blood volume during pregnancy can lead to what condition?

  • Concentrated hemoglobin levels
  • Physiological anemia of pregnancy
  • Polycythemia
  • Thrombocytopenia


Answer: Physiological anemia of pregnancy

39. A pregnant patient with a history of genital herpes should receive antiviral prophylaxis near term to:

  • Cure the herpes infection permanently
  • Prevent a recurrent outbreak during delivery
  • Treat gestational diabetes
  • Lower her blood pressure


Answer: Prevent a recurrent outbreak during delivery

40. A patient in her third trimester complains of pain and bleeding and is diagnosed with placental abruption. This is a medical emergency because:

  • It is a normal part of labor
  • It can deprive the fetus of oxygen and cause severe maternal bleeding
  • It always resolves on its own without intervention
  • It is a sign of a urinary tract infection


Answer: It can deprive the fetus of oxygen and cause severe maternal bleeding

41. Which of the following is the most reliable sign of pregnancy?

  • Nausea
  • Missed menstrual period
  • Visualization of a fetus via ultrasound
  • Breast tenderness


Answer: Visualization of a fetus via ultrasound

42. A pharmacist should advise a pregnant patient with a headache to use which of the following as a first-line agent?

  • Ibuprofen
  • Naproxen
  • Aspirin
  • Acetaminophen


Answer: Acetaminophen

43. A pregnant patient asks about travel. A key piece of advice is to:

  • Avoid all travel during the entire pregnancy
  • Plan for frequent breaks to walk around during long car or plane rides to prevent DVT
  • Only travel by boat
  • Travel only during the last month of pregnancy


Answer: Plan for frequent breaks to walk around during long car or plane rides to prevent DVT

44. What is the purpose of performing an amniocentesis?

  • To determine the baby’s gender only
  • To obtain amniotic fluid for genetic testing of the fetus
  • To treat nausea and vomiting
  • To measure the mother’s blood glucose


Answer: To obtain amniotic fluid for genetic testing of the fetus

45. For a pregnant patient with a known opioid use disorder, the recommended standard of care is:

  • Abrupt cessation of all opioids
  • Medically supervised withdrawal
  • Maintenance therapy with methadone or buprenorphine
  • Switching to a short-acting opioid


Answer: Maintenance therapy with methadone or buprenorphine

46. Which of the following is a common gastrointestinal change in pregnancy?

  • Increased gastric emptying
  • Decreased transit time in the colon
  • Decreased gastric emptying and constipation
  • Increased gastric acid production


Answer: Decreased gastric emptying and constipation

47. A pharmacist should counsel a pregnant patient to avoid which of the following foods due to the risk of Listeria?

  • Well-cooked meats
  • Pasteurized dairy products
  • Washed fruits and vegetables
  • Unpasteurized soft cheeses and deli meats


Answer: Unpasteurized soft cheeses and deli meats

48. Braxton Hicks contractions are:

  • A sign of active labor
  • A serious complication of pregnancy
  • Irregular, usually painless practice contractions that do not cause cervical change
  • A symptom of a urinary tract infection


Answer: Irregular, usually painless practice contractions that do not cause cervical change

49. An important non-pharmacologic treatment for leg cramps during pregnancy is:

  • Decreasing fluid intake
  • Standing for long periods
  • Calf stretching exercises and adequate hydration
  • Taking a strong muscle relaxant


Answer: Calf stretching exercises and adequate hydration

50. The overarching goal of pharmacy care during pregnancy is to:

  • Ensure the patient takes as few medications as possible
  • Support the health of the mother and fetus by ensuring safe and effective medication use
  • Only focus on the health of the fetus
  • Defer all medication-related questions to the obstetrician


Answer: Support the health of the mother and fetus by ensuring safe and effective medication use

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