Chapter 10: Antepartum Fetal Assessment

Chapter 10: Antepartum Fetal Assessment

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A pregnant client’s biophysical profile score is 8. She asks the nurse to explain the results. What is the nurse’s best response?

a.	“The test results are within normal limits.”
b.	“Immediate birth by cesarean birth is being considered.”
c.	“Further testing will be performed to determine the meaning of this score.”
d.	“An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding birth.”

 

 

ANS:  A

The normal biophysical score ranges from 8 to 10 points if the amniotic fluid volume is adequate. A normal score allows conservative treatment of high-risk patients. Birth can be delayed if fetal well-being is an issue. Scores less than 4 would be investigated, and birth could be initiated sooner than planned. This score is within normal range, and no further testing is required at this time. The results of the biophysical profile are usually available immediately after the procedure is performed.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   179

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Physiologic Integrity

 

2. Which analysis of maternal serum may predict chromosomal abnormalities in the fetus?

a.	Biophysical profile
b.	Multiple-marker screening
c.	Lecithin-to-sphingomyelin ratio
d.	Blood type and crossmatch of maternal and fetal serum

 

 

ANS:  B

Maternal serum can be analyzed for abnormal levels of alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), inhibin A, and estriol. The multiple-marker screening may predict chromosomal defects in the fetus. The biophysical profile is used to evaluate fetal status during the antepartum period. Five variables are used, but none are concerned with chromosomal problems. The lecithin-to-sphingomyelin ratio is used to determine fetal lung maturity. The blood type and crossmatch will not predict chromosomal defects in the fetus.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   170

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Physiologic Integrity

 

3. The clinic nurse is obtaining a health history on a newly pregnant client. Which is an indication for fetal diagnostic procedures if present in the health history?

a.	Maternal diabetes
b.	Weight gain of 25 lb
c.	Maternal age older than 30
d.	Previous infant weighing more than 3000 g at birth

 

 

ANS:  A

Diabetes is a risk factor in pregnancy because of possible impairment of placental perfusion. Excessive weight gain is an indication for testing. Normal weight gain is 25 to 35 lb. A maternal age older than 35 years is an indication for testing. Having had another infant weighing more than 4000 g is an indication for testing.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   169

OBJ:   Nursing Process Step: Evaluation     MSC:  Client Needs: Physiologic Integrity

 

4. When is the most accurate time to determine gestational age through ultrasound?

a.	First trimester
b.	Second trimester
c.	Third trimester
d.	No difference in accuracy among the trimesters

 

 

ANS:  A

Gestational age determination by ultrasonography is increasingly less accurate after the first trimester. Gestational age determination is best done in the first trimester. There is a difference in trimesters when doing a gestational age ultrasonography.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   167

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Physiologic Integrity

 

5. The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to determine whether the fetus has which?

a.	Hemophilia
b.	Sickle cell anemia
c.	A neural tube defect
d.	A normal lecithin-to-sphingomyelin ratio

 

 

ANS:  C

An open neural tube allows a high level of AFP to seep into the amniotic fluid and enter the maternal serum. Hemophilia is a genetic defect and is best detected with chromosomal studies, such as chorionic villus sampling or amniocentesis. Sickle cell anemia is a genetic defect and is best detected with chromosomal studies such as chorionic villus sampling or amniocentesis. L/S ratios are determined with an amniocentesis and are usually done in the third trimester.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   168

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Physiologic Integrity