Deck 15: Prenatal Diagnostic Tests

Question 1

The primary reason for evaluating alpha-fetoprotein (AFP)levels in maternal serum is to determine if the fetus has

A) Hemophilia
B) A neural tube defect
C) Sickle cell anemia
D) A normal lecithin/sphingomyelin (L/S) ratio

Answer 1

A neural tube defect

Question 2

Transvaginal ultrasonography is often performed during the first trimester.While preparing your 6-week-gestation patient for this procedure,she expresses concerns over the necessity for this test.The nurse should explain that this diagnostic test may be necessary to determine which of the following? Select all that apply.

A) Multifetal gestation
B) Bicornate uterus
C) Presence and location of pregnancy (intrauterine or elsewhere)
D) Amniotic fluid volume
E) Presence of ovarian cysts

Answer 2

Multifetal gestation
Bicornate uterus
Presence and location of pregnancy (intrauterine or elsewhere)
Presence of ovarian cysts

Question 3

Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy,including that

A) Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis.
B) Screening for maternal serum alpha-fetoprotein (MSAFP) levels is recommended between 10 and 12 weeks of gestation in order to give parents time to consider options.
C) Percutaneous umbilical blood sampling (PUBS) is one of the multiple marker screen tests for Down syndrome.
D) MSAFP is a screening tool only; it identifies candidates for more definitive procedures.

Answer 3

MSAFP is a screening tool only; it identifies candidates for more definitive procedures.

Question 4

When is the best time to determine gestational age based on biparietal diameter through ultrasound?

A) 4 to 6 weeks
B) 5 to 7 weeks
C) 7 to 10 weeks
D) 12 to 20 weeks

Question 5

Which diagnostic test evaluates the effect of fetal movement on fetal heart activity?

A) Contraction stress test (CST)
B) Sonography
C) Biophysical profile
D) Nonstress test (NST)

Question 6

Ultrasonography is an important and safe technique used in antepartum surveillance.It provides critical information related to fetal activity,gestational age and fetal well-being.Which statement regarding ultrasonography during pregnancy is most accurate?

A) Ultrasonography uses infrared technology to create an image.
B) Ultrasonography is only utilized as an adjunct to more invasive tests.
C) Ultrasonography is not harmful to the fetus.
D) Ultrasonography is not a component of biophysical profile testing.

Question 7

Which response by the nurse is most appropriate to this statement: "This test isn't my idea,but my husband insists"?

A) "Don't worry. Everything will be fine."
B) "Why don't you want to have this test?"
C) "You're concerned about having this test?"
D) "It's your decision."

Question 8

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

A) Multiple-marker screening
B) Lecithin/sphingomyelin (L/S) ratio
C) Biophysical profile
D) Type and crossmatch of maternal and fetal serum

Question 9

What is the purpose of amniocentesis for the patient hospitalized at 34 weeks with pregnancy-induced hypertension?

A) Identification of abnormal fetal cells
B) Detection of metabolic disorders
C) Determination of fetal lung maturity
D) Identification of sex of the fetus

Question 10

A woman who is 36 weeks pregnant reports to the labor and delivery triage area expressing concerns that her baby "is not moving." Along with a nonstress test (NST)the nurse might also use ______________ to determine fetal well-being.

Question 11

The nurse's role in diagnostic testing is to provide

A) Advice to the couple
B) Assistance with decision-making
C) Information about the tests
D) Reassurance about fetal safety

Question 12

An NST in which two or more fetal heart rate (FHR)accelerations of 15 beats per minute (bpm)or more occur with fetal movement in a 20-minute period is termed

A) Nonreactive
B) Positive
C) Negative
D) Reactive

Question 13

While working with the pregnant woman in her first trimester,the nurse is aware that chorionic villus sampling can be performed during pregnancy as early as _____ weeks.

A) 4
B) 8
C) 10
D) 12

Question 14

The purpose of initiating contractions in a CST is to

A) Determine the degree of fetal activity.
B) Apply a stressful stimulus to the fetus.
C) Identifying fetal acceleration patterns.
D) Increase placental blood flow.

Question 15

In many settings,nurses may perform nonstress tests (NST),conduct an initial assessment of the woman and begin necessary interventions for nonreassuring results.These nursing procedures are accomplished after additional education and training under established protocols.Which nursing action is necessary when preparing the patient for the NST?

A) Position the woman on her left side.
B) Be certain that the woman is seated comfortably in a reclining chair.
C) Encourage the woman to drink one liter of water prior to the test.
D) Place conduction gel on the woman's abdomen with one belt.

Question 16

The nurse providing care for the pregnant woman understands that a factor indicating the need for fetal diagnostic procedures is

A) Maternal diabetes
B) Maternal age older than 30 years
C) Previous infant more than 3000 g at birth
D) Weight gain of 25 pounds

Question 17

The major advantage of chorionic villus sampling (CVS)over amniocentesis is that it

A) Is not an invasive procedure
B) Does not require hospitalization
C) Has less risk of spontaneous abortion
D) Is performed earlier in pregnancy

Question 18

Which nursing intervention is necessary before a second-trimester transabdominal ultrasound?

A) Place the woman NPO for 12 hours.
B) Instruct the woman to drink 1 to 2 quarts of water.
C) Administer a soapsuds enema.
D) Perform an abdominal prep.

Question 19

A pregnant woman's biophysical profile score is 8.She asks the nurse to explain the results.The nurse's best response is

A) "The test results are within normal limits."
B) "Immediate delivery 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 delivery."

Question 20

Percutaneous umbilical cord sampling (PUBS),also called cordocentesis,involves the aspiration of fetal blood from the umbilical cord for prenatal diagnosis or therapy.Major indications include (select all that apply)

A) Rh disease
B) Fetal well-being
C) Infection
D) Lung maturity
E) Karyotyping

Question 21

The nurse has instructed the pregnant patient to self-assess movement of her fetus by doing "kick counts." The nurse knows that the woman has had effective learning when she states "Two or three times a day I will be sure that my baby moves at least three times in an hour." Is this statement true or false?