Deck 9: Assessing the Fetus

Question 1

A pregnant patient 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 patient'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 patient return for her regularly scheduled prenatal visit.

Answer 1

Refer to the physician for additional testing.

Question 2

What is the term for a nonstress test in which there are two or more fetal heart rate accelerations of 15 or more beats per minute (BPM) with fetal movement in a 20-minute period?

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

Answer 2

Reactive

Question 3

A biophysical profile is performed on a pregnant patient. 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. Which answer 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.

Answer 3

A score of 8 would indicate normal results.

Question 4

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 5

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

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

Question 6

The clinic nurse is obtaining a health history on a newly pregnant patient. 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 years
D) Previous infant weighing more than 3000 g at birth

Question 7

For which patient would an L/S ratio of 2:1 potentially be considered 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 8

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 9

When is the earliest interval that chorionic villus sampling (CVS) can be performed during pregnancy?

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

Question 10

Which factors 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

Question 11

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 patient is Rh-negative
D) Betamethasone

Question 12

What does optimal nursing care after an amniocentesis include?

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

Question 13

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

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

Question 14

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 patient.
C) Send the patient out for a meal and repeat the test to confirm that the results are valid.
D) Ask the patient to perform a fetal kick count assessment for the next 30 minutes and then reassess the patient.

Question 15

What point in the pregnancy 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

Question 16

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 17

Which aspect of fetal diagnostic testing is most important to expectant parents?

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

Question 18

Which analysis of maternal serum is the best predictor of 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 19

In preparing a pregnant patient for a nonstress test (NST), which of the following should be included in the plan of care?

A) Have the patient 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 patient for comfort, adjusting the tocotransducer belt to locate fetal heart rate.
D) Have an infusion pump prepared with oxytocin per protocol for evaluation.

Question 20

A pregnant patient's biophysical profile score is 8. The patient asks the nurse to explain the results. What is the nurse's most appropriate 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 21

A patient at 36 weeks gestation is undergoing a nonstress (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 22

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 nonstress 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 23

Transvaginal ultrasonography is often performed during the first trimester. A 6-week-gestation patient 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 24

The nurse is instructing a patient 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.

Question 25

The nurse is preparing a patient for a nonstress test (NST). Which interventions should the nurse plan to implement? (Select all that apply.)

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

Question 26

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 27

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 28

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 states that will be collected for the initial screening process?

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