Chapter 13 Assessment of Fetal Well-Being

Chapter 13   Assessment of Fetal Well-Being

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1) The nurse is responding to phone calls. Which call should the nurse return first?

1. 37 weeks’ gestation, reports no fetal movement for 24 hours
2. 29 weeks’ gestation, reports increased fetal movement
3. 32 weeks’ gestation, reports decreased fetal movement for 2 days
4. 35 weeks’ gestation, reports decreased fetal movement for 4 hours

Answer:  1

Explanation:  1. A lack of fetal movement in a fetus in the third trimester can indicate fetal hypoxia or fetal death. This client is the highest priority.

2. Increased fetal movement is not indicative of a problem.
3. Although decreased fetal movement can indicate intrauterine growth restriction or fetal hypoxia, this patient is not the highest priority.
4. Although decreased fetal movement can indicate intrauterine growth restriction or fetal hypoxia, four hours is a very short amount of time to assess decreased fetal movement.

Page Ref: 234-235

Cognitive Level:  Application

Client Need&Sub:  Physiological Integrity

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care

Learning Outcome:  LO 13.1-Identify pertinent information to be discussed with the woman regarding her own assessment of fetal activity and methods of recording fetal activity as a means of establishing fetal well-being.

MNL LO:  Explain the nurse’s role and responsibilities in the administration of antenatal testing.

 

2) A woman at 28 weeks’ gestation is asked to keep a fetal activity diary 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 over 30 minutes. The most appropriate initial comment by the nurse would be:

1. “You need to come to the clinic right away for further evaluation.”
2. “Have you been smoking?”
3. “When did you eat last?”
4. “Your baby might be asleep.”

Answer:  4

Explanation:  1. The mother would need to come to the clinic only if there had been no fetal activity for several hours.

2. Smoking typically will stimulate the infant.
3. After meals, an infant typically is active and moving.
4. Lack of fetal activity for 30 minutes typically is insignificant and means only that the infant is sleeping. If the mother truly is concerned, in 30 minutes, she could eat a complex-carbohydrate snack. This would stimulate the infant, and the mother should have fetal activity. But at present, this is an indicator the infant is sleeping.

Page Ref: 234-235

Cognitive Level:  Analyzing

Client Need&Sub:  Physiological Integrity

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion

Learning Outcome:  LO 13.1-Identify pertinent information to be discussed with the woman regarding her own assessment of fetal activity and methods of recording fetal activity as a means of establishing fetal well-being.

MNL LO:  Explain the nurse’s role and responsibilities in the administration of antenatal testing.

 

3) The nurse is preparing a client in her second trimester for a three-dimensional ultrasound examination. Which statement indicates that teaching had been effective?

1. “If the ultrasound is normal, it means my baby has no abnormalities.”
2. “The nuchal translucency measurement will diagnose Down syndrome.”
3. “I might be able to see who the baby looks like with the ultrasound.”
4. “Measuring the length of my cervix will determine if I will deliver early.”

Answer:  3

Explanation:  1. Not all fetal anomalies are detectable by ultrasound.

2. Nuchal translucency measurements are screening, not diagnostic, for trisomies 13, 18, and 21.
3. Ultrasounds provide a very clear photo-like image of the fetus, often providing parents the opportunity to identify a familial characteristic such as nose shape.
4. Transvaginal ultrasound is used to measure the cervical length as a screening for risk of preterm labor. However, a normal-length cervix does not preclude preterm birth.

Page Ref: 236-238

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion

Learning Outcome:  LO 13.2-Describe the methods, clinical applications, and results of ultrasound in the nursing care management of the pregnant woman.

MNL LO:  Examine indications and procedures for antenatal testing performed during the second trimester.

 

 

4) A woman is at 32 weeks’ gestation. Her fundal height measurement at this clinic appointment is 26 centimeters. After reviewing her ultrasound results, the healthcare provider asks the nurse to schedule the patient for a series of sonograms to be done every two weeks. The nurse should make sure that the patient understands that the main purpose for this is to:

1. Assess for congenital anomalies.
2. Evaluate fetal growth.
3. Determine fetal presentation.
4. Rule out a suspected hydatidiform mole.

Answer:  2

Explanation:  1. Assessment of anomalies would require only one ultrasound.

2. A person who is at 32 weeks’ gestation should measure 32 cm of fundal height. When a discrepancy between fundal height and measurement exists, the purpose of serial ultrasounds is to monitor fetal growth.
3. Fetal presentation would require only one ultrasound.
4. Ruling out a hydatidiform mole would require only one ultrasound.

Page Ref: 239

Cognitive Level:  Application

Client Need&Sub:  Physiological Integrity

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion

Learning Outcome:  LO 13.2-Describe the methods, clinical applications, and results of ultrasound in the nursing care management of the pregnant woman.

MNL LO:  Examine indications and procedures for antenatal testing performed during the third trimester.