Deck 14: Assessment of Fetal Well-Being

Question 1

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

A)Gravida 4,para 3,39 weeks,with a history of one spontaneous abortion at 8 weeks
B)Gravida 1,para 0,40 weeks,with a history of endometriosis and a prior appendectomy
C)Gravida 3,para 2,with a history of gestational diabetes controlled by diet
D)Gravida 2,para 1,36 weeks,with hypertension disorder of pregnancy

Answer 1

Gravida 2,para 1,36 weeks,with hypertension disorder of pregnancy

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:

A)Assess for congenital anomalies.
B)Evaluate fetal growth.
C)Determine fetal presentation.
D)Rule out a suspected hydatidiform mole.

Answer 2

Evaluate fetal growth.

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?

A)Fetal heart rate baseline of 150 with two accelerations to 160 for 10 seconds within 20 minutes
B)Fetal heart rate baseline of 140 with one acceleration to 160 for 15 seconds within 30 minutes
C)Fetal heart rate baseline of 140 with two accelerations to 155 for 15 seconds within 20 minutes
D)Fetal heart rate baseline of 130 with two accelerations to 140 for 15 seconds within 20 minutes

Answer 3

Fetal heart rate baseline of 140 with two accelerations to 155 for 15 seconds within 20 minutes

Question 4

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

A)"I might go into labor early."
B)"It could produce a congenital defect in my baby."
C)"Actually,there are no real risks to this procedure."
D)"The test could stunt my baby's growth."

Question 5

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

A)Fetal lungs are still immature.
B)The fetus has a congenital anomaly.
C)Fetal lungs are mature.
D)The fetus is small for gestational age.

Question 6

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

A)A gravida with intrauterine growth restriction
B)A gravida with mild hypertension of pregnancy
C)A gravida who is post-term
D)A gravida who complains of decreased fetal movement for 2 days

Question 7

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

A)"Be sure to come in with a full bladder."
B)"Remember not to eat anything before the test."
C)"You will feel some contractions during the test."
D)"The test should last no longer than 30 minutes."

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?

A)28-year-old with history of rheumatic heart disease
B)18-year-old with exposure to HIV
C)20-year-old with a history of preterm labor
D)35-year-old with a child with spina bifida

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:

A)A negative test.
B)A reactive test.
C)A nonreactive test.
D)An equivocal test.

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:

A)"You need to come to the clinic right away for further evaluation."
B)"Have you been smoking?"
C)"When did you eat last?"
D)"Your baby might be asleep."

Question 11

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

A)Asks the woman to sign an operative consent form prior to the procedure.
B)Has the woman empty her bladder before the test begins.
C)Assists the woman into a supine position on the examining table.
D)Instructs the woman to eat a fat-free meal 2 hours before the scheduled test time.

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:

A)Positive nonstress test.
B)Negative contraction stress test.
C)Positive contraction stress test.
D)Negative nonstress test.

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?

A)"CVS carries a higher risk of miscarriage."
B)"CVS can be done earlier in my pregnancy than can amniocentesis."
C)"The diagnosis comes sooner if we use amniocentesis."
D)"CVS has a risk of giving me an infection."

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?

A)"I can't get up and walk around during the test."
B)"I'll have an IV started before the test."
C)"I must avoid drinks containing caffeine for 24 hours before the test."
D)"I need to have a full bladder 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?

A)A
B)B.
C)C.
D)D.