The following vignette applies to the next 2 items. The items in the set must be answered in sequential order. Once you click
Proceed to Next Item, you will not be able to add or change an answer.
A 29-year-old woman, gravida 1 para 0, comes to the office at 16 weeks gestation to establish prenatal care. She has a history of a
cold knife conization 2 years ago for high-grade cervical intraepithelial neoplasia Other than obesity, she has no medical problems
The patient smoked cigarettes but quit once she learned she was pregnant She does not use alcohol or illicit drugs. Temperature is
37 C (98 6 F), blood pressure is 100/64 mm Hg, and pulse is 72/min. The fetal heart rate is 140/min by Doppler ultrasound.
Item 1 of 2
Which of the following is the best next step in evaluating this patient's risk for preterm labor?
QA Cervical nucleic acid amplification testing
0 B. Digital cervical examination
0 C. Papanicolaou test
0 D. Test for fetal fibronectin
0 E. Transabdominal ultrasound
0 F Transvaginal ultrasound
Item 2 of 2
A transvaginal ultrasound is performed at 18 weeks gestation and reveals a short cervix with a length of 1.8 cm (0 71 in) Which of the
following is the best next step in the treatment of this patient?
Q A Calcium channel blockade to facilitate myometrial relaxation
Q B. Corticosteroid stimulation of fetal pneumocyte development
Q C. Cyclooxygenase inhibition of prostaglandin production
Q D. Progesterone-mediated maintenance of uterine quiescence
Q E. Prostaglandin-induced softening of the cervix
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