Question 1

A client in the third trimester has just undergone an amniocentesis to determine fetal lung maturity.Which statement regarding this testing is important for the nurse in formulating a care plan?

Accepted Answer

A)   Because of new imaging techniques,an amniocentesis should have been performed 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 Rho(
D)  immunoglobulin may be necessary.
D)   The presence of meconium in the amniotic fluid is always a cause for concern. C

Question 2

Which assessments are included in the fetal biophysical profile (BPP)? (Select all that apply. )

Accepted Answer

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

Question 3

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 heart rate of approximately 120 beats per minute without any decelerations.What is the correct interpretation of this test?

Accepted Answer

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

Question 4

A 41-week pregnant multigravida arrives at the labor and delivery unit after testing indicated that her fetus could be experiencing some difficulties in utero.Which diagnostic tool yields more detailed information about the condition of the fetus?

Accepted Answer

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

Question 5

Biophysical risks include factors that originate with either the mother or the fetus and affect the functioning of either one or both.The nurse who provides prenatal care should have an understanding of these risk factors.Match the specific pregnancy problem with the related risk factor.

-Fetal congenital anomalies

Accepted Answer

A)  Polyhydramnios
B)  IUGR (maternal cause) 
C)  Oligohydramnios
D)  Chromosomal abnormalities
E)  IUGR (fetoplacental cause)

Question 6

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

Accepted Answer

A)   Multiple-marker screening
B)   Lecithin-sphingomyelin ratio (L/S ratio) 
C)   Biophysical profile (BPP) 
D)   Blood type and crossmatch of maternal and fetal serum

Question 7

Cell-free deoxyribonucleic acid (cfDNA)screening is a new method of noninvasive prenatal testing (NIPT)that has recently become available in the clinical setting.This technology can provide a definitive diagnosis of which findings? (Select all that apply. )

Accepted Answer

A)   Fetal Rh status
B)   Fetal gender
C)   Maternally transmitted gene disorder
D)   Paternally transmitted gene disorder
E)   Trisomy 21

Question 8

A pregnant woman's biophysical profile (BPP)score is 8.She asks the nurse to explain the results.How should the nurse respond initially?

Accepted Answer

A)   "The test results are within normal limits."
B)   "Immediate delivery 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 delivery."

Question 9

How does the nurse document a non-stress test (NST)during which two or more fetal heart rate (FHR)accelerations of 15 beats per minute or more occur with fetal movement in a 20-minute period?

Accepted Answer

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

Question 10

While working with the pregnant client in her first trimester,what information does the nurse provide regarding when chorionic villus sampling (CVS)can be performed (in weeks of gestation)?

Accepted Answer

A)   4
B)   8
C)   10
D)   14

Question 11

Biophysical risks include factors that originate with either the mother or the fetus and affect the functioning of either one or both.The nurse who provides prenatal care should have an understanding of these risk factors.Match the specific pregnancy problem with the related risk factor.

-Smoking,alcohol,and illicit drug use

Accepted Answer

A)  Polyhydramnios
B)  IUGR (maternal cause) 
C)  Oligohydramnios
D)  Chromosomal abnormalities
E)  IUGR (fetoplacental cause)

Question 12

The indirect Coombs' test is a screening tool for Rh incompatibility.An amniocentesis may be a necessary next step it the titer is greater than what?

Accepted Answer

A)   1:2
B)   1:4
C)   1:8
D)   1:12

Question 13

The nurse is planning the care for a laboring client with diabetes mellitus.This client is at greater risk for which clinical finding?

Accepted Answer

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

Question 14

Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy.Which statement regarding monitoring techniques is the most accurate?

Accepted Answer

A)   Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis.
B)   Maternal serum AFP (MSAFP) screening is recommended only for women at risk for neural tube defects (NTDs) .
C)   Percutaneous umbilical blood sampling (PUBS) is one of the triple-marker tests for Down syndrome.
D)   Maternal serum AFP (MSAFP) is a screening tool only;it identifies candidates for more definitive diagnostic procedures.

Question 15

In comparing the abdominal and transvaginal methods of ultrasound examination,which information should the nurse provide to the client?

Accepted Answer

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 16

In the past,factors to determine whether a woman was likely to develop a high-risk pregnancy were primarily evaluated from a medical point of view.A broader,more comprehensive approach to high-risk pregnancy has been adopted today.Four categories have now been established,based on the threats to the health of the woman and the outcome of pregnancy.Which category should not be included in this group?

Accepted Answer

A)   Biophysical
B)   Psychosocial
C)   Geographic
D)   Environmental

Question 17

A 39-year-old primigravida woman believes that she is approximately 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;however,she tells the nurse that she is trying to cut down.Her laboratory data are within normal limits.What diagnostic technique would be useful at this time?

Accepted Answer

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

Question 18

Which information is an important consideration when comparing the contraction stress test (CST)with the nonstress test (NST)?

Accepted Answer

A)   The NST has no known contraindications.
B)   The CST has fewer false-positive results when compared with the NST.
C)   The CST is more sensitive in detecting fetal compromise,as opposed to the NST.
D)   The CST is slightly more expensive than the NST.

Question 19

Which information is the highest priority for the nurse to comprehend regarding the biophysical profile (BPP)?

Accepted Answer

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

Question 20

A 30-year-old gravida 3,para 2-0-0-2 is at 18 weeks of gestation.Which screening test should the nurse recommend be ordered for this client?

Accepted Answer

A)   Biophysical profile (BPP) 
B)   Chorionic villi sampling
C)   Maternal Serum Alpha-Fetoprotein Screening (MSAFP) screening
D)   Screening for diabetes mellitus

Exam 26: Assessment of High Risk Pregnancy

A client in the third trimester has just undergone an amniocentesis to determine fetal lung maturity.Which statement regarding this testing is important for the nurse in formulating a care plan?

Which assessments are included in the fetal biophysical profile (BPP) ? (Select all that apply. )

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 heart rate of approximately 120 beats per minute without any decelerations.What is the correct interpretation of this test?

A 41-week pregnant multigravida arrives at the labor and delivery unit after testing indicated that her fetus could be experiencing some difficulties in utero.Which diagnostic tool yields more detailed information about the condition of the fetus?

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

Cell-free deoxyribonucleic acid (cfDNA) screening is a new method of noninvasive prenatal testing (NIPT) that has recently become available in the clinical setting.This technology can provide a definitive diagnosis of which findings? (Select all that apply. )

A pregnant woman's biophysical profile (BPP) score is 8.She asks the nurse to explain the results.How should the nurse respond initially?

How does the nurse document a non-stress test (NST) during which two or more fetal heart rate (FHR) accelerations of 15 beats per minute or more occur with fetal movement in a 20-minute period?

While working with the pregnant client in her first trimester,what information does the nurse provide regarding when chorionic villus sampling (CVS) can be performed (in weeks of gestation) ?

The indirect Coombs' test is a screening tool for Rh incompatibility.An amniocentesis may be a necessary next step it the titer is greater than what?

The nurse is planning the care for a laboring client with diabetes mellitus.This client is at greater risk for which clinical finding?

Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy.Which statement regarding monitoring techniques is the most accurate?

In comparing the abdominal and transvaginal methods of ultrasound examination,which information should the nurse provide to the client?

Which information is an important consideration when comparing the contraction stress test (CST) with the nonstress test (NST) ?

Which information is the highest priority for the nurse to comprehend regarding the biophysical profile (BPP) ?

A 30-year-old gravida 3,para 2-0-0-2 is at 18 weeks of gestation.Which screening test should the nurse recommend be ordered for this client?