Deck 14: Assessment of Fetal Well-Being

Question 1

A woman at 28 weeks' gestation is asked to keep a fetal activity diary and to bring the results with her to her next clinic visit. One week later, she calls the clinic and anxiously tells the nurse that she has not felt the baby move for over 30 minutes. The most appropriate initial comment by the nurse would be:

A)"You need to come to the clinic right away for further evaluation."
B)"Have you been smoking?"
C)"When did you eat last?"
D)"Your baby might be asleep."

Answer 1

"Your baby might be asleep."

Question 2

At 32 weeks' gestation, a woman is scheduled for a second nonstress test (following the one she had at 28 weeks' gestation). Which response by the patient would indicate an adequate understanding of this procedure?

A)"I can't get up and walk around during the test."
B)"I'll have an IV started before the test."
C)"I must avoid drinks containing caffeine for 24 hours before the test."
D)"I need to have a full bladder for this test."

Answer 2

"I can't get up and walk around during the test."

Question 3

Each of the following pregnant women is scheduled for a 14-week antepartum visit. In planning care, the nurse would give priority teaching on amniotic fluid alpha-fetoprotein (AFP) screening to which patient?

A)28-year-old with history of rheumatic heart disease
B)18-year-old with exposure to HIV
C)20-year-old with a history of preterm labor
D)35-year-old with a child with spina bifida

Answer 3

35-year-old with a child with spina bifida

Question 4

In assisting with an abdominal ultrasound procedure for determination of fetal age, the nurse:

A)Asks the woman to sign an operative consent form prior to the procedure.
B)Has the woman empty her bladder before the test begins.
C)Assists the woman into a supine position on the examining table.
D)Instructs the woman to eat a fat-free meal two hours before the scheduled test time.

Question 5

The nurse knows that a lecithin/sphingomyelin (L/S) ratio finding of 2:1 on amniotic fluid means :

A)Fetal lungs are still immature.
B)Fetal lungs are mature.
C)The fetus is small for gestational age.
D)The fetus has a congenital anomaly.

Question 6

Of all the patients who have been scheduled to have a biophysical profile, for which patient should the nurse clarify the physician's order?

A)A gravida with intrauterine growth restriction
B)A gravida with mild hypertension of pregnancy
C)A gravida who is post-term
D)A gravida who complains of decreased fetal movement for 2 days

Question 7

Each of the following pregnant women is scheduled for a 14-week antepartal visit. In planning care, the nurse would give priority teaching on amniotic fluid alpha-fetoprotein (AFP) screening to which client?

A)18-year-old with exposure to HIV
B)35-year-old with a child with spina bifida
C)20-year-old with a history of preterm labor
D)28-year-old with history of rheumatic heart disease

Question 8

A pregnant woman is having a nipple-stimulated contraction stress test. Which result indicates hyperstimulation?

A)The fetal heart rate decelerates when three contractions occur within a 10-minute period.
B)The fetal heart rate accelerates when contractions last up to 60 seconds.
C)There are more than five fetal movements in a 10-minute period.
D)There are more than three uterine contractions in a 6-minute period.

Question 9

The nurse is responding to phone calls. Which call should the nurse return first?

A)37 weeks' gestation, reports no fetal movement for 24 hours
B)29 weeks' gestation, reports increased fetal movement.
C)32 weeks' gestation, reports decreased fetal movement for 2 days
D)35 weeks' gestation, reports decreased fetal movement for 4 hours

Question 10

A woman who is 12 weeks' gestation asks the nurse if she can undergo chorionic villus sampling (CVS) testing in order to determine whether her baby has a neural tube defect. Which response is best?

A)"Yes, at 12 weeks' gestation, CVS can be used to diagnose a neural tube defect."
B)"No, because CVS testing is not performed until after 20 weeks' gestation."
C)"Yes, at 12 weeks' gestation, CVS is combined with amniocentesis to diagnose neural tube defects."
D)"No, because CVS testing alone at any stage cannot detect neural tube defects."

Question 11

A woman is at 32 weeks' gestation. Her fundal height measurement at this clinic appointment is 26 centimeters. After reviewing her ultrasound results, the healthcare provider asks the nurse to schedule the patient for a series of sonograms to be done every two weeks. The nurse should make sure that the patient understands that the main purpose for this is to:

A)Assess for congenital anomalies.
B)Evaluate fetal growth.
C)Determine fetal presentation.
D)Rule out a suspected hydatidiform mole.

Question 12

During a nonstress test, the nurse notes that the fetal heart rate decelerates about 15 beats during a period of fetal movement. The decelerations occur twice during the test and last 20 seconds each. The nurse realizes these results will be interpreted as:

A)A negative test.
B)A reactive test.
C)A non-reactive test.
D)An equivocal test

Question 13

The nurse is reviewing nursing documentation related to the care of a patient who had an amniocentesis. Which nursing notes reflect appropriate patient care?

A)An Rh-positive patient received RhoGAM after the amniocentesis.
B)The patient was monitored for 30 minutes after completion of the test.
C)Prior to discharge, the patient demonstrated vaginal spotting.
D)The patient reported that she takes insulin before each meal and at bedtime.

Question 14

The nurse is preparing a patient in her second trimester for a three-dimensional ultrasound examination. Which statement indicates that teaching had been effective?

A)"If the ultrasound is normal, it means my baby has no abnormalities."
B)"The nuchal translucency measurement will diagnose Down syndrome."
C)"I might be able to see who the baby looks like with the ultrasound."
D)"Measuring the length of my cervix will determine if I will deliver early."

Question 15

A woman who is 15 weeks' gestation received normal chorionic villus sampling (CVS) results and abnormal quadruple screen test results. For detection of congenital anomalies, which test should the nurse expect the woman to be offered next?

A)Amniocentesis
B)Ultrasound
C)Contraction Stress Test (CST)
D)Nonstress test (NST)

Question 16

The prenatal clinic nurse is responding to a patient who has had an assessment for fetal well-being. Which statement indicates that the patient understands the test result?

A)"The normal Doppler velocimetry wave result indicates my placenta is getting enough blood to the baby."
B)"The reactive nonstress test means that my baby is not growing because of a lack of oxygen."
C)"Because my contraction stress test was positive, we know that my baby will tolerate labor well."
D)"My biophysical profile score of 6 points indicates everything being normal and healthy for my baby."