Deck 10: Antepartum Fetal Assessment

Question 1

Which should be considered a contraindication for transcervical chorionic villus sampling?

A) Rh-negative mother
B) Gestation less than 15 weeks
C) Maternal age younger than 35 years
D) Positive for group B Streptococcus

Answer 1

Positive for group B Streptococcus

Question 2

When is the most accurate time to determine gestational age through ultrasound?

A) First trimester
B) Second trimester
C) Third trimester
D) No difference in accuracy among the trimesters

Answer 2

First trimester

Question 3

Which nursing intervention is necessary prior to a second-trimester transabdominal ultrasound?

A) Perform an abdominal prep.
B) Administer a soap suds enema.
C) Ensure the client is NPO for 12 hours.
D) Instruct the client to drink 1 to 2 quarts of water.

Answer 3

Instruct the client to drink 1 to 2 quarts of water.

Question 4

Which is the major advantage of chorionic villus sampling over amniocentesis?

A) It is not an invasive procedure.
B) It does not require a hospital setting.
C) It requires less time to obtain results.
D) It has less risk of spontaneous abortion.

Question 5

The nurse's role in diagnostic testing is to provide which of the following?

A) Advice to the couple
B) Information about the tests
C) Reassurance about fetal safety
D) Assistance with decision making

Question 6

Which analysis of maternal serum may predict chromosomal abnormalities in the fetus?

A) Biophysical profile
B) Multiple-marker screening
C) Lecithin-to-sphingomyelin ratio
D) Blood type and crossmatch of maternal and fetal serum

Question 7

What does nursing care after amniocentesis include?

A) Forcing fluids by mouth
B) Monitoring uterine activity
C) Placing the client in a supine position for 2 hours
D) Applying a pressure dressing to the puncture site

Question 8

Which response by the nurse is most appropriate to the statement, "This test isn't my idea, but my husband insists?"

A) "It's your decision."
B) "Don't worry. Everything will be fine."
C) "Why don't you want to have this test?"
D) "You're concerned about having this test?"

Question 9

The clinic nurse is obtaining a health history on a newly pregnant client. Which is an indication for fetal diagnostic procedures if present in the health history?

A) Maternal diabetes
B) Weight gain of 25 lb
C) Maternal age older than 30
D) Previous infant weighing more than 3000 g at birth

Question 10

What is the purpose of amniocentesis for a client hospitalized at 34 weeks of gestation with pregnancy-induced hypertension?

A) Determine if a metabolic disorder is genetic.
B) Identify the sex of the fetus.
C) Identify abnormal fetal cells.
D) Determine fetal lung maturity.

Question 11

The results of a contraction stress test (CST) are positive. Which intervention is necessary based on this test result?

A) Repeat the test in 1 week so that results can be trended based on this baseline result.
B) Contact the health care provider to discuss birth options for the client.
C) Send the client out for a meal and repeat the test to confirm that the results are valid.
D) Ask the client to perform a fetal kick count assessment for the next 30 minutes and then reassess the client.

Question 12

On which aspect of fetal diagnostic testing do parents usually place the most importance?

A) Safety of the fetus
B) Duration of the test
C) Cost of the procedure
D) Physical discomfort caused by the procedure

Question 13

What is the purpose of initiating contractions in a contraction stress test (CST)?

A) Increase placental blood flow.
B) Identify fetal acceleration patterns.
C) Determine the degree of fetal activity.
D) Apply a stressful stimulus to the fetus.

Question 14

In preparing a pregnant client for a non-stress test (NST), which of the following should be included in the plan of care?

A) Have the client void prior to being placed on the fetal monitor because a full bladder will interfere with results.
B) Maintain NPO status prior to testing.
C) Position the client for comfort, adjusting the tocotransducer belt to locate fetal heart rate.
D) Have an infusion pump prepared with oxytocin per protocol for evaluation.

Question 15

When is the earliest that chorionic villus sampling can be performed during pregnancy?

A) 4 weeks
B) 8 weeks
C) 10 weeks
D) 12 weeks

Question 16

A biophysical profile is performed on a pregnant client. The following assessments are noted: nonreactive stress test (NST), three episodes of fetal breathing movements (FBMs), limited gross movements, opening and closing of hang indicating the presence of fetal tone, and adequate amniotic fluid index (AFI) meeting criteria. What would be the correct interpretation of this test result?

A) A score of 10 would indicate that the results are equivocal.
B) A score of 8 would indicate normal results.
C) A score of 6 would indicate that birth should be considered as a possible treatment option.
D) A score of 9 would indicate reassurance.

Question 17

What does a score of 9 on a biophysical profile signify?

A) Normal
B) Abnormal
C) Equivocal
D) Nonreactive

Question 18

A pregnant client's biophysical profile score is 8. She asks the nurse to explain the results. What is the nurse's best response?

A) "The test results are within normal limits."
B) "Immediate birth by cesarean birth is being considered."
C) "Further testing will be performed to determine the meaning of this score."
D) "An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding birth."

Question 19

The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to determine whether the fetus has which?

A) Hemophilia
B) Sickle cell anemia
C) A neural tube defect
D) A normal lecithin-to-sphingomyelin ratio

Question 20

What is the term for a non-stress test in which there are two or more fetal heart rate accelerations of 15 or more bpm with fetal movement in a 20-minute period?

A) Positive
B) Negative
C) Reactive
D) Nonreactive

Question 21

Transvaginal ultrasonography is often performed during the first trimester. A 6-week-gestation client expresses concerns over the necessity for this test. The nurse should explain that this diagnostic test may be necessary to determine which of the following? (Select all that apply.)

A) Multifetal gestation
B) Bicornuate uterus
C) Presence and location of pregnancy
D) Amniotic fluid volume
E) Presence of ovarian cysts

Question 22

Which complication could occur as a result of percutaneous umbilical blood sampling (PUBS)?

A) Postdates pregnancy
B) Fetal bradycardia
C) Placenta previa
D) Uterine rupture

Question 23

A newly pregnant patient tells the nurse that she has irregular periods and is unsure of when she got pregnant. Scheduling an ultrasound is a standing prescription for the patient's health care provider. When is the best time for the nurse to schedule the patient's ultrasound?

A) Immediately
B) In 2 weeks
C) In 4 weeks
D) In 6 weeks

Question 24

Which factor serves as a clinical indicator for a third trimester amniocentesis?

A) Sex of the fetus
B) Rh isoimmunization
C) Placenta previa
D) Placental abruption

Question 25

Match each term with the correct definition.

Lecithin-to-sphingomyelin (L/S) ratio

A)A test for estimating fetal lung maturity
B)A test to assess blood flow to identify abnormalities
C)A test to diagnose fetal chromosomal, metabolic, or DNA abnormalities

Question 26

A woman who is 36 weeks pregnant asks the nurse to explain the vibroacoustic stimulator (VAS) test. Which should the nurse include in the response? (Select all that apply.)

A) The test is invasive.
B) The test uses sound to elicit fetal movements.
C) The test may confirm nonreactive non-stress test results.
D) The test can only be performed if contractions are present.
E) Vibroacoustic stimulation can be repeated at 1-minute intervals up to three times.

Question 27

Which clinical conditions are associated with increased levels of alpha fetoprotein (AFP)? (Select all that apply.)

A) Down syndrome
B) Molar pregnancy
C) Twin gestation
D) Incorrect gestational age assessment of a normal fetus-estimation is earlier in the pregnancy
E) Threatened abortion

Question 28

A patient at 36 weeks gestation is undergoing a non-stress (NST) test. The nurse observes the fetal heart rate baseline at 135 beats per minute (bpm) and four nonepisodic patterns of the fetal heart rate reaching 160 bpm for periods of 20 to 25 seconds each. How will the nurse record these findings?

A) NST positive, nonreassuring
B) NST negative, reassuring
C) NST reactive, reassuring
D) NST nonreactive, nonreassuring

Question 29

A pregnant woman is scheduled to undergo chorionic villus sampling (CVS) based on genetic family history. Which medication does the nurse anticipate will be administered?

A) Magnesium sulfate
B) Prostaglandin suppository
C) RhoGAM if the client is Rh-negative
D) Betamethasone

Question 30

The nurse is preparing a client for a non-stress test (NST). Which interventions should the nurse plan to implement? (Select all that apply.)

A) Ensure that the client has a full bladder.
B) Plan approximately 15 minutes for the test.
C) Have the client sit in a recliner with the head elevated 45 degrees.
D) Apply electronic monitoring equipment to the client's abdomen.
E) Instruct the client to press an event marker every time she feels fetal movement.

Question 31

The nurse is reviewing the procedure for alpha-fetoprotein (AFP) screening with a patient at 16 weeks' gestation. The nurse determines that the patient understands the teaching when she mentions that which fluid will be collected for the initial screening process?

A) Urine
B) Blood
C) Saliva
D) Amniotic

Question 32

A pregnant client has received the results of her triple-screen testing and it is positive. She provides you with a copy of the test results that she obtained from the lab. What would the nurse anticipate as being implemented in the client's plan of care?

A) No further testing is indicated at this time because results are normal.
B) Refer to the physician for additional testing.
C) Validate the results with the lab facility.
D) Repeat the test in 2 weeks and have the client return for her regularly scheduled prenatal visit.

Question 33

Match each term with the correct definition.

Chorionic villus sampling (CVS)

A)A test for estimating fetal lung maturity
B)A test to assess blood flow to identify abnormalities
C)A test to diagnose fetal chromosomal, metabolic, or DNA abnormalities

Question 34

Match each term with the correct definition.

Doppler ultrasound

A)A test for estimating fetal lung maturity
B)A test to assess blood flow to identify abnormalities
C)A test to diagnose fetal chromosomal, metabolic, or DNA abnormalities

Question 35

For which client would an L/S ratio of 2:1 potentially be considered to be abnormal?

A) A 38-year-old gravida 2, para 1, who is 38 weeks' gestation
B) A 24-year-old gravida 1, para 0, who has diabetes
C) A 44-year-old gravida 6, para 5, who is at term
D) An 18-year-old gravida 1, para 0, who is in early labor at term

Question 36

The health care provider has prescribed an initial rate of 1 milliunits (mU)/min of diluted Pitocin to be started on a client having a contraction stress test (CST). What mL/hr will the nurse set the infusion pump if the dilution of the Pitocin is 10 units of Pitocin in 1000 mL of 0.25 normal saline? Record your answer as a whole number.
___________ mL/hr

Question 37

The nurse is reviewing maternal serum alpha-fetoprotein (MSAFP) results. Which conditions are associated with elevated levels of MSAFP? (Select all that apply.)

A) Fetal demise
B) Neural tube defects
C) Abdominal wall defects
D) Chromosomal trisomies
E) Gestational trophoblastic disease

Question 38

The nurse is instructing a client on how to perform kick counts. Which information should the nurse include in the teaching session? (Select all that apply.)

A) Use a clock or timer when performing kick counts.
B) Your bladder should be full before performing kick counts.
C) Notify your health care provider if you have not felt movement in 24 hours.
D) Protocols can provide a structured timetable for concentrating on fetal movements.
E) You should lie on your side, place your hands on the largest part of the abdomen, and concentrate on the number of movements felt.