An 18-year-old primigravid woman comes for her initial prenatal visit at 16 weeks' gestation. She is not sure about the date of her last menstrual period but says that the pregnancy probably occurred immediately after she stopped taking oral contraceptives 5 months ago. Maternal serum α-fetoprotein (MSAFP) level is increased to 3 multiples of the median. Which of the following is the most appropriate next step in management? a. Repeat measurement of MSAFP level
b. Triple screening for MSAFP, serum β-hCG, and serum estriol levels
c. Ultrasonography
d. Amniocentesis for measurement of α-fetoprotein level
e. Amniocentesis for chromosomal analysis

If gloves become heavily soiled and additional patient care tasks must be performed on that patient, what should you do? a. no action is necessary as it's the same patient b. change gloves c. double glove d. wash the gloves

The frequency in wich you perform certain exercise depends on the blank of the exercise

Sally is a 43-year-old mother of two who has gained 50 pounds over the past 5 years. she is 64 inches tall and weighs 180 pounds with a bmi of 30.8. her waist circumference is 37 inches. she acknowledges that she is not as physically active as she would like to be. she also notes how recent stresses in her life have affected her sleep and seem to have triggered her appetite for sweets and comfort foods. sally's father recently died from complications of type 2 diabetes, and her mother and sisters are overweight. sally says she is very motivated to "not get diabetes" and is disturbed that her recent physical exam revealed mildly elevated blood pressure, glucose, and cholesterol levels. 1. sally stated that recent stresses in her life are affecting her sleep and seemed to have triggered her appetite for sweets and comfort foods. which of the following statements would be best to explain why her lack of sleep has increased her appetite? a. lack of sleep decreases ghrelin levels. b. levels of neuropeptide y, a brain chemical that causes carbohydrate cravings, are high and may contribute to her sleep problems. c. the satiety hormone leptin increases with lack of sleep. d. lack of sleep increases uncoupling protein. e. lack of sleep increases levels of ghrelin which stimulates appetite and decreases levels of leptin which decreases appetite.