Deck 26: Assessment for Risk Factors in Pregnancy

Question 1

A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test indicated that her fetus could be experiencing some difficulties in utero.Which diagnostic tool yields more detailed information about the fetus?

A)Ultrasound for fetal anomalies
B)Biophysical profile (BPP)
C)Maternal serum alpha-fetoprotein (MSAFP)screening
D)Percutaneous umbilical blood sampling (PUBS)

Answer 1

Biophysical profile (BPP)

Question 2

In the United States today:

A)More than 20% of pregnancies meet the definition of high risk to either the mother or the infant
B)Other than biophysical criteria,sociodemographic factors place both the mother and baby at risk
C)High risk pregnancy status extends from first confirmation of pregnancy to birth
D)High risk pregnancy is less critical a medical concern because of the reduction in family size and the decrease in unwanted pregnancies

Answer 2

Other than biophysical criteria,sociodemographic factors place both the mother and baby at risk

Question 3

A maternal serum alpha-fetoprotein (MSAFP)test indicates an elevated level.It is repeated and again is reported as higher than normal.What is the next step in the assessment sequence to determine the well-being of the fetus?

A)Percutaneous umbilical blood sampling (PUBS)
B)Ultrasound for fetal anomalies
C)Biophysical profile (BPP)for fetal well-being
D)Amniocentesis for genetic anomalies

Answer 3

Ultrasound for fetal anomalies

Question 4

A woman arrives at the clinic seeking confirmation that she is pregnant.The following information is obtained: She is 24 years old with a body mass index (BMI)of 17.5.She admits to having used cocaine "several times" during the past year and drinks alcohol occasionally.Her blood pressure is 108/70 mm Hg,her pulse rate is 72 beats/min,and her respiratory rate is 16 breaths/min.The family history is positive for diabetes mellitus and cancer.Her sister recently gave birth to an infant with a neural tube defect (NTD).Which characteristics place the woman in a high risk category?

A)Blood pressure,age,BMI
B)Drug/alcohol use,age,family history
C)Family history,blood pressure (BP),BMI
D)Family history,BMI,drug/alcohol abuse

Question 5

A client asks her nurse,"My doctor told me that he is concerned with the grade of my placenta because I am overdue.What does that mean?" The best response by the nurse is:

A)"Your placenta changes as your pregnancy progresses,and it is given a score that indicates the amount of calcium deposits it has.The more calcium deposits,the higher the grade,or number,that is assigned to the placenta.It also means that less blood and oxygen can be delivered to your baby."
B)"Your placenta isn't working properly,and your baby is in danger."
C)"This means that we will need to perform an amniocentesis to detect if you have any placental damage."
D)"Don't worry about it.Everything is fine."

Question 6

Intrauterine growth restriction (IUGR)is associated with what pregnancy-related risk factors? Choose all that apply.

A)Poor nutrition
B)Maternal collagen disease
C)Gestational hypertension
D)Premature rupture of membranes
E)Smoking

Question 7

A 39-year-old primigravida thinks that she is about 8 weeks pregnant,although she has had irregular menstrual periods all her life.She has a history of smoking approximately one pack of cigarettes a day,but she tells you that she is trying to cut down.Her laboratory data are within normal limits.What diagnostic technique could be used with this pregnant woman at this time?

A)Ultrasound examination
B)Maternal serum alpha-fetoprotein (MSAFP)screening
C)Amniocentesis
D)Nonstress test (NST)

Question 8

In comparing the abdominal and transvaginal methods of ultrasound examination,nurses should explain to their clients that:

A)Both require the woman to have a full bladder
B)The abdominal examination is more useful in the first trimester
C)Initially the transvaginal examination can be painful
D)The transvaginal examination allows pelvic anatomy to be evaluated in greater detail

Question 9

Nurses should be aware that the biophysical profile (BPP):

A)Is an accurate indicator of impending fetal well-being
B)Is a compilation of health risk factors of the mother during the later stages of pregnancy
C)Consists of a Doppler blood flow analysis and an amniotic fluid index (AFI)
D)Involves an invasive form of ultrasonic examination

Question 10

With regard to amniocentesis,nurses should be aware that:

A)Because of new imaging techniques,it is now possible in the first trimester
B)Despite the use of ultrasonography,complications still occur in the mother or infant in 5% to 10% of cases
C)Administration of RhoD immunoglobulin may be necessary
D)The presence of meconium in the amniotic fluid is always cause for concern

Question 11

Risk factors tend to be interrelated and cumulative in their effect.While planning the care for a laboring client with diabetes mellitus,the nurse is aware that she is at a greater risk for:

A)Oligohydramnios
B)Polyhydramnios
C)Postterm pregnancy
D)Chromosomal abnormalities

Question 12

In comparison to contraction stress tests (CSTs),the nonstress test (NST)for antepartum fetal assessment:

A)Has no known contraindications
B)Has fewer false-positive results
C)Is more sensitive in detecting fetal compromise
D)Is slightly more expensive

Question 13

A nurse sees a woman for the first time when she is 30 weeks pregnant.The woman has smoked throughout the pregnancy,and fundal height measurements now are suggestive of intrauterine growth restriction (IUGR)in the fetus.In addition to ultrasound to measure fetal size,what is another tool useful in confirming the diagnosis?

A)Doppler blood flow analysis
B)Contraction stress test (CST)
C)Amniocentesis
D)Daily fetal movement counts

Question 14

With regard to maternal,fetal,and neonatal health problems,nurses should be aware that:

A)Infection has replaced pulmonary embolism as one of the three top causes of maternal death attributable to pregnancy
B)The leading cause of death in the neonatal period is disorders related to short gestation and low birth weight
C)Factors related to the maternal death rate include age and marital status but not race
D)Antepartum fetal deaths can best be prevented by better recognizing and responding to abnormalities of pregnancy and labor

Question 15

A woman is undergoing a nipple-stimulated contraction stress test (CST).She is having contractions that occur every 3 minutes.The fetal heart rate (FHR)has a baseline of approximately 120 beats/min without any decelerations.The interpretation of this test is said to be:

A)Negative
B)Positive
C)Satisfactory
D)Unsatisfactory

Question 16

A 30-year-old gravida 3,para 2-0-0-2 is at 18 weeks of gestation.What screening test should be suggested to her?

A)Biophysical profile
B)Chorionic villi sampling
C)Maternal serum alpha-fetoprotein (MSAFP)screening
D)Screening for diabetes mellitus

Question 17

When nurses help their expectant mothers assess the daily fetal movement counts (DFMCs)they should be aware that:

A)Alcohol or cigarette smoke can irritate the fetus into greater activity
B)"Kick counts" should be taken every half hour and averaged every 6 hours,with every other 6-hour stretch off
C)The fetal alarm signal should go off when fetal movements stop entirely for 12 hours
D)Obese mothers familiar with their bodies can assess fetal movement as well as average-sized women

Question 18

Of these psychosocial factors,which has the least negative effect on the health of the mother and/or fetus?

A)Moderate coffee consumption
B)Moderate alcohol consumption
C)Cigarette smoke
D)Emotional distress

Question 19

At 35 weeks of pregnancy,a woman experiences preterm labor.Although tocolytics are administered and she is placed on bed rest,she continues to experience regular uterine contractions and her cervix is beginning to dilate and efface.What is an important test for fetal well-being at this time?

A)Percutaneous umbilical blood sampling (PUBS)
B)Ultrasound for fetal size
C)Amniocentesis for fetal lung maturity
D)Nonstress test (NST)

Question 20

In the first trimester,ultrasonography can be used to gain information on:

A)Amniotic fluid volume
B)The presence of maternal abnormalities
C)Placental location and maturity
D)Cervical length

Question 21

Which assessment is not included in the fetal biophysical profile (BPP)?

A)Fetal movement
B)Fetal tone
C)Fetal heart rate
D)Amniotic fluid index
E)Placental grade

Question 22

The timing of childbirth for women at risk for uteroplacental insufficiency (UPI)is often determined by magnetic resonance imaging (MRI).Is this statement true or false?

Question 23

Maternal serum alpha-fetoprotein (MSAFP)levels are used as a screening tool for ______________________________ in pregnancy.

Question 24

Assessment of risk to the mother and fetus should include environmental factors such as noxious chemicals and pollutants.Is this statement true or false?