Chapter 19 Assessment of Fetal Well-Being

Chapter 19   Assessment of Fetal Well-Being

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1) A standard ultrasound examination is performed during the second or third trimester and includes an evaluation of which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Confirm fetal heart activity.
2. Evaluate the cervix.
3. Determine fetal presentation.
4. Amniotic fluid volume.
5. Fetal number.

Answer:  3, 4, 5

Explanation:  3. A standard ultrasound examination is performed during the second or third trimester and includes an evaluation to determine fetal presentation.

4. A standard ultrasound examination is performed during the second or third trimester and includes an evaluation of amniotic fluid volume.
5. A standard ultrasound examination is performed during the second or third trimester and includes an evaluation of fetal number.

Page Ref: 414

Cognitive Level:  Understanding

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  4 Delineate the use of ultrasound in the second trimester to assess fetal life, number, presentation, anatomy, age, and growth.

MNL LO:  2.8.3 Examine indications and procedures for antenatal testing performed during the second trimester.

 

2) When assisting with a transabdominal sampling, which of the following would the nurse do?

1. Obtain preliminary urinary samples.
2. Have the woman empty her bladder before the test begins.
3. Assist the woman into a supine position on the examining table.
4. Instruct the woman to eat a fat-free meal 2 hours before the scheduled test time.

Answer:  3

Explanation:  3. Clients are placed in a supine position on the table.

Page Ref: 436

Cognitive Level:  Understanding

Client Need/Sub:  Physiological Integrity: Physiological Adaptation

Standards:  QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  2 Identify indications and interpret findings for ultrasound examinations performed in the first trimester.

MNL LO:  2.8.1 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 has 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 whether I will deliver early.”

Answer:  3

Explanation:  3. Three-dimensional ultrasound uses algorithms to vary opacity, transparency, and depth to project an image. This allows curved structures such as the fetal face to be viewed.

Page Ref: 413

Cognitive Level:  Understanding

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all health care settings. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome:  4 Delineate the use of ultrasound in the second trimester to assess fetal life, number, presentation, anatomy, age, and growth.

MNL LO:  2.8.1 Explain the nurse’s role and responsibilities in the administration of antenatal testing.

4) A woman at 28 weeks’ gestation is asked to keep a fetal activity record 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 more than 30 minutes. Which of the following would be the nurse’s most appropriate initial comment?

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:  4. Lack of fetal activity for 30 minutes typically is insignificant. Movement varies considerably, but most women feel fetal movement at least 10 times in 3 hours.

Page Ref: 424

Cognitive Level:  Applying

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome:  5 Identify pertinent information to be discussed with the woman regarding her own assessment of fetal activity and methods of recording fetal activity.

MNL LO:  2.8.4 Examine indications and procedures for antenatal testing performed during the third trimester.

 

5) Which of the following tests provides information about the fetal number?

1. Amniocentesis
2. Standard second-trimester sonogram
3. Beta hCG
4. Maternal serum alpha-fetoprotein

Answer:  2

Explanation:  2. A standard (comprehensive) second trimester sonogram provides the information about the fetus, placenta, and uterine conditions including fetal number.

Page Ref: 419

Cognitive Level:  Understanding

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Knowledge and Science: Systematically reflect on practice as a basis for the generation of new knowledge and innovation. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome:  4 Delineate the use of ultrasound in the second trimester to assess fetal life, number, presentation, anatomy, age, and growth.

MNL LO:  2.8.3 Examine indications and procedures for antenatal testing performed during the second trimester.