Question 1

Which client's indications most warrant fetal monitoring in the third trimester?

Accepted Answer

The client with hypertension disorder of pregnancy (Option D) has the most indication for fetal monitoring in the third trimester. Hypertension is a significant risk factor for fetal distress, growth restriction, and preterm birth. The other clients do not have indications for closer fetal monitoring in the third trimester.

Question 2

A woman is at 32 weeks' gestation.Her fundal height measurement at this clinic appointment is 26 centimeters.After reviewing her ultrasound results,the health care provider asks the nurse to schedule the client for a series of sonograms to be done every 2 weeks.The nurse should make sure that the client understands that the main purpose for this is to:

Accepted Answer

The main purpose for scheduling a series of sonograms every 2 weeks at 32 weeks' gestation and measuring fundal height is to evaluate fetal growth. This ensures that the fetus is growing appropriately and may help detect any potential problems that require intervention or delivery. Assessing congenital anomalies is typically done earlier in pregnancy, and determining fetal presentation would be assessed closer to the due date. ruling out a suspected hydatidiform mole is not a typical reason for scheduling serial sonograms.

Question 3

A type 1 diabetic who is at 32 weeks' gestation is having a nonstress test for fetal well-being,since she has been having problems with glucose control.Which of the following meets the criteria for her test to be considered reactive?

Accepted Answer

A reactive nonstress test for a fetus is defined by at least two accelerations of the fetal heart rate (FHR) from the baseline, with each acceleration being at least 15 beats per minute above baseline and lasting for at least 15 seconds, within a 20-minute period. Choice C meets these criteria.

Question 4

Which response would indicate that a client clearly understands the risks of an amniocentesis?

Accepted Answer

Amniocentesis carries a risk of inducing preterm labor, which is accurately reflected in choice A. The procedure involves inserting a needle through the abdominal wall into the amniotic sac to collect a sample of amniotic fluid, and while it is generally safe, it does have a small risk of causing complications such as preterm labor. Choices B and D are incorrect because amniocentesis does not cause congenital defects or stunt a baby's growth. Choice C is incorrect because it denies the existence of any risks associated with the procedure.

Question 5

The nurse knows that a lecithin/sphingomyelin (L/S)ratio finding of 2:1 on amniotic fluid means:

Accepted Answer

A lecithin/sphingomyelin (L/S)ratio finding of 2:1 on amniotic fluid means that fetal lungs are mature. This ratio indicates that there is enough surfactant present in the lungs, allowing them to expand and contract properly. A ratio of less than 2:1 indicates fetal lung immaturity, while a ratio greater than 2:1 indicates fetal lung maturity. Therefore, option C is the correct choice.

Question 6

Of all the clients who have been scheduled to have a biophysical profile,the nurse would clarify the order for which client?

Accepted Answer

A biophysical profile is typically ordered for pregnancies with complications that could affect the baby's health, such as intrauterine growth restriction, being post-term, or decreased fetal movement. Mild hypertension of pregnancy, while a concern, may not directly indicate the need for a biophysical profile unless it has led to conditions like preeclampsia that could compromise fetal well-being. Therefore, the nurse might clarify the order for a client with mild hypertension of pregnancy, as the other conditions more clearly justify the need for a biophysical profile.

Question 7

The client is having a nonstress test the next day.Which instruction should the nurse give to the client?

Accepted Answer

Nonstress tests, which monitor fetal heart rate and movement, typically do not require a full bladder, fasting, or cause contractions. They usually last about 20-40 minutes, making option D the correct instruction.

Question 8

Each of the following pregnant women is scheduled for a 14-week antepartal visit.In planning care,the nurse would give priority teaching on amniotic fluid alpha-fetoprotein (AFP)screening to which client?

Accepted Answer

The AFP screening test is used to assess the risk for neural tube defects such as spina bifida. Therefore, the nurse would give priority teaching on AFP screening to the 35-year-old woman with a child with spina bifida. The other clients have different health concerns that would require different priority teachings. For example, the 28-year-old with rheumatic heart disease may need teaching on prophylactic antibiotics. The 18-year-old with exposure to HIV may need teaching on preventing mother-to-child transmission of HIV. The 20-year-old with a history of preterm labor may need teaching on signs and symptoms of preterm labor and when to seek medical attention.

Question 9

During a nonstress test,the nurse notes that the fetal heart rate decelerates about 15 beats during a period of fetal movement.The decelerations occur twice during the test,and last 20 seconds each.The nurse realizes these results will be interpreted as:

Accepted Answer

A nonstress test is interpreted as reactive if there are two or more accelerations in fetal heart rate of at least 15 beats per minute, lasting at least 15 seconds, within a 20-minute period. If there are no accelerations, or if the accelerations do not meet the criteria for reactivity, the test is considered nonreactive. In this case, the fetal heart rate decelerates during fetal movement, which is not a reassuring sign and counts as a "negative" finding for the test. Therefore, the test is considered nonreactive, which suggests that further evaluation may be warranted to assess fetal well-being.

Question 10

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:

Accepted Answer

Fetal sleep cycles can last 20 to 40 minutes, during which time movement may not be felt. This is a normal occurrence and can be a reassuring explanation for the lack of perceived movement, especially if the absence of movement is a short duration like 30 minutes.

Question 11

In assisting with an abdominal ultrasound procedure for determination of fetal age,the nurse:

Accepted Answer

For an abdominal ultrasound, especially in the context of determining fetal age, the patient is typically assisted into a supine position on the examining table. This position allows for optimal visualization of the fetus. The other options are not standard preparations for an abdominal ultrasound for fetal age determination.

Question 12

A client at 37 weeks' gestation has a mildly elevated blood pressure.Her antenatal testing demonstrates a fetal heart rate baseline of 150 with three contractions in 10 minutes,no decelerations,and accelerations four times in 1 hour.This test would be considered a:

Accepted Answer

The test described is a contraction stress test. A negative contraction stress test indicates no late decelerations with contractions, which is the case here.

Question 13

A client and her partner are carriers of sickle-cell disease.They are considering prenatal diagnosis with either amniocentesis or chorionic villus sampling (CVS).Which statement indicates that further teaching is needed on these two procedures?

Accepted Answer

The statement "The diagnosis comes sooner if we use amniocentesis" is incorrect. In fact, CVS can provide results as early as 10-12 weeks of gestation, while amniocentesis is typically performed between 15-20 weeks. Further teaching is needed to correct this misunderstanding.

Question 14

At 32 weeks' gestation,a woman is scheduled for a second nonstress test (following the one she had at 28 weeks' gestation).Which response by the client would indicate an adequate understanding of this procedure?

Accepted Answer

The correct response indicates that the client understands the need to remain still during the nonstress test. Option B may or may not be true, as it depends on the healthcare provider's preference, while option C is not necessary for the nonstress test. Option D is actually incorrect, as a full bladder is not required for this test.

Question 15

The nurse is preparing the client for an amniocentesis.The ultrasound shows the fetus to be positioned as in the picture.At what site would the nurse prep the client for the amniocentesis?

Accepted Answer

The answer of The nurse is preparing the client for...

Quiz 14: Assessment of Fetal Well-Being

Which client's indications most warrant fetal monitoring in the third trimester?

A type 1 diabetic who is at 32 weeks' gestation is having a nonstress test for fetal well-being,since she has been having problems with glucose control.Which of the following meets the criteria for her test to be considered reactive?

Which response would indicate that a client clearly understands the risks of an amniocentesis?

The nurse knows that a lecithin/sphingomyelin (L/S) ratio finding of 2:1 on amniotic fluid means:

Of all the clients who have been scheduled to have a biophysical profile,the nurse would clarify the order for which client?

The client is having a nonstress test the next day.Which instruction should the nurse give to the client?

Each of the following pregnant women is scheduled for a 14-week antepartal visit.In planning care,the nurse would give priority teaching on amniotic fluid alpha-fetoprotein (AFP) screening to which client?

During a nonstress test,the nurse notes that the fetal heart rate decelerates about 15 beats during a period of fetal movement.The decelerations occur twice during the test,and last 20 seconds each.The nurse realizes these results will be interpreted as:

In assisting with an abdominal ultrasound procedure for determination of fetal age,the nurse:

A client at 37 weeks' gestation has a mildly elevated blood pressure.Her antenatal testing demonstrates a fetal heart rate baseline of 150 with three contractions in 10 minutes,no decelerations,and accelerations four times in 1 hour.This test would be considered a:

A client and her partner are carriers of sickle-cell disease.They are considering prenatal diagnosis with either amniocentesis or chorionic villus sampling (CVS) .Which statement indicates that further teaching is needed on these two procedures?

At 32 weeks' gestation,a woman is scheduled for a second nonstress test (following the one she had at 28 weeks' gestation) .Which response by the client would indicate an adequate understanding of this procedure?

The nurse is preparing the client for an amniocentesis.The ultrasound shows the fetus to be positioned as in the picture.At what site would the nurse prep the client for the amniocentesis?