Week 8 - Antepartal testing

The nurse knows that RhoGAM is given to O negative mothers for which reason?

To prevent antibody formation in Rh-negative women

The nurse is caring for a client who is scheduled for a contraction stress test (CST). During the procedure, the nurse's best action is to:

Monitor the fetal heart rate (FHR) and fetal activity

The nurse is caring for a client at 32 weeks gestation who requires a non-invasive 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?

Non-stress test (NST)

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?

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

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?

"Empty your bladder before the test."

A woman planning on becoming pregnant is receiving perinatal education from the nurse. Which statements by the client would concern the nurse? Select all that apply.

"I have to consume a large amount of alcohol to cause significant harm to my child." "Beer is okay since it is low in alcohol" "I can have a glass of red wine since the food will absorb it."

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?

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

The nurse is performing an admission assessment on a client who is 14 weeks pregnant. The client told the nurse that she is having uncertainty about the pregnancy. Which is the best response by the nurse?

"Tell me what you are uncertain about."

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. The nurse's best response is:

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

The maternal serum alpha-fetoprotein (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?

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

The nurse is caring for a client on the electronic fetal monitor (EFM). Which will be the nurse's priority?

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 non-stress test (NST). A score of 2/10 will prompt to nurse to:

Prepare the client for immediate delivery

A client is scheduled for an amniocentesis. Which is the most important instruction that the nurse would include in the plan of care?

Provide breathing and relaxation techniques the client can use

The nurse reviews the biophysical profile (BPP) report of 8/10 and interprets the result as:

Reassuring

The nurse is performing a vibroacoustic stimulation, a screening tool that uses auditory stimulation (an artificial larynx) to assess fetal well-being with electronic fetal monitor (EFM). The nurse has placed the artificial larynx in the indicated area on the maternal abdomen two times lasting for one second and has noted no fetal accelerations. The next step would be to:

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

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?

RhoGAM

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

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 5. Confirm fetal cardiac activity

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

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. 4. Inform the client to report decreased fetal movements below the normal.

The physician is getting ready to perform an abdominal amniocentesis test. Select where the provider would place the needle to obtain amniotic fluid.

Right on top of the abdomen

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:

Semi-Fowler's or lateral

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:

Semi-fowlers or lateral

The nurse is reviewing the biophysical profile (BPP) results and would expect which variables to be included in this test? Select all that apply.

2. Fetal tone 3. Amniotic fluid volume 4. Fetal breathing movements 5. Fetal movement

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.

4. "A nonstress test is a screening tool that uses fetal heart rate patterns and accelerations as an indicator of fetal well-being." 5. "Maternal Serum Alfa-Fetoprotein is a screening test that assesses for levels of AFP in the maternal blood to detect certain developmental defects in the fetus, such as neural tube defects."

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?

Terbulatine

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?

The client reports abdominal cramping

A nursing student is examining a client's chart on the Antepartum unit and asks why an umbilical artery Doppler flow test is ordered. which would be an appropriate response for the nurse? Select all that apply.

3. "It is non-invasive screening technique that uses advanced ultrasound technology to assess resistance to blood flow in the placenta." 4. "Images are obtained of blood flow in the umbilical artery." 5. "This test assesses placental perfusion."

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?

8

The nurse understands that the diagnostic/screening test below uses high-frequency sound waves to produce an image of the fetus organs or tissues and is the most common diagnostic test in the first trimester during pregnancy. Which would the nurse include in the plan of care instructions for this client?

A full bladder is necessary for the test.

Based on the image below, the nursing student on an Antepartum unit recognized that the client is on the electronic fetal monitoring (EFM) for which test?

A nonstress tests

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:

The result reflects polyhydramnios and may indicate fetal malformation, such as NTDs, obstruction of 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?

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

A nurse is monitoring a 30 weeks gestation client on the antepartum unit. Which assessment findings concern the nurse?

There are several variable decelerations that last for 30 seconds within a 20 minutes period.

The nurse explains to the nursing student that a triple marker screening (multiple marker screening) is done to accomplish which?

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

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?

Keep your bladder full for the procedure

The nursing student asks the nurse about tests that are commonly performed for a suspected brain abnormality. How would the nurse respond?

Magnetic resonance imaging

During an amniocentesis, the nurse instructs the client to call the nurse if she experiences:

Abdominal cramping

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:

Amniocentesis

The nurse on the antepartum unit is caring for a client post chorionic villus sampling procedure. Which would the nurse's priority intervention be?

Assess the fetal heart rate (FHR)

The nurse on the antepartum unit is caring for a client post chorionic villus sampling procedure. Which would the nurse's priority intervention be?

Assess the fetal heart rate (FHR).

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?

Assess the perineal area

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.

Biophysical profile Ultrasound Vibroacoustic Stimulation (VAS)

The nurse reviews the client's amniotic fluid index (AFI) report and the AFI shows 24 cm. The nurse's best action would be to:

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?

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

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:

Chorionic villus sampling (CVS)

A nurse is caring for a pregnant client who is to have a contraction stress test (CST). Which findings are indications for this procedure? Select all that apply.

Decreased fetal movement A non reactive NST

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?

Down syndrome (Trisomy 21)

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.

Estimate gestational age Confirm the clients due date Detect fetal anomalies Assess biophysical profile (BPP)

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:

Fetal lung immaturity