The correct answer is A. The decision of whether to have a termination of pregnancy is a deeply personal one. This patient has just been notified that she is pregnant with a 10-week fetus. She is unsure whether she wants to keep her pregnancy or terminate it. In this setting, the most appropriate next step is to counsel the patient regarding her options or refer the patient for counseling. In a balanced way, the patient should be fully informed of all of her options including raising the child herself, placing the child up for adoption, and abortion.
To notify the patient's parents (choice B) is not appropriate. Such an act would violate the patient's confidentiality. A 34-year-old woman is an adult and issues of parental notification do not apply.
To notify the patient's partner (choice C) is not appropriate. This notification would also violate confidentiality.
To schedule a termination of pregnancy (choice D) would not be appropriate. This patient has just informed the physician that she is unsure what she wants to do. To just go ahead and schedule the termination without proper counseling of the patient would not be a balanced or proper approach for the patient.
To tell the patient that she is likely to have a miscarriage (choice E) is inappropriate. This patient may have a miscarriage, as might any patient with a first-trimester pregnancy. However, once an intrauterine pregnancy with fetal cardiac activity is identified, the risk of miscarriage is approximately 10%. Therefore, she is most likely not to have a miscarriage.
Category:
Obstetrics MCQs
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