Antepartal Tests

A nurse is caring for a client who is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation. The nurse would provide which explanation about this test to the client? 1. It is a screening test for spinal defects in the fetus. 2. It looks for different types of diseases in the fetal cells. 3. This test identifies a Rh incompatibility between the mother and fetus. 4. It assesses fetal lung maturity and lecithin/sphingomyelin (L/S) ratio.

1

The nurse is caring for a client who had a percutaneous umbilical blood sampling procedure (PUBS) an hour ago. The client complains of lower back pains and the electronic fetal monitor (EFM) shows some contractions. Which medication would the nurse anticipate the healthcare provider to order? 1. Terbutaline 2. Labetalol 3. Percocet 4. Oxytoci

1

The client asked the nurse what a complication of the amniocentesis procedure could be. which would be the nurse's best response? Select all that apply. 1. Maternal or fetal hemorrhage 2. Leakage of amniotic fluid 3. Preterm labor 4. Maternal or fetal infection 5. Nausea/vomiting

1, 2, 3, 4

The nurse knows that the assessment of fetal status is a key component of perinatal care. In a class discussion with nursing students, which would the nurse identify as appropriate methods used for ongoing assessment of the fetal-well-being during pregnancy? Select all that apply. 1. Non-stress test (NST) 2. Daily fetal movement count (kick count) 3. Biophysical profile 4. Amniotic fluid index 5. Vibroacoustic stimulation

1, 2, 3, 4, 5

A nurse is discussing the indications for an ultrasound with pregnant women in a prenatal education class. A client, who is in her first trimester, asks the nurse which tests the ultrasound could assess for at this time. Which would be an appropriate nursing response? Select all that apply. 1. Estimate gestational age 2. Evaluate the uterus structures 3. Confirm intrauterine pregnancy 4. Detect fetal anomalies 5. Confirm fetal cardiac activity

1, 2, 3, 5

The nurse is caring for a 30 weeks gestational client on the antepartum unit. In the client's discharge plan of care, the nurse should include which instructions on daily fetal movement count? Select all that apply. 1. The woman must lie on her side while counting movements. 2. If fetal movement is decreased, inform the client to eat and drink some fluids, rest, and focus on fetal movement for an hour. 3. The client must increase her caffeine intake to initiate fetal movements. 4. Inform the client to report decreased fetal movements below the normal. 5. The client must only begin her fetal count in the morning

1, 2, 4

The nurse is reviewing antenatal screening and diagnostic testing with a group of nursing students. The nurse explains that this test inserts a needle into the maternal abdominal area through the uterine cavity to obtain amniotic fluid. One of the student's best response is: 1. Amniocentesis 2. Percutaneous biopsy 3. Percutaneous umbilical cord sampling 4. Chorionic villus sampling (CVS)

1, 4

A nurse is monitoring a 30 weeks gestation client on the antepartum unit. Which assessment findings concern the nurse? 1. The EFM strip shows two or more accelerations that increase 10 beats above the FHR baseline for 10 seconds in 20 minutes. 2. There are several variable decelerations that last for 30 seconds within a 20 minutes period. 3. There are no decelerations noted on the EFM strip. 4. The EFM strip shows a baseline fetal heart rate (FHR) of 120 bpm (beats per minute).

2

The nurse explains to the nursing student that a triple marker screening (multiple marker screening) is done to accomplish which? 1. To identify amniotic fluid index (AFI) 2. To detect some trisomy and neural tube defects (NTDs), such as anencephaly, omphalocele 3. To obtain blood sample for a complete blood count (CBC) analysis 4. To identify fetal lung maturity

2

The nurse is caring for a 38 weeks gestational client who is scheduled for a contraction stress test (CST). Which would the nurse do to prepare the client? 1. Inform the client to remove all her jewelry. 2. Have the client void before the test. 3. Position the client in the prone position. 4. Perform a fundus measurement.

2

The nurse is caring for a client on the electronic fetal monitor (EFM). Which will be the nurse's priority? 1. Position the client in a lithotomy position 2. Place the client on a lateral position to prevent compression of the inferior vena cava 3. Put a folded sheet under the back of the client 4. Have the client sit up for the test

2

The nurse is caring for a client who completed the chorionic villus sampling test 2 hours ago. Which finding would be concerning for the nurse? 1. The client complains of nausea. 2. The client reports abdominal cramping. 3. The client's temperature is 98.3 degrees Fahrenheit. 4. The client's blood pressure is 102/64.

2

The nurse is reviewing the biophysical profile (BPP) results and would expect which variables to be included in this test? Select all that apply. 1. Fetal position 2. Fetal tone 3. Amniotic fluid volume 4. Fetal breathing movements 5. Fetal movement

2, 3, 4, 5

The nurse admits a client who is 34 weeks pregnant on the Labor & Delivery unit. The client complains of no fetal movements since the morning. The health care provider (HCP) orders a non-stress test (NST) which is performed, but the result does not show any fetal heart rate accelerations within a 20-minute period. Which test would the nurse anticipate the HCP ordering? Select all that apply. 1. Maternal serum alfa-fetoprotein profile (MSAFP) 2. Biophysical profile 3. Amniocentesis 4. Ultrasound 5. Vibroacoustic Stimulation (VAS)

2, 4, 5

A nurse working on the antepartum unit is caring for a 20 weeks gestation mother. As the nurse reviews the client's record, she notices that the lung maturity indicator test L/S ratio is < 2:1. The nurse knows that this result is indicative of: 1. Fetal lung maturity 2. Effective lung function 3. Fetal lung immaturity 4. Effective lung growth

3

A pregnant client at 34 weeks gestation called the OB/GYN clinic, stating that she does not feel any fetal activity. How would the nurse respond to the client? 1. "Tell me about your intake of meals and fluids." 2. "When was the last time you ate?" 3. "Come to the hospital so that further assessments can be done." 4. "You will need to have a biophysical profile test."

3

The biophysical profile reports the following test results: Three episodes of limb movement; one episode of active extension with return to flexion of the fetal limb or trunk and opening and closing of the hand; absent pockets of amniotic fluid; one breathing episode that lasts a minimum of 30 secs; the NST was reactive. Which is the total score? 1. 5 2. 10 3. 8 4. 6

3

The client is prepared to have the amniocentesis test and asked the nurse the reason for the ultrasound. Which is the nurse's best response? 1. "It is used for the purpose of identifying the fetal gestational age." 2. "It is for assisting the perinatologist to visualize the intestinal wall." 3. "It is used to take fetal measurements and locate the placenta, and the amniotic sac." 4. "It is used for the purpose of obtaining images of the gestational uterine structures."3

3

The maternal serum alpha-fetoprotein (MSAFP) is a screening tool indicated for all high-risk pregnant clients between 15 -20 weeks gestation. A client who is 18 weeks pregnant had her blood drawn for this test. Her test results showed low levels which is associated with which disorder? 1. Spina bifida 2. Diabetes mellitus 3. Down syndrome (Trisomy 21) 4. Anencephaly

3

The nurse is caring for an 18 weeks gestation client who recently had an amniocentesis procedure. The client informed the nurse that she feels her underwear is wet. Which would be the nurse's first action? 1. Call the physician 2. Measure the client's vital signs 3. Assess the perineal area 4. Administer IV fluids

3

While caring for a mother during a transabdominal ultrasound procedure, which finding would the nurse be most concerned about? 1. The radiology technician inserted a sterile sheathed probe into the vagina. 2. The client is in lithotomy position. 3. The client is in high-fowler position. 4. The client has pillow under her head.

3

During a prenatal education class, the educator discussed the types of environmental substances that can negatively impact pregnancy. Which statement from one of her clients would concern the nurse? 1. "Exposure to substance abuse drugs in not good for the pregnancy." 2. "Exposure to air and environmental pollutants is harmful to the fetus." 3. "Exposure to alcohol use causes harm to the fetus." 4. "It is ok to use marijuana for pain."

4

The nonstress test (NST) uses electronic fetal monitoring (EFM) to assess fetal well-being. A nursing caring for a 32 weeks' gestational client on EFM will place the client in the following position: 1. High-fowler 2. Prone 3. Lithotomy 4. Semi-Fowler's or lateral

4

The nurse is caring for a pregnant client and knows that this test is done for chromosomal analysis between 10-12 weeks' gestation to detect fetal anomalies caused by genetic disorders. It does not test for neural tube defects (NTDs). The nurse identified the following test as: 1. Amniocentesis 2. Triple marker screening 3. Percutaneous umbilical cord sampling 4. Chorionic villus sampling (CVS)

4

The nurse is reading the contraction stress test (CST) result and interprets it as a negative result. Which is the criteria for interpretation of a negative result? 1. There are two late decelerations of fetal heart rate (FHR) with 50% of uterine contractions noted on the EFM. 2. There are significant variable decelerations. 3. There is no fetal activity. 4. There are no decelerations (variable or late) in a 10-minute EFM strip with three uterine contractions greater than 40 seconds.

4

The nurse observed that there are five or more contractions in 10 minutes and a contraction greater than 10 minutes on the electronic fetal monitoring (EFM) strip. The nurse discontinued the IV oxytocin. Which is the next step the nurse should take? 1. Continue to monitor the client. 2. Readjust the EFM belts on the client's abdomen. 3. Continue the IV oxytocin. 4. Call the physician.

4

The nurse reviews a pregnant client's record and notes that the amniotic fluid index (AFI) is 30 cm. The nurse understands that this measurement can indicate: 1. An AFI of 30 cm is average measurement of amniotic fluid in pregnancy and represents good renal perfusion. 2. This result is indicative of oligohydramnios (decreased or no amniotic fluid) and can be associated with increased prenatal death, and close maternal and fetal monitoring is needed. 3. The result is good measurement and shows increased urine production. 4. The result reflects polyhydramnios and may indicate fetal malformation, such as NTDs, obstruction of fetal gastrointestinal tract.

4