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Chapter 7 CME Post Test: Contraception and Abortion Aftercare

This is the post-test for Chapter 7 of the TEACH Abortion Training Curriculum. A score of >=80% is required to claim CME, and if necessary, allows you to retake the exam after review.

Note: Your personal information will only be used internally for CME tracking purposes.

7.1. Which criteria should be met before a patient is discharged home after an early vacuum aspiration abortion?

A. Adequate pregnancy tissue is found on evaluation
B. Severe cramping has subsided and the patient is comfortable
C. Self-care instructions have been reviewed (including medications and when to call the clinic).
D. If sedatives were used, the patient is now alert and oriented, vitals and O2 saturation stable, patient has a ride.
E. A, B, and C only
F. All of the above

7.2. Identify one TRUE statement about post-abortion contraception:

A. Early all patients desire contraceptive counseling on the day of abortion.
B. Oral contraceptives, patch, ring, shot, implant, and IUD can all be started on the same day as first trimester aspiration abortion.
C. Contraceptive implant (ex. Nexplanon) placed at the time of mifepristone for medication abortion significantly increases risk of continuing pregnancy.
D. IUD placed on the day of a first-trimester aspiration has a significantly higher rate of expulsion.

7.3. A patient calls you with abdominal cramping the day following an aspiration abortion. What advice would you give them for managing post-procedure pain?

A. Use a heating pad
B. Take pain medications (such as NSAIDs, Tylenol)
C. Rest as needed, advancing activity as tolerated.
D. Call if they develop excessive pain, heavy bleeding, or sustained fever.
E. All of the above

7.4. Regarding contraception among transgender and gender diverse (TGD) individuals assigned female at birth, the following statements are true EXCEPT:

A. GTD individuals may have a desired or undesired pregnancy after transitioning socially, medically, or both, and may seek prenatal or abortion care.
B. TGD people can ovulate on testosterone even if they are not having periods.
C. TGD people attempt self-managed abortion (i.e. without clinical supervision) at higher rates than the population at large.
D. Menstruation is a reliable marker for fertility in GTD patients.
E. TGD patients on hormone therapy can use medication abortion (i.e. this is not a contraindication.

7.5. Forty-five minutes after performing a 12-week vacuum aspiration, you are called to the recovery room to evaluate the patient. The patient is clutching their abdomen and complains of severe pelvic and rectal pressure. Bleeding is negligible and vital signs are stable. The most likely diagnosis is:

A. Continuing intrauterine pregnancy
B. Acute hematometra
C. Uterine perforation
D. Pelvic infection
E. Retained products of conception

7.6. Five days after an uncomplicated first trimester vacuum aspiration, the patient calls complaining of heavy bleeding. The differential diagnosis would include:

A. Retained tissue
B. Hematometra
C. Gestational trophoblastic disease
D. Post-abortal endometritis
E. A, B and D only
F. All of the above

7.7. Many providers advise patients to limit their activity after abortion. For which of the following does evidence of harm actually exist: