We strongly urge you to print out these CME Post-Test Questions before starting each module to help guide you through the material. You will have the opportunity to answer the questions on-line at the end of each module.
| 1. |
The FDA-approved ("standard") regimen for medical abortion is:
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A. |
Mifepristone 600 mg PO followed 2 days later by misoprostol 400 µg PV for pregnancies up to 49 days' gestation
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B. |
Mifepristone 600 mg PO followed 2 days later by misoprostol 400 µg PO for pregnancies up to 63 days' gestation
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C. |
Mifepristone 400 mg PO followed 2 days later by misoprostol 600 µg PO for pregnancies up to 49 days' gestation
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D. |
Mifepristone 600 mg PO followed 2 days later by misoprostol 400 µg PO for pregnancies up to 49 days' gestation
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| 2. |
The success rate (complete abortion without the need for surgery) of the standard FDA-approved mifepristone/misoprostol regimen in gestations of ≤ 49 days is:
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A. |
87% to 92%
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B. |
Less than 92%
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C. |
Greater than 97%
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D. |
92% to 97%
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| 3. |
All of the following statements regarding the acceptability of medical abortion are true except:
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A. |
Surveys indicate that one third of ob-gyns currently providing abortion services would not provide medical abortion services.
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B. |
Clinicians' opinions about medical abortion tend to improve over time.
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C. |
Women cite greater "naturalness" as an advantage of medical over surgical abortion.
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D. |
Medical abortion has been rated "satisfactory" or "very satisfactory" by 88% to 97% of women.
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| 4. |
All of the following statements regarding vaginal versus oral misoprostol are true except:
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A. |
After oral dosing, plasma levels peak at around 30 minutes and drop off sharply within 2 hours.
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B. |
Following vaginal administration, plasma levels peak at around 80 minutes and remain relatively high for 4 hours.
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C. |
Compared to oral misoprostol, vaginal misoprostol is associated with a more rapid expulsion of the conceptus.
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D. |
The incidence of vomiting and diarrhea is significantly higher among women receiving vaginal misoprostol.
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| 5. |
Comparison of methotrexate/misoprostol and the standard mifepristone/misoprostol regimen when used through 49 days' gestation demonstrates:
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A. |
The two regimens achieve approximately equal efficacy by 4 weeks after initiation of the treatment.
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B. |
More women will abort earlier with mifepristone/misoprostol.
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C. |
Both regimens are potentially teratogenic.
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D. |
All of the above
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| 1. |
Which of the following statements regarding side effects and complications associated with medical abortion is true? |
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A. |
Side effects are common, while complications are relatively rare. |
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B. |
Side effects and complications in medical abortion can be viewed as a continuum. |
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C. |
Most side effects are to be expected and are generally minor. |
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D. |
All of the above |
| 2. |
Which of the following guidelines is useful for prompting a woman to call her medical abortion provider? |
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A. |
Vaginal bleeding lasting longer than 3 days |
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B. |
Vaginal spotting on day 10 following mifepristone
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C. |
Soaking through 2 maxipads per hour for 2 consecutive hours |
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D. |
Passing blood clots 2 hours after taking misoprostol |
| 3. |
Which of the following findings on ultrasonography 2 weeks after medical abortion with mifepristone/misoprostol is consistent with an "incomplete abortion"?
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A. |
A persistent nonviable gestational sac |
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B. |
A gestational sac in the oviduct |
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C. |
The presence of intrauterine debris in an asymptomatic patient 2 weeks after mifepristone administration
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D. |
A persistent gestational sac with cardiac activity visible on ultrasound at follow-up |
| 4. |
The incidence of continuing pregnancy following medical abortion with mifepristone/misoprostol for pregnancies ≤ 49 days' gestation is approximately:
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A. |
9% |
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B. |
6% |
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C. |
3% |
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D. |
1% |
| 5. |
Which of the following statements about the management of side effects in medical abortion is true? |
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A. |
Following administration of mifepristone or methotrexate, medical abortion patients should be sent home with medications to treat all potential side effects.
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B. |
Adequate counseling and patient preparation are essential components of managing side effects.
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C. |
Narcotic analgesics are contraindicated in medical abortion. |
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D. |
Most side effects occur from 7 to 14 days after patients take misoprostol.
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| 1. |
Which of the following features is common to both medical abortion and surgical abortion?
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A. |
Number of visits
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B. |
Predictability of time to completion
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C. |
High success rate
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D. |
Invasiveness
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| 2. |
Which of the following statements describes the goals of abortion counseling?
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A. |
Ensure the woman has considered her options and knows that whatever decision she makes is her choice.
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B. |
Educate and prepare the woman for what to expect.
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C. |
Empathize and provide support to the woman.
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D. |
All of the above
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| 3. |
Women choose medical abortion over surgical abortion for all of the following reasons except:
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A. |
Desire to avoid surgery
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B. |
Perception of medical abortion as better or easier
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C. |
No need to interact with a health care provider
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D. |
Perception of medical abortion as more natural
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| 4. |
Which of the following is a challenge specific to medical abortion counseling?
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A. |
Patients must understand the need for a surgical abortion if the medical procedure fails.
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B. |
Success depends on the woman's active participation throughout the process.
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C. |
Follow-up is critical to confirm complete abortion.
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D. |
All of the above
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| 5. |
Which of the following statements does not accurately describe the side effects of medical abortion?
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A. |
The side effects of medical abortion are frequently debilitating.
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B. |
Nausea is the most common gastrointestinal side effect.
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C. |
Pain typically peaks after administration of misoprostol.
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D. |
Fatigue is fairly common on the day the pregnancy is expelled.
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| 1. |
Transabdominal and transvaginal ultrasound differ in all of the following features except:
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A. |
View of the pelvic organs
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B. |
Invasiveness
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C. |
Difficulty of learning how to perform the procedure
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D. |
Gestational age at which pregnancy can be detected
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| 2. |
For transabdominal ultrasound, the discriminatory level is:
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A. |
800 mIU/mL
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B. |
360 mIU/mL
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C. |
2,000 mIU/mL
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D. |
3,600 mIU/mL
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| 3. |
On ultrasound, a true gestational sac is characterized by:
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A. |
A "double-ring" sign
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B. |
An echolucent fluid collection without a "double-ring" sign
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C. |
An echogenic layer of tissue lining the uterine cavity
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D. |
A "grape-like" sonographic image
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| 4. |
Which of the following formulas can be used for estimating gestational age:
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A. |
Mean sac diameter (mm) + 42 ± 3 days
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B. |
Embryonic length (mm) + 42 ± 3 days
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C. |
Mean sac diameter (mm) + 30 ± 7 days
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D. |
Embryonic length (mm) + 30 ± 3 days
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| 5. |
Which of the following statements about the use of ultrasonography in medical abortion practice is true:
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A. |
Every patient who undergoes a medical abortion must have a pelvic ultrasound prior to the procedure.
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B. |
Every patient who undergoes a medical abortion must have a pelvic ultrasound to confirm the outcome of the procedure.
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C. |
Ultrasonography should be available in medical abortion practice, but it is not required for every patient.
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D. |
Exposure to high-frequency sound waves poses a significant risk to the health of the woman.
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| 1. |
Facilities that provide medical abortion services require on-site space for all of the following functions except:
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A. |
Private counseling
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B. |
Physical examination
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C. |
Surgical backup
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D. |
Medication administration
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| 2. |
Which of the following statements about on-call services is true?
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A. |
All calls should be triaged by physicians.
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B. |
All providers of medical abortion services consistently report that medical abortion services involve more phone calls than surgical abortion services do.
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C. |
A clinician must be available at all times.
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D. |
Patient preparation is unlikely to have an impact on the number of calls a practice receives from women undergoing medical abortion.
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| 3. |
The counseling session for medical abortion:
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A. |
Should take about 90 minutes
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B. |
Should include a discussion of what to expect during the procedure, as well as informed consent
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C. |
Can take place in group sessions that provide emotional support
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D. |
Is usually conducted over the phone
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| 4. |
Quality assurance and quality improvement rely on:
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A. |
Clear guidelines and standards to define responsibilities and scope of practice
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B. |
Quality control checks on all laboratory equipment
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C. |
Secure storage of medication
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D. |
All of the above
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| 5. |
Which of the following statements regarding billing and reimbursement for medical abortion services is false?
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A. |
The CPT code for medical abortion is the same as for surgical abortion.
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B. |
Some insurance companies have designated billing codes for medical abortion.
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C. |
Charges for medical abortion depend on staff time, components of the service, and the cost of the medications.
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D. |
The AMA has not designated a universal CPT code specific to medical abortion.
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