Maternity Chapter 16

1) A pregnant patient's healthcare provider is using the Hadlock method to determine gestational age and growth of the fetus. Which measurements will be used to make this fetal determination? Select all that apply. 1. Femur length 2. Biparietal diameter 3. Head circumference 4. Abdominal circumference 5. Crown to rump measurement

1. Femur length 2. Biparietal diameter 3. Head circumference 4. Abdominal circumference

When assisting with a transabdominal ultrasound sampling, which of the following would the nurse do? A) Obtain preliminary urinary samples. B) Have the woman empty her bladder before the test begins. C) Assist the woman into a supine position on the examining table. D) Instruct the woman to eat a fat-free meal 2 hours before the scheduled test time.

C) Assist the woman into a supine position on the examining table.

1) The nurse is preparing to conduct a nonstress test with a pregnant patient. In which order should the nurse complete the steps of the procedure? 1. Obtain baseline measurement for 20 minutes 2. Place the patient in the semi-Fowler's position 3. Place the pressure transducer over the uterine fundus 4. Give the patient a handheld marker to indicate when fetal movement is felt 5. Place the ultrasound transducer from the external fetal monitor over the F H R

2, 5, 3, 1, 4

The pregnant client and her partner are both 40 years old. The nurse is explaining the options of chorionic villus sampling (C V S) and amniocentesis for genetic testing. The nurse should correct the client if she makes which statement? A) "Amniocentesis results are available sooner than C V S results are." B) "C V S carries a higher risk of limb abnormalities." C) "Amniocentesis cannot detect a neural tube defect." D) "C V S is performed through my belly or my cervix."

A) "Amniocentesis results are available sooner than C V S results are."

The client and her partner are carriers of sickle cell disease. They are considering prenatal diagnosis with either amniocentesis or chorionic villus sampling (C V S). Which statements indicate that further teaching is needed on these two diagnostic procedures? Select all that apply. A) "Chorionic villus sampling carries a lower risk of miscarriage." B) "Amniocentesis can be done earlier in my pregnancy than C V S." C) "Neither test will conclusively diagnose sickle cell disease in our baby." D) "The diagnosis comes sooner if we have C V S, not amniocentesis." E) "Amniocentesis is more accurate in diagnosis than the C V S."

A) "Chorionic villus sampling carries a lower risk of miscarriage." B) "Amniocentesis can be done earlier in my pregnancy than C V S." E) "Amniocentesis is more accurate in diagnosis than the C V S."

At 32 weeks' gestation, a woman is scheduled for a second nonstress test (following one she had at 28 weeks' gestation). Which statement by the client would indicate an adequate understanding of this procedure? A) "I can't get up and walk around during the test." B) "I'll have an I V started before the test." C) "I can still smoke before the test." D) "I need to have a full bladder for this test."

A) "I can't get up and walk around during the test."

The nurse is preparing a client for amniocentesis. Which statement would indicate that the client clearly understands the risks of amniocentesis? A) "I might go into labor early." B) "It could produce a congenital defect in my baby." C) "Actually, there are no real risks to this procedure." D) "The test could stunt my baby's growth."

A) "I might go into labor early."

The prenatal clinic nurse is explaining test results to a client who has had an assessment for fetal well-being. Which statement indicates that the client understands the test results? A) "The normal Doppler velocimetry wave result indicates my placenta is getting enough blood to the baby." B) "The reactive nonstress test means that my baby is not growing because of a lack of oxygen." C) "Because my contraction stress test was positive, we know that my baby will tolerate labor well." D) "My biophysical profile score of 6 points to everything being normal and healthy for my baby."

A) "The normal Doppler velocimetry wave result indicates my placenta is getting enough blood to the baby."

A 27-year-old married woman is 16 weeks pregnant and has an abnormally low maternal serum alpha-fetoprotein test. Which statement indicates that the couple understands the implications of this test result? A) "We have decided to have an abortion if this baby has Down syndrome." B) "If we hadn't had this test, we wouldn't have to worry about this baby." C) "I'll eat plenty of dark green leafy vegetables until I have the ultrasound." D) "The ultrasound should be normal because I'm under the age of 35."

A) "We have decided to have an abortion if this baby has Down syndrome."

The client at 14 weeks' gestation has undergone a transvaginal ultrasound to assess cervical length. The ultrasound revealed cervical funneling. How should the nurse explain these findings to the client? A) "Your cervix has become cone-shaped and more open at the end near the baby." B) "Your cervix is lengthened, and you will deliver your baby prematurely." C) "Your cervix is short, and has become wider at the end that extends into the vagina." D) "Your cervix was beginning to open but now is starting to close up again."

A) "Your cervix has become cone-shaped and more open at the end near the baby."

The nurse is responding to phone calls. Whose call should the nurse return first? A) A client at 37 weeks' gestation reports no fetal movement for 24 hours. B) A client at 29 weeks' gestation reports increased fetal movement. C) A client at 32 weeks' gestation reports decreased fetal movement X 2 days. D) A client at 35 weeks' gestation reports decreased fetal movement X 4 hours.

A) A client at 37 weeks' gestation reports no fetal movement for 24 hours.

A 28-year-old woman has been an insulin-dependent diabetic for 10 years. At 36 weeks' gestation, she has an amniocentesis. A lecithin/sphingomyelin (L/S) ratio test is performed on the sample of her amniotic fluid. Because she is a diabetic, what would an obtained 2:1 ratio indicate for the fetus? A) The fetus may or may not have immature lungs. B) The amniotic fluid is contaminated. C) The fetus has a neural tube defect. D) There is blood in the amniotic fluid.

A) The fetus may or may not have immature lungs.

Of all the clients who have been scheduled to have a biophysical profile, the nurse should check with the physician to clarify the order for which client? A) A gravida with intrauterine growth restriction B) A gravida with mild hypotension of pregnancy C) A gravida who is postterm D) A gravida who complains of decreased fetal movement for 2 days

B) A gravida with mild hypotension of pregnancy

1) The nurse provides the following diagram to a patient in the 3rd trimester of pregnancy. For which diagnostic test is the nurse preparing this patient? A) Ultrasound B) Amniocentesis C) Biophysical profile D) Contraction stress test

B) Amniocentesis

1) The nurse provides the following diagram to a patient who is 10 weeks pregnant and scheduled for a sonogram. Why is this test being used? A) Estimate fetal weight B) Determine gestational age C) Evaluate placenta integrity D) Calculate pelvis dimensions

B) Determine gestational age

A client at 37 weeks' gestation has a mildly elevated blood pressure. Her antenatal testing demonstrates three contractions in 10 minutes, no decelerations, and accelerations four times in 1 hour. What would this test be considered? A) Positive nonstress test B) Negative contraction stress test C) Positive contraction stress test D) Negative nonstress test

B) Negative contraction stress test

Which of the following tests provides information about the fetal number? A) Amniocentesis B) Standard second-trimester sonogram C) Beta h C G D) Maternal serum alpha-fetoprotein

B) Standard second-trimester sonogram

The nurse anticipates that the physician will most likely order a cervicovaginal fetal fibronectin test for which client? A) The client at 34 weeks' gestation with gestational diabetes B) The client at 32 weeks' gestation with regular uterine contractions C) The client at 37 weeks' multi-fetal gestation D) The client at 20 weeks' gestation with ruptured amniotic membranes

B) The client at 32 weeks' gestation with regular uterine contractions

The nurse is reviewing amniocentesis results. Which of the following would indicate that client care was appropriate? A) The client who is R h-positive received R h immune globulin after the amniocentesis. B) The client was monitored for 30 minutes after completion of the test. C) The client began vaginal spotting before leaving for home after the test. D) The client identified that she takes insulin before each meal and at bedtime.

B) The client was monitored for 30 minutes after completion of the test.

The nurse is preparing a client in her second trimester for a three-dimensional ultrasound examination. Which statement indicates that teaching has been effective? A) "If the ultrasound is normal, it means my baby has no abnormalities." B) "The nuchal translucency measurement will diagnose Down syndrome." C) "I might be able to see who the baby looks like with the ultrasound." D) "Measuring the length of my cervix will determine whether I will deliver early."

C) "I might be able to see who the baby looks like with the ultrasound."

The client with an abnormal quadruple screen is scheduled for an ultrasound. Which statement indicates that the client understands the need for this additional antepartal fetal surveillance? A) "After the ultrasound, my partner and I will decide how to decorate the nursery." B) "During the ultrasound we will see which of us the baby looks like most." C) "The ultrasound will show whether there are abnormalities with the baby's spine." D) "The blood test wasn't run correctly, and now we need to have the sonogram."

C) "The ultrasound will show whether there are abnormalities with the baby's spine."

During a nonstress test, the nurse notes that the fetal heart rate decelerates about 15 beats during a period of fetal movement. The decelerations occur twice during the test, and last 20 seconds each. The nurse realizes these results will be interpreted as which of the following? A) A negative test B) A reactive test C) A nonreactive test D) An equivocal test

C) A nonreactive test

A standard ultrasound examination is performed during the second or third trimester and includes an evaluation of which of the following? Select all that apply. A) Confirm fetal heart activity. B) Evaluate the cervix. C) Determine fetal presentation. D) Assess amniotic fluid volume. E) Determine fetal number.

C) Determine fetal presentation. D) Assess amniotic fluid volume. E) Determine fetal number.

The nurse knows that a lecithin/sphingomyelin (L/S) ratio finding of 2:1 in amniotic fluid means which of the following? A) Fetal lungs are still immature. B) The fetus has a congenital anomaly. C) Fetal lungs are mature. D) The fetus is small for gestational age.

C) Fetal lungs are mature.

Which of the following tests has become a widely accepted method of evaluating fetal status? A) Contraction stress test (C S T) B) M S A F P test C) Nonstress test (N S T) D) Nuchal translucency test

C) Nonstress test (N S T)

The client at 24 weeks' gestation is experiencing painless vaginal bleeding after intercourse. The physician has ordered a transvaginal ultrasound examination. Which statements by the client indicate an understanding of why this exam has been requested? Select all that apply. A) "This ultrasound will show the baby's gender." B) "This ultrasound might cause the miscarriage of my baby." C) "This ultrasound carries a risk of creating a uterine infection." D) "This ultrasound can determine the location of my placenta." E) "This ultrasound might detect whether the placenta is detaching prematurely."

D) "This ultrasound can determine the location of my placenta." E) "This ultrasound might detect whether the placenta is detaching prematurely."

A woman at 28 weeks' gestation is asked to keep a fetal activity record and to bring the results with her to her next clinic visit. One week later, she calls the clinic and anxiously tells the nurse that she has not felt the baby move for more than 30 minutes. Which of the following would be the nurse's most appropriate initial comment? A) "You need to come to the clinic right away for further evaluation." B) "Have you been smoking?" C) "When did you eat last?" D) "Your baby might be asleep."

D) "Your baby might be asleep."

Each of the following pregnant women is scheduled for a 14-week antepartal visit. In planning care, the nurse would give priority teaching on amniotic fluid alpha-fetoprotein (A F P) screening to which client? A) 28-year-old with history of rheumatic heart disease B) 18-year-old with exposure to H I V C) 20-year-old with a history of preterm labor D) 35-year-old with a child with spina bifida

D) 35-year-old with a child with spina bifida

The nurse is returning phone calls from clients. Which client does the nurse anticipate would not require a serum beta h C G? A) A client with a risk of ectopic pregnancy B) A client with spotting during pregnancy C) A client with previous pelvic inflammatory disease D) A client with a previous history of twins

D) A client with a previous history of twins

The nurse is working in an outpatient clinic. Which client's indications most warrant fetal monitoring in the third trimester? A) Gravida 4, para 3, 39 weeks, with a history of one spontaneous abortion at 8 weeks B) Gravida 1, para 0, 40 weeks, with a history of endometriosis and a prior appendectomy C) Gravida 3, para 2, with a history of gestational diabetes controlled by diet D) Gravida 2, para 1, 36 weeks, with a history of preterm labor or cervical insufficiency

D) Gravida 2, para 1, 36 weeks, with a history of preterm labor or cervical insufficiency