Chapter 9: Assessing the Fetus
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Questions and Answers

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?

  • “The test results are within normal limits.” (correct)
  • “Immediate birth by cesarean birth is being considered.”
  • “Further testing will be performed to determine the meaning of this score.”
  • “An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding birth.”
  • Which analysis of maternal serum is the best predictor of chromosomal abnormalities in the fetus?

  • Biophysical profile
  • Multiple-marker screening (correct)
  • Lecithin-to-sphingomyelin ratio
  • Blood type and crossmatch of maternal and fetal serum
  • 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?

  • Maternal diabetes (correct)
  • Weight gain of 25 lb
  • Maternal age older than 30 years
  • Previous infant weighing more than 3000 g at birth
  • What point in the pregnancy is the most accurate time to determine gestational age through ultrasound?

    <p>First trimester</p> Signup and view all the answers

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

    <p>A neural tube defect</p> Signup and view all the answers

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

    <p>10 weeks</p> Signup and view all the answers

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

    <p>Safety of the fetus</p> Signup and view all the answers

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

    <p>Information about the tests</p> Signup and view all the answers

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

    <p>Positive for group B Streptococcus</p> Signup and view all the answers

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

    <p>Determine fetal lung maturity.</p> Signup and view all the answers

    What does optimal nursing care after an amniocentesis include?

    <p>Monitoring uterine activity</p> Signup and view all the answers

    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?

    <p>Reactive</p> Signup and view all the answers

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

    <p>Apply a stressful stimulus to the fetus.</p> Signup and view all the answers

    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?

    <p>A score of 8 would indicate normal results.</p> Signup and view all the answers

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

    <p>Position the patient for comfort, adjusting the tocotransducer belt to locate fetal heart rate.</p> Signup and view all the answers

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

    <p>Contact the health care provider to discuss birth options for the patient.</p> Signup and view all the answers

    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?

    <p>Refer to the physician for additional testing.</p> Signup and view all the answers

    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?

    <p>RhoGAM if the patient is Rh-negative</p> Signup and view all the answers

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

    <p>A 24-year-old gravida 1, para 0, who has diabetes</p> Signup and view all the answers

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

    <p>Fetal bradycardia</p> Signup and view all the answers

    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?

    <p>Immediately</p> Signup and view all the answers

    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?

    <p>Blood</p> Signup and view all the answers

    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?

    <p>NST reactive, reassuring</p> Signup and view all the answers

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

    <p>Twin gestation</p> Signup and view all the answers

    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.)

    <p>Multifetal gestation</p> Signup and view all the answers

    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.)

    <p>The test uses sound to elicit fetal movements.</p> Signup and view all the answers

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

    <p>Have the patient sit in a recliner with the head elevated 45 degrees.</p> Signup and view all the answers

    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.)

    <p>Use a clock or timer when performing kick counts.</p> Signup and view all the answers

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