Antepartal Tests

A nurse in the antepartum unit is reviewing the indications for ultrasound by trimester of pregnancy. Put the following nursing actions in the order in which they will occur. 1. Confirm the client's due date. 2. Estimate gestational age. 3. Detect fetal anomalies. 4. Assess biophysical profile (BPP).

2. Estimate gestational age. 1. Confirm the client's due date. 3. Detect fetal anomalies. 4. Assess biophysical profile (BPP).

A nurse is a guest speaker for a maternal and newborn class and her topic is antenatal testing. One of the students demonstrates understanding of the risk factors for fetal genetic disorders when she responds with which of the following statements? Select all that apply. A. "The client is more than 35 years old." B. "The client has a history of genetic disorders." C. "The client uses folic acid every day." D. "The client has a history of birth control use." E. "The client has a positive alpha-fetoprotein (AFT) screening test."

A. "The client is more than 35 years old." B. "The client has a history of genetic disorders." E. "The client has a positive alpha-fetoprotein (AFT) screening test."

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. A. Estimate gestational age B. Evaluate the uterus structures C. Confirm intrauterine pregnancy D. Detect fetal anomalies E. Confirm fetal cardiac activity

A. Estimate gestational age B. Evaluate the uterus structures C. Confirm intrauterine pregnancy E. Confirm fetal cardiac activity

A woman beginning antenatal testing is receiving education from the nurse. Which of the following are the responsibility of the nurse? Select all that apply. A. Explain how the test is performed and what to expect. B. Obtain consent for the procedures or testing to take place. C. Encourage any questions or further clarifications that need to be given. D. Provide comfort and maintain modesty. E. Inform her of the test results and answer any follow-up questions.

A. Explain how the test is performed and what to expect. C. Encourage any questions or further clarifications that need to be given. D. Provide comfort and maintain modesty.

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

A. It is a screening test for open defects in the fetus.

The nurse is caring for a client at 35 weeks' gestation who requires a noninvasive screen tool to indicate well-being of the fetus. The findings of the test performed indicate reactivity when the fetal heart rate (FHR) increases 15 beats above baseline, lasting for 15 seconds twice or more in 20 minutes. Which test did the nurse use to obtain these findings? A. Nonstress test (NST) B. Ultrasound C. Biophysical profile (BPP) D. Amniocentesis

A. Nonstress test (NST)

The nurse is caring for a patient who is 30 weeks' gestation 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. A. The woman must lie on her side while counting movements. B. If fetal movement is decreased, inform the client to eat and drink some fluids, rest, and focus on fetal movement for an hour. C. The client must increase her caffeine intake to initiate fetal movements. D. Inform the client to report decreased fetal movements below the normal. E. The client must only begin her fetal count in the morning.

A. The woman must lie on her side while counting movements. B. If fetal movement is decreased, inform the client to eat and drink some fluids, rest, and focus on fetal movement for an hour. D. Inform the client to report decreased fetal movements below the normal.

The client has asked the nurse about possible complications of the amniocentesis procedure. Which would be the nurse's best response? Select all that apply. A. Trauma to the fetus or placenta B. Leakage of amniotic fluid C. Preterm labor D. Maternal or fetal infection E. Nausea and vomiting

A. Trauma to the fetus or placenta B. Leakage of amniotic fluid C. Preterm labor D. Maternal or fetal infection

A client who is 21 weeks' pregnant is scheduled for an amniocentesis today. The client informs the nurse that her bladder feels full. Which is the nurse's best response? A. "Do not drink any more liquids for the rest of the day." B. "Empty your bladder before the test." C. "You will need to measure the urine. D. "Keep your bladder full for the procedure."

B. "Empty your bladder before the test."

The nurse is caring for a 24-week gestational age client. The client states that she is worried about the scheduled antenatal tests. Which is the nurse's best response? A. "There is no need to worry because all the tests are noninvasive procedures." B. "Tell me what your concerns are." C. "You are not scheduled for the tests until tomorrow." D. "The risks for the tests are minimal."

B. "Tell me what your concerns are."

The nurse on the antepartum unit is caring for a client post-chorionic villus sampling (CVS) procedure. Which of the following would be the nurse's priority intervention? A. Provide 2 L of fluids during the shift. B. Assess the fetal heart rate (FHR). C. Administer RhoGAM. D. Administer oxygen 2 L via nasal cannula.

B. Assess the fetal heart rate (FHR).

The nurse admits a client who is 34 weeks' pregnant on the labor and delivery unit. The client complains of no fetal movements since the morning. The health-care provider (HCP) orders a nonstress test (NST), which is performed, but the result does not show any fetal heart rate (FHR) accelerations within a 20-minute period. Which test would the nurse anticipate the HCP ordering? Select all that apply. A. Maternal serum alpha-fetoprotein profile (MSAFP) B. Biophysical profile (BPP) C. Amniocentesis D. Ultrasound E. Vibroacoustic stimulation (VAS)

B. Biophysical profile (BPP) D. Ultrasound E. Vibroacoustic stimulation (VAS)

The nurse is reviewing the biophysical profile (BPP) results and would expect which variables to be included in this test? Select all that apply. A. Fetal position B. Fetal tone C. Amniotic fluid volume D. Fetal breathing movements E. Fetal movement

B. Fetal tone C. Amniotic fluid volume D. Fetal breathing movements E. Fetal movement

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? A. Inform the client to remove all her jewelry. B. Have the client void before the test. C. Position the client in the prone position. D. Perform a fundus measurement.

B. Have the client void before the test.

The nursing student asks the nurse about tests that are commonly performed for a suspected brain abnormality. Which test would the nurse mention in her response? A. Nonstress test (NST) B. Magnetic resonance imaging (MRI) C. Amniocentesis D. Doppler velocimetry

B. Magnetic resonance imaging (MRI)

The nurse is caring for a client who is scheduled for a contraction stress test (CST). During the procedure, what is the nurse's best action? A. Assess the mother's vital signs every hour. B. Monitor the fetal heart rate (FHR) and fetal activity. C. Have the mother brush her nipples for 15 minutes. D. Hang dextrose IV fluids.

B. Monitor the fetal heart rate (FHR) and fetal activity.

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

B. Place the client on a lateral position to prevent compression of the inferior vena cava.

The biophysical profile (BPP) is an ultrasound assessment of fetal status along with a nonstress test (NST). A score of 2/10 will prompt to nurse to do which of the following? A. Reposition the client on the left side B. Prepare the client for immediate delivery C. Continue to monitor the fetal heart rate and the mother's vital signs D. Repeat the biophysical profile screening test

B. Prepare the client for immediate delivery

The nurse is performing a vibroacoustic stimulation on a term patient on obstetrics (OB) triage. The nurse has performed the procedure two times lasting for 1 second and has noted no fetal accelerations. What is the next step? A. Call the physician. B. Repeat the test again for 1 second on the indicated area of the maternal abdomen. C. Provide comfort measures. D. Schedule the client for a week's follow-up visit.

B. Repeat the test again for 1 second on the indicated area of the maternal abdomen.

The nurse is caring for a client in her 18th week of pregnancy during a routine prenatal visit. After reviewing the client's history and current assessment, what tests will the nurse anticipate being performed and/or scheduled today? Select all that apply. A. Nonstress test (NST) B. Specialized obstetric ultrasound (US) C. Alpha-fetoprotein (AFP) D. Vibroacoustic stimulation (VAS) E. Chorionic villus sampling (CVS) F. Magnetic resonance imaging (MRI) G. Amniocentesis H. 3D ultrasound (US) I. Nuchal translucence (NT)

B. Specialized obstetric ultrasound (US) C. Alpha-fetoprotein (AFP) G. Amniocentesis H. 3D ultrasound (US)

A client who is 37 weeks' gestational age just had an amniotic fluid index test (AFI) assessment. The nurse is concerned with which AFI result? A. The AFI measurement is 22 cm. B. The AFI measurement is 4 cm. C. The AFI measurement is 12 cm. D. The AFI measurement is 9 cm.

B. The AFI measurement is 4 cm.

The nurse is caring for a client who completed the chorionic villus sampling (CVS) test 2 hours ago. Which finding would be concerning for the nurse? A. The client complains of nausea. B. The client reports abdominal cramping. C. The client's temperature is 98.3°F (36.8°C). D. The client's blood pressure is 102/64.

B. The client reports abdominal cramping.

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

B. There are several variable decelerations that last for 30 seconds within a 20-minute period.

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

B. To detect some trisomy and neural tube defects (NTDs), such as anencephaly and omphalocele

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? A. "Tell me about your intake of meals and fluids." B. "When was the last time you ate?" C. "Come to the hospital so that further assessments can be done." D. "You will need to have a biophysical profile (BPP) test."

C. "Come to the hospital so that further assessments can be done."

A new nurse to the labor and delivery unit asks a seasoned nurse how she should respond if a patient states they do not feel comfortable signing a consent form. The seasoned nurse's best response is which of the following? A. "You can trust the doctors, they know what they are doing. Encourage the patient to sign." B. "If the patient feels uncomfortable, be sure to let them know how often we perform that procedure and everything will be ok." C. "If the patient is not comfortable signing the form, the physician will need to readdress the situation." D. "The patient should request a different provider and pursue the information themselves to ensure this is the procedure they want."

C. "If the patient is not comfortable signing the form, the physician will need to readdress the situation."

A nursing student is examining a client's chart on the antepartum unit and asks why an umbilical artery Doppler flow test is ordered. What would be an appropriate response by the nurse? Select all that apply. A. "It is used for some mothers to identify the gestational age of the fetus." B. "It is used to detect any abnormal structures of the fetus." C. "It is a noninvasive screening technique that uses advanced ultrasound technology to assess resistance to blood flow in the placenta." D. "Images are obtained of blood flow in the umbilical artery." E. "This test assesses placental perfusion."

C. "It is a noninvasive screening technique that uses advanced ultrasound technology to assess resistance to blood flow in the placenta." D. "Images are obtained of blood flow in the umbilical artery." E. "This test assesses placental perfusion."

The client is prepared to have the amniocentesis test and asks the nurse the reason for the ultrasound. Which is the nurse's best response? A. "It is used for the purpose of identifying the fetal gestational age." B. "It is for assisting the perinatologist to visualize the intestinal wall." C. "It is used to take fetal measurements and locate the placenta, as well as the amniotic sac." D. "It is used for the purpose of obtaining images of the gestational uterine structures."

C. "It is used to take fetal measurements and locate the placenta, as well as the amniotic sac."

A pregnant mother in her third trimester is scheduled for an amniotic fluid index (AFI) test. The nurse understands the reason for the test when she verbalizes which statement? A. "The test is a screening tool that assesses fetal accelerations." B. "The test evaluates the uterine and cervical structures of the pregnancy." C. "The test is a screening tool that measures the volume of amniotic fluid with ultrasound." D. "The test uses a needle to puncture the abdomen to obtain amniotic fluid."

C. "The test is a screening tool that measures the volume of amniotic fluid with ultrasound."

A client in her first trimester is undergoing an ultrasound test in the radiology department. A nursing student is observing and asks the nurse why the physician ordered a three-dimensional (3D) ultrasound. Which of the following is the nurse's best response? A. "The test will tell us if the mother is in pre-term labor." B. "The physician wants to know the age of the fetus." C. "The test is needed for further evaluation of possible fetal anomalies of the face, heart, or skeletal system." D. "The test will identify the sex of the baby."

C. "The test is needed for further evaluation of possible fetal anomalies of the face, heart, or skeletal system."

The maternal serum alpha-fetoprotein profile (MSAFP) is a screening tool for certain developmental defects in the fetus. The client wants to know at what time in her gestational period the test should be performed. Which is the nurse's best response? A. "The test should be scheduled in the first trimester of the pregnancy." B. "The test should be scheduled in the last trimester of the pregnancy." C. "The test should be scheduled between 15 and 20 weeks' gestation." D. "The test is scheduled between 30 and 34 weeks' gestation."

C. "The test should be scheduled between 15 and 20 weeks' gestation."

During an amniocentesis, the nurse instructs the client to call the nurse if she experiences which of the following? A. Fetal movements B. Hunger C. Abdominal cramping D. Fetal kicks

C. Abdominal cramping

The nurse reviews the client's umbilical artery Doppler test. What would be the nurse's interpretation if the result of the end-diastolic blood flow is absent or reversed? A. Normal B. Equivocal C. Abnormal D. Equal

C. Abnormal

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? A. Call the physician. B. Measure the client's vital signs. C. Assess the perineal area. D. Administer IV fluids

C. Assess the perineal area.

The nurse reviews the client's amniotic fluid index (AFI) report and the AFI shows 5 cm. What would be the nurse's best action? A. Inform the charge nurse B. Assess the maternal vital signs C. Call the physician D. Administer IV fluids

C. Call the physician

The nurse is monitoring a client on the electronic fetal monitor (EFM). She observes one variable deceleration on the strip within a 20-minute period. Which would be the nurse's best action? A. Continue to assess the maternal vital signs. B. Keep the client in the supine position. C. Change the client's position to the left or right side. D. Call the physician.

C. Change the client's position to the left or right side.

The maternal serum alpha-fetoprotein profile (MSAFP) is a screening tool indicated for all high-risk pregnant clients between 15 and 20 weeks' gestation. A client who is 18 weeks' pregnant had her blood drawn for this test. Her test results showed low levels, which are associated with which disorder? A. Spina bifida B. Diabetes mellitus C. Down syndrome (trisomy 21) D. Anencephaly

C. Down syndrome (trisomy 21)

A nurse working on the antepartum unit is caring for a patient who is 32 weeks' gestation and being observed for antepartum complications and genetic testing. As the nurse reviews the client's record, she notes the amniocentesis results show the L/S ratio to be less than 2:1. The nurse knows this result is indicative of which of the following? A. Fetal lung maturity B. Effective lung function C. Fetal lung immaturity D. Effective lung growth

C. Fetal lung immaturity

Which of the following nursing responsibilities are a part of abdominal ultrasound testing? A. Placing the client in a lithotomy position. B.Placing the client on her side. C. Informing the patient that a full bladder is necessary for the test. D. Informing the patient that a needle will be inserted into her abdominal wall.

C. Informing the patient that a full bladder is necessary for the test.

The nurse is caring for a client following an amniocentesis procedure. The nurse reviews the client's chart and notices that the client's blood type is O negative. Which does the nurse anticipate administering? A. Antibiotic IV B. Blood transfusion—1 unit of packed red blood cells (RBCs) C. RhoGAM D. Normal saline—IV fluids bolus

C. RhoGAM

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

D. Call the physician.

The nurse is teaching a group of students about the different types of tests performed at different stages of pregnancy. Which statement would the nurse include in the teaching? Select all that apply. A. "Amniocentesis is an ultrasound assessment of the fetal status with a nonstress test (NST). It utilizes ultrasound with an electronic fetal monitor (EFM) to assess five variables." B. "Biophysical profile (BPP) is a diagnostic procedure where a needle is inserted through the abdominal wall into the uterine cavity to obtain amniotic fluid and is commonly performed for genetic testing." C. "Amniocentesis is necessary to elevate the uterus out of the pelvis for better visualization of the fetus's body. It is done during the first half of the pregnancy." D. "A nonstress test (NST) is a screening tool that uses fetal heart rate (FHR) patterns and accelerations as an indicator of fetal well-being." E. "Maternal serum alpha-fetoprotein is a screening test that assesses for levels of alpha-fetoprotein (AFP) in the maternal blood to detect certain developmental defects in the fetus, such as neural tube defects (NTDs)."

D. "A nonstress test (NST) is a screening tool that uses fetal heart rate (FHR) patterns and accelerations as an indicator of fetal well-being." E. "Maternal serum alpha-fetoprotein is a screening test that assesses for levels of alpha-fetoprotein (AFP) in the maternal blood to detect certain developmental defects in the fetus, such as neural tube defects (NTDs)."

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? A. "Exposure to substance abuse drugs is not good for the pregnancy." B. "Exposure to air and environmental pollutants is harmful to the fetus." C. "Exposure to alcohol use causes harm to the fetus." D. "I work in the radiology department, but I'm sure I'll be fine while pregnant."

D. "I work in the radiology department, but I'm sure I'll be fine while pregnant."

Which test would be performed on a client who is at 10 to 12 weeks' gestation, requires a sample of placental tissue, and is performed when a client is concerned about chromosomal disorders? A. Amniocentesis B. Triple marker screening C. Percutaneous umbilical cord sampling D. Chorionic villus sampling (CVS)

D. Chorionic villus sampling (CVS)

A client is scheduled for an amniocentesis. Which is an important instruction that the nurse would include while providing comfort to the patient at this time? A. Tell the client to drink 2 L of fluids. B. Instruct the client not to have anything by mouth for 8 hours. C. Place the client in a lithotomy position. D. Provide breathing and relaxation techniques the client can use.

D. Provide breathing and relaxation techniques the client can use.

A nurse caring for a 32 weeks' gestation client obtaining a nonstress test (NST) will place the client in which of the following positions? A. High-Fowler's B. Prone C. Lithotomy D. Semi-Fowler's

D. Semi-Fowler's

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 which of the following? A. An AFI of 30 cm is an average measurement of amniotic fluid in pregnancy and represents good renal perfusion. B. This result is indicative of oligohydramnios (decreased or no amniotic fluid) and can be associated with increased prenatal death; close maternal and fetal monitoring is needed. C. The result is a good measurement and shows increased urine production. D. The result reflects polyhydramnios and may indicate fetal malformation, such as neural tube defects (NTDs) and obstruction of the fetal gastrointestinal tract.

D. The result reflects polyhydramnios and may indicate fetal malformation, such as neural tube defects (NTDs) and obstruction of the fetal gastrointestinal tract.

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? A. There are two late decelerations of fetal heart rate (FHR) with 50% of uterine contractions (UCs) noted on the electronic fetal monitor (EFM). B. There are significant variable decelerations. C. There is no fetal activity. D. There are no decelerations (variable or late) in a 10-minute EFM strip with three uterine contractions greater than 40 seconds.

D. There are no decelerations (variable or late) in a 10-minute EFM strip with three uterine contractions greater than 40 seconds.

The nurse knows that RhoGAM is given to O-negative mothers for which reason? A. To increase lung maturity B. To promote lung function C. To increase folic acid production D. To prevent antibody formation in Rh-negative women

D. To prevent antibody formation in Rh-negative women