Dr. Zack’s Safe Pregnancy IQ Test™ It’s important that you answer the questions honestly and do not guess. When in doubt, instead of guessing, please select “I’m not certain” as your answer so that you will have an accurate assessment of your pregnancy knowledge.Critical Decisions1. Which of the following could make the biggest difference in the outcome of your pregnancy?*(a) Your doctor(b) Your hospital(c) Your health insurance(d) I’m not certain2. Given the choice between delivering at a small accredited hospital one mile from your house or a large accredited regional hospital 17 miles away, the safest choice for you and your baby would be:*(a) The closest accredited hospital for immediate medical care(b) The largest accredited regional hospital, time permitting(c) Both accredited hospitals would be okay(d) I’m not certain3. Expectant mothers who know their local hospitals are accredited may safely rely on this accreditation as a strong indicator that their hospital is safe and will produce a good outcome for their birthing experience.*(a) True(b) False(c) I’m not certainAssembling Your Healthcare Team4. Most women choose what kind of pregnancy healthcare provider:*(a) An experienced midwife(b) A family practitioner(c) A board-certified OB/GYN(d) I’m not certain5. When selecting your doctor, the most important question to ask (after determining the doctor’s qualifications) is:*(a) Where do you have admitting privileges?(b) Are you comfortable handling high-risk pregnancies?(c) Will you be the doctor delivering my baby?(d) I’m not certain6. If you deliver at a large specialty or subspecialty hospital and your doctor is late, your baby may be delivered by a hospitalist (a doctor employed by the hospital).*(a) True(b) False(c) I’m not certain7. If you deliver at a teaching hospital, medical students, interns, and residents may have a right to participate in your care.*(a) True(b) False(c) It depends(d) I’m not certain8. If your doctor practices at a faith-based hospital, or if you have reason to believe your doctor’s medical decisions are guided by strongly held religious beliefs, you must determine:*(a) Whose life will be saved if both you and your baby are at risk in a medical emergency(b) Whether your doctor will oppose or support your decision to terminate a pregnancy if genetic testing indicates you have a child with devastating genetic defects(c) Both of the above(d) I’m not certain9. Midwifes are safe healthcare providers for home births.*(a) True(b) False(c) I’m not certain10. Laws governing the practice of midwifery vary from state to state.*(a) True(b) False(c) I’m not certain11. Surgical doctors object to midwives delivering babies because they don’t want economic competition.*(a) True(b) False(c) I’m not certain12. Which of the following would be a safe choice for delivering your baby?*(a) A board-certified OB/GYN at a specialty or subspecialty hospital(b) A perinatologist at a specialty or subspecialty hospital(c) A certified nurse-midwife delivering at a specialty or a subspecialty hospital with an OB/GYN and anesthesiologist standing by(d) All of the above(e) I’m not certain13. Certified nurse-midwives can provide full maternity care (excluding surgical interventions), including delivering babies at hospitals where they have admitting privileges.*(a) True(b) False(c) I’m not certain14. An uneventful pregnancy without any risk factors is a reliable indicator that a home birth will also be low risk and uneventful.*(a) True(b) False(c) I’m not certain15. In the event of a maternal hemorrhage or other life-threatening medical emergency, it will be impossible for a midwife delivering at home to:*(a) Demonstrate a safe mechanism for obtaining medical consultation, collaboration, and referral(b) Demonstrate appropriate techniques for emergency management, including transportation(c) Perform a surgical intervention to save the mother and/or her baby(d) All of the above(e) I'm not certain16. The authors of What to Expect When You’re Expecting state that women planning on a home birth should be no further away from a hospital than 30 miles. This statement:*(a) Cannot be found in the Standards for the Practice of Midwifery(b) Was made up by the authors(c) Has no basis in fact(d) All of the above(e) I’m not certain17. Throughout most of your labor, the most important medical support person in the room will be your:*(a) Doctor(b) Spouse or birth partner(c) Labor and delivery nurse(d) I’m not certain18. Because of liability laws and hospital protocols, any nurse assigned to the labor and delivery ward must be qualified by nursing education and specific certifications in basic and advanced fetal heart monitoring, labor triage, and neonatal intensive care.*(a) True(b) False(c) I’m not certain19. Failure to recognize warning signs that a mom or her baby is in distress may result in catastrophic injuries such as:*(a) Brain damage to the baby(b) Fetal demise (baby dies)(c) Mom dying(d) All of the above(e) I’m not certain20. Not all nurses are qualified to be in a labor and delivery unit, or monitoring your progress. The following nurses should not be allowed to participate in your labor and delivery:*(a) Floater nurses (nurses who travel around the hospital where needed because of staffing shortages) who lack adequate training in labor and delivery(b) Inexperienced nurses (a nurse without proper obstetrical training)(c) Nurses who have been out of nursing more than one to two years and who are not up to date on changing protocols and advances in labor and delivery(d) All of the above(e) I’m not certain21. You have a right to ask for another labor and delivery nurse if:*(a) You determine that she’s too inexperienced(b) She’s not educationally qualified(c) You just don’t click with her(d) All of the above(e) a and b only(f) I’m not certain22. Which of the following statements about doulas is false?*(a) “Doula” is a Greek word meaning “To mother the mother”(b) Doulas can provide you with encouragement and labor coaching(c) A doula can provide medical care and is a good substitute for a labor and delivery nurse(d) I’m not certainWhen to Call Your Doctor23. You should call your doctor immediately if you are in an accident, if you’ve had a hard fall, or if you receive a blow to your abdomen while pregnant.*(a) True(b) False(c) I’m not certain24. A decrease in your baby’s activity level during your third trimester could mean:*(a) Your baby is just responding to what you’ve been doing(b) Your baby is just responding to what you’ve been eating(c) Your baby is in trouble and you should contact your doctor immediately(d) All of the above(e) I’m not certain25. You should contact your doctor immediately if any first-trimester spotting continues for more than a day or two or turns into sustained bleeding.*(a) True(b) False(c) I’m not certain26. You should contact your doctor immediately if you experience any spotting or bleeding in the second or third trimester.*(a) True(b) False(c) I’m not certain27. You should contact your doctor immediately if:*(a) Your bleeding becomes heavy or is mingled with tissue(b) You experience a fever, chills, cramping, or acute abdominal pain(c) Both a and b(d) Neither a nor b(e) I’m not certain28. You should contact your doctor immediately if:*(a) You have severe difficulty breathing(b) It hurts to breathe(c) You have chest pains, your pulse is racing, or your breathing is very rapid(d) All of the above(e) I’m not certain29. If you aren’t sure whether you are experiencing true labor contractions or Braxton Hicks contractions (“practice” contractions, not true labor contractions, named after the British physician who first identified them), you should call your doctor.*(a) True(b) False(c) I’m not certain30. If you cannot satisfy your thirst or hunger no matter how many fluids or how much food you consume, it could mean that:*(a) You are pregnant(b) You have gestational diabetes(c) Both a and b(d) I’m not certain31. If while pregnant you are chronically lethargic and exhausted or are experiencing dizzy spells, it could mean that you have:*(a) Hypertension(b) Cardiac arrhythmias (irregular heartbeats)(c) Chronic fatigue associated with anemia(d). All of the above(e) I’m not certain32. If you experience a fever during your pregnancy, you should:*(a) Take your temperature(b) Take aspirin or Tylenol(c) Wait three hours before calling your doctor(d) Call your doctor immediately if your temperature is above 100.4 Fahrenheit (38 degrees Celsius)(e) a and d(f) I’m not certain33. Tingling, burning, or numbness in your hands could be a sign of:*(a) Gestational diabetes(b) Carpal tunnel syndrome(c) A relatively common development in pregnancy(d) b and c(e) I’m not certain34. A diagnostic test done during your pregnancy:*(a) Will tell you that you do or do not have a certain condition(b) Will indicate a potential problem(c) Should not be done; you should only have screening tests done during your pregnancy(d) I’m not certain35. You should contact your doctor immediately if:*(a) Your headaches are severe or unrelieved for more than three hours(b) Your headache is accompanied by dizziness(c) Both a and b(d) I’m not certain36.Prolonged severe headaches:*(a) May be linked to hypertension(b) May indicate preeclampsia(c) Could indicate a problem that can put you and your baby at serious risk for complications(d) All of the above(e) I’m not certain37. One of the most dangerous pregnancy mistakes is:*(a) Missing the warning sign of leaking fluid(b) Mistaking leaking fluid for urine rather than amniotic fluid(c) Failing to contact your doctor immediately when you suspect you are leaking fluid(d) All of the above(e) I’m not certain38. Abdominal pain in your first trimester could signify:*(a) Indigestion(b) A molar pregnancy (tissue that normally becomes a fetus instead becomes an abnormal noncancerous growth in your uterus)(c) An ectopic pregnancy (pregnancy in which the fertilized egg implants outside the uterus)(d) I’m not certain39. Later in your pregnancy, abdominal pain accompanied by bleeding and/or neck and shoulder pain could indicate:*(a) A uterine or other infection(b) Preeclampsia(c) Premature labor(d) Placental abruption(e) Appendicitis(f) All of the above(g) I’m not certain40. Rectal pain or bleeding could be a sign of:*(a) Hemorrhage(b) Pregnancy-induced hypertension(c) Gestational diabetes(d) Pregnancy-induced hemorrhoids(e) I’m not certain41. Low back pain, especially if accompanied by a fever, could be an indication of:*(a) A strained back from the weight of your fetus(b) The onset of seasonal flu(c) A urinary tract infection(d) I’m not certain42. Vaginal discharge could signify:*(a) Nothing at all(b) Elevated hormones(c) Cervical incompetence(d) Premature rupture of your membranes(e) All of the above(f) I’m not certain43. A cord prolapse occurs when the umbilical cord is wrapped around the baby’s head or neck.*(a) True(b) False(c) I’m not certain44. Which statement is false? Problems with your vision during pregnancy:*(a) Are usually caused by fluid retention(b) Are never serious and usually go away after you deliver(c) Could indicate preeclampsia, a pregnancy condition associated with high blood pressure(d) Should be brought to your doctor’s attention immediately(e) I’m not certain45. Nausea and vomiting are normal symptoms that every woman experiences.*(a) True(b) False(c) I’m not certain46. “Morning sickness” always occurs in the morning.*(a) True(b) False(c) I’m not certain47. Which statement is true? Excessive or prolonged vomiting:*(a) Can be dealt with at home by increasing your fluid intake(b) Can be dealt with at home by taking an over-the-counter anti-nausea medication like Pepto-Bismol(c) May indicate hyperemesis gravidarum, a condition that could require medical intervention or hospitalization for IV fluid replacement and medication(d) I’m not certain48. Symptoms of severe preeclampsia may include:*(a) Swelling of the face and hands(b) Rapid weight gain(c) Dizziness(d) Blurry vision(e) Headaches(f) Upper abdominal pain(g) All of the aboveh. I'm not certainChildbirth, Labor, and Delivery49. One of the most obvious signs that you’re in labor or that labor is about to begin is the breaking of your water.*(a) True(b) False(c) I’m not certain50. When your mucus plug comes out, the water from your uterus will come out in a gush.*(a) True(b) False(c) I’m not certain51. When you first begin to feel contractions, you should go straight to the hospital.*(a) True(b) False(c) I’m not certain52. Which statement is false? Braxton Hicks contractions are:*(a) Unpredictable(b) Practice contractions(c) Irregular contractions(d) True contractions(e) I’m not certain53. Which statement is true? Real labor contractions are:*(a) Regular, become stronger, become longer, and become more frequent (every five to eight minutes)(b) Like strong menstrual cramps involving your whole uterus(c) Consistent and do not go away or change when you walk, move, or take a warm bath or shower(d) All of the above(e) I’m not certain54. Wherever you are when your water breaks, be sure to:*(a) Note the color of your fluid(b) Note the odor of your fluid(c) Call your doctor and go directly to the hospital(d) All of the above(e) I’m not certain55. There are four stages of labor. The final stage is recovery.*(a) True(b) False(c) I’m not certain56. An episiotomy is a surgical procedure routinely used to enlarge the birth opening*(a) True(b) False(c) I’m not certain57. Which statement is false? Delivery of the placenta:*(a) Is the hardest part of labor(b) Normally takes five to 30 minutes(c) Must be complete or the retained placenta can cause complications(d) I’m not certain58. Which of the following vaginal deliveries should always take place in the operating room?*(a) Breech deliveries(b) Multiple births(c) Babies with cephalopelvic disproportion (CPD) or macrosomia(d) Both a and b(e) All of the above(f) I’m not certain59. The American Congress of Obstetricians and Gynecologists (ACOG) discourages the practice of elective C-sections. An elective C-section is the practice of doing a cesarean section by appointment or the convenience of the mother rather than a medical emergency to protect a mother or her baby.*(a) True(b) False(c) I’m not certain60. Which statement is false?*(a) A shoulder dystocia occurs when your baby’s shoulders lodge (get stuck) in your pelvis after the emergence of your baby’s head(b) A McRoberts maneuver eliminates most instances of shoulder dystocia(c) Any doctor can perform a Woods Corkscrew maneuver in conjunction with the McRoberts maneuver(d) A shoulder dystocia is a true emergency for both mother and baby(e) I’m not certain61. After you give birth, you shouldn’t soak more than two pads in an hour or continuously pass clots with bursts of bright red blood.*(a) True(b) False(c) I’m not certain62. Statistics indicate that in all instances, it is perfectly safe for a woman who has had a cesarean to deliver vaginally with her next pregnancy.*(a) True(b) False(c) I’m not certain63. Which statement is false? If you deliver at home or a birthing center with a midwife:*(a) The midwife cannot perform any life-saving surgical intervention(b) There’s a high likelihood that you will die before you get to a hospital if you are hemorrhaging profusely(c) The likelihood of death from postpartum hemorrhage is too small to be a factor in whether you should deliver at a hospital, at home, or a birthing center(d) I’m not certainMiscellaneous Questions64. While you’re on a fetal monitor, your baby will be assessed for acceleration, various types of decelerations (early, late, and variable), and variability. Which of the following is most dangerous for the fetus?*(a) Early deceleration(b) Variable deceleration(c) Late deceleration(d) I’m not certain65. When looking at a fetal heart monitor tracing (the white strip of paper that looks like an EKG—electrocardiogram-- graph that checks for problems in your heart’s electrical activity), it is important to know that:*(a) A flat tracing is bad(b) A chaotic tracing with peaks and valleys is good(c) Neither a nor b is correct(d) Both a and b are correct(e) I’m not certain66. If you eat peanut products while pregnant, you may be increasing your baby’s susceptibility to this serious allergy.*(a) True(b) False(c) I’m not certain67. To protect your unborn baby, you should:*(a) Never self-diagnose(b) Never self-medicate(c) Always call when your gut tells you something is wrong(d) All of the above(e) I’m not certain68. When it comes to pain management, a drug-free delivery is always better for your baby.*(a) True(b) False(c) I’m not certain69. In theory, epidurals can be administered at any time prior to delivery.*(a) True(b) False(c) I’m not certain70. General anesthesia is frequently used to help moms who are frightened of childbirth because they can sleep through the experience.*(a) True(b) False(c) I’m not certain71. In order to protect your unborn baby, it is absolutely essential that you make full disclosure to your doctor of any previous:*(a) Blood transfusions(b) Pregnancies (whether or not they went to term)(c) Miscarriages(d) Abortions (spontaneous or planned)(e) All of the above(f) I’m not certain72. Untreated blood type incompatibilities can result in fetal demise (death).*(a) True(b) False(c) I’m not certain73. If you choose to breastfeed, the same strict dietary rules that applied to your food, alcohol, and drugs during your pregnancy remain in effect.*(a) True(b) False(c) I’m not certain74. Not all premature births can or should be stopped.*(a) True(b) False(c) I’m not certain75. The United States Food and Drug Administration (FDA) classifies prescription drugs into five categories, A, B, C, D and X. The following categories of drugs are safe to take during pregnancy:*(a) A(b) B(c) Both a and b(d) C(e) D(f) X(g) I’m not certain76. The classic teratogenic period (the time when your baby is most at risk for birth defects) is:*(a) Days 1–30(b) Days 31–71(c) Days 72–90(d) Days 91–180(e) None of the above(f) I’m not certain77. Regarding fish, which is the true statement?*(a) Eating up to 12 ounces of shrimp, catfish, canned light tuna, or salmon per week is safe(b) Avoid swordfish, shark, king mackerel, and tilefish in pregnancy(c) Fish caught by friends in local rivers, lakes, or coastal areas are generally safe to consume(d) a and b are correct(e) a, b, and c are correct(f) I’m not certain78. You want to get pregnant. When does ovulation occur?*(a) Two weeks before your next period(b) One week before your next period(c) Two weeks after your period(d) I’m not certain79. What is the implication of a blood type that is Rh negative if both parents are Rh negative?*(a) You will need RhoGAM® during and after your pregnancy(b) You will need RhoGAM® before, during, and after your pregnancy(c) You will not need RhoGAM®(d) I’m not certain80. It is important to take folic acid:*(a) At least six weeks before you conceive(b) Because it decreases the incidence of cleft palate(c) Because it decreases the incidence of neural tube defects(d) a and c(e) a, b, and c(f) I’m not certain81. Drinking alcoholic beverages while pregnant:*(a) Can lead to fetal alcohol syndrome only if you consume large amounts(b) Is safe in very small amounts(c) Should not be done(d) The amount of alcohol that is safe to consume in pregnancy has not been established(e) All of the above(f) c and d(g) I’m not certain82. A good patient is one who:*(a) Respects her doctor’s private time(b) Only calls during office hours unless her water has broken and it’s time to go to the hospital(c) Calls her doctor immediately when her instincts tell her something isn’t right(d) I’m not certain83. You should never deliver vaginally if you are a woman:*(a) With a vertical (classical) or T-shaped scar from a previous cesarean(b) With a history of previous rupture(c) Who has had a previous myomectomy (surgical removal of fibroids) where the uterine cavity was entered(d) All of the above(e) None of the above(f) I’m not certain84. Every expectant mother should write a birth plan.*(a) True(b) False(c) I’m not certain85. Smoking during pregnancy is associated with:*(a) Miscarriage(b) Low birthweight(c) Premature birth(d) Stillbirth(e) Placental abruption(f) All of the above(g) I’m not certain86. A pregnant woman should increase her calories by how many per day?*(a) 600 calories per day(b) 300 calories per day(c) 1,000 calories per day(d) 1,500 calories per day(e) I’m not certain87. A screening test done during your pregnancy:*(a) Will tell you that you do or do not have a specific condition(b) Will indicate a potential problem(c) Should not be done; you should only have diagnostic tests done during your pregnancy(d) I’m not certain