Chapter 6: Antepartal Tests

A patient in the second trimester of pregnancy becomes upset when the health care provider (HCP) schedules several screening tests. The patient voices concern that something is wrong with her baby. Which statement by the nurse will reduce the patient's anxiety?

"Screening tests are primarily to identify those without disease or abnormality."

The nurse is performing an NST along with a biophysical profile scoring (BPP) on a patient at 39 weeks gestation. The nurse determines the fetus has a nonreactive NST. The fetus has trunk or limb movement two times; is noted to be opening and closing hands; has a 45-second breathing episode; and has two 2-cm pockets of amniotic fluid. The nurse should assign a BPP score of ____________________/10.

6

The nurse is providing pre-amniocentesis teaching for a patient who is at 18 weeks gestation. Which information does the nurse provide? Select all that apply.

A full bladder will assist in ultrasound visualization. Discomfort will be minimized with a local anesthetic.

. The nurse is providing care for a 45-year-old patient who has just learned she is in the second trimester of pregnancy. The patient thought she was experiencing manifestations of menopause until she recognized fetal movement. Which diagnostic test does the nurse expect to be prescribed for this patient?

Amniocentesis

A patient is scheduled for transvaginal ultrasound testing. Which preparation by the nurse is appropriate?

Ascertain whether the patient has a latex or banana allergy.

A patient is in her first trimester of her second pregnancy. The patient's first child was born with a trisomy 21 defect. The patient is requesting testing to determine whether the current fetus has the same defect. Which initial testing does the nurse expect the HCP to prescribe?

Fetal ultrasound

A patient in the third trimester of pregnancy is instructed on how to perform daily fetal movement count. The nurse needs to inform the patient what to do if fetal movement is decreased. Which patient actions are appropriately recommended by the nurse? Select all that apply.

Eat something. Arrange for a period of rest. Focus on movement for 1 hour.

An adolescent patient who is 15 weeks pregnant refuses to have an alpha-fetoprotein test performed because, "I don't like needles." Which initial approach does the nurse take to achieve the testing?

Explain the testing is important in detecting serious birth defects.

A patient who is at 30 weeks gestation is involved in a car crash. The nurse recognizes that which initial testing will be used to assess fetal well-being?

Nonstress testing

A patient in the second trimester of pregnancy is scheduled for a Doppler flow study because the health care provider (HCP) is concerned about an assessment finding during a routine prenatal visit. Which finding of concern does the nurse suspect?

Patient shows no weight gain in 2 weeks.

A patient who is at 20 weeks gestation is being prepared for an MRI after a nonconclusive ultrasound testing for suspected brain abnormality related to possible zika virus exposure. Which nursing actions are appropriate for this patient? Select all that apply.

Provide information regarding the test. Allow patient to express feelings about her high-risk pregnancy. Promote open communication with her primary health care providers. Provide psychological support to the patient and her partner.

The nurse is reviewing the purpose of a modified BPP for a patient at 38 weeks gestation. The nurse recognizes which determinations can be made through a modified BPP regarding fetal well-being? Select all that apply.

The NST is an indicator of short-term fetal well-being. The test is considered most predictive for perinatal outcomes. The AFI is an indicator of long-term placental function. An AFI of 5 cm is indicative of fetal asphyxia.

The nurse is assisting a patient who is pregnant to prepare for an MRI scheduled to assess fetal brain development. Which situation causes the nurse to notify the radiology department personnel?

The patient has a permanent body piercing.

The nurse is assessing a patient who just received confirmation of pregnancy. While collecting information about the patient's medical history, which information alerts the nurse to biophysical risk factors? Select all that apply.

The patient has been a strict vegetarian for 25 years. The patient is medically treated for rheumatoid arthritis.

An Eastern European Jewish couple had two children who died from Tay-Sachs disease. The couple is currently pregnant and have asked for genetic confirmation about this fetus with the intention of early termination if the fetus tests positively. For which reason does the nurse expect chorionic villa sampling to be prescribed?

The test is performed as early as 10 weeks gestation.

A patient has experienced an uneventful pregnancy but begins to have vaginal spotting at 38 weeks gestation. The health care provider (HCP) suspects placenta previa initiated by cervical thinning. Which testing does the nurse expect the HCP to schedule?

Ultrasonography studies

____________________ stimulation may be effective in eliciting a change in fetal behavior, fetal startle movements, and increased FHR variability.

Vibroacoustic

A patient is scheduled for a contraction stress test (CST) at 36 weeks gestation. The nurse is aware that a successful testing is dependent on which factor?

Whether uterine contractions can be stimulated

The ____________________ in conjunction with NST is a strong indicator of fetal status, as it is accurate in detecting fetal hypoxia.

amniotic fluid index

The nurse is aware that some ____________________ tests, such as multiple marker screening and ultrasound, are offered to all pregnant women.

screening