Deck 10: Assessment of High-Risk Pregnancy

Question 1

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

A) Place the woman NPO for 12 hours.
B) Instruct the woman not void until after the test.
C) Administer an enema.
D) Perform an abdominal preparation.

Answer 1

Instruct the woman not void until after the test.

Question 2

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."

Answer 2

"The test results are within normal limits."

Question 3

A 39-year-old primigravida thinks that she is about 8 weeks pregnant,although she has had irregular menstrual periods all her life.She has a history of smoking approximately one pack of cigarettes a day,but she tells you that she is trying to cut down.Her laboratory data are within normal limits.What diagnostic technique could be used with this pregnant woman at this time?

A) Ultrasound examination
B) Maternal serum alpha-fetoprotein (MSAFP) screening
C) Amniocentesis
D) Nonstress test (NST)

Answer 3

Ultrasound examination

Question 4

A woman arrives at the clinic seeking confirmation that she is pregnant.The following information is obtained: She is 24 years old with a body mass index (BMI)of 17.5.She admits to having used cocaine "several times" during the past year and drinks alcohol occasionally.Her blood pressure (BP)is 108/70 mm Hg,her pulse rate is 72 beats/min,and her respiratory rate is 16 breaths/min.The family history is positive for diabetes mellitus and cancer.Her sister recently gave birth to an infant with a neural tube defect (NTD).Which characteristics place the woman in a high risk category?

A) Blood pressure, age, and BMI
B) Drug/alcohol use, age, and family history
C) Family history, blood pressure, and BMI
D) Family history, BMI, and drug/alcohol abuse

Question 5

In comparing the abdominal and transvaginal methods of ultrasound examination,nurses should explain to their patients that:

A) both require the woman to have a full bladder.
B) the abdominal examination is more useful in the first trimester.
C) initially the transvaginal examination can be painful.
D) the transvaginal examination allows pelvic anatomy to be evaluated in greater detail.

Question 6

A patient asks her nurse,"My doctor told me that he is concerned with the grade of my placenta because I am overdue.What does that mean?" The best response by the nurse is:

A) "Your placenta changes as your pregnancy progresses, and it is given a score that indicates the amount of calcium deposits it has. The more calcium deposits, the higher the grade, or number, that is assigned to the placenta. It also means that less blood and oxygen can be delivered to your baby."
B) "Your placenta isn't working properly, and your baby is in danger."
C) "This means that we will need to perform an amniocentesis to detect if you have any placental damage."
D) "Don't worry about it. Everything is fine."

Question 7

Risk factors tend to be interrelated and cumulative in their effect.While planning the care for a laboring patient with diabetes mellitus,the nurse is aware that she is at a greater risk for:

A) oligohydramnios.
B) polyhydramnios.
C) postterm pregnancy.
D) Chromosomal abnormalities.

Question 8

When nurses help their expectant mothers assess the daily fetal movement counts,they should be aware that:

A) alcohol or cigarette smoke can irritate the fetus into greater activity.
B) "kick counts" should be taken every half hour and averaged every 6 hours, with every other 6-hour stretch off.
C) the fetal alarm signal should go off when fetal movements stop entirely for 12 hours.
D) obese mothers familiar with their bodies can assess fetal movement as well as average-size women.

Question 9

A 40-year-old woman is 10 weeks pregnant.Which diagnostic tool would be appropriate to suggest to her at this time?

A) Biophysical profile (BPP)
B) Amniocentesis
C) Maternal serum alpha-fetoprotein (MSAFP) screening
D) Transvaginal ultrasound

Question 10

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 11

Compared with contraction stress test (CST),nonstress test (NST)for antepartum fetal assessment:

A) has no known contraindications.
B) has fewer false-positive results.
C) is more sensitive in detecting fetal compromise.
D) is slightly more expensive.

Question 12

While working with the pregnant woman in her first trimester,the nurse is aware that chorionic villus sampling (CVS)can be performed during pregnancy at:

A) 4 weeks.
B) 8 weeks.
C) 10 weeks.
D) 14 weeks.

Question 13

A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test indicated that her fetus could be experiencing some difficulties in utero.Which diagnostic tool would yield more detailed information about the fetus?

A) Ultrasound for fetal anomalies
B) Biophysical profile (BPP)
C) Maternal serum alpha-fetoprotein (MSAFP) screening
D) Percutaneous umbilical blood sampling (PUBS)

Question 14

The nurse providing care for the antepartum woman should understand that contraction stress test (CST):

A) sometimes uses vibroacoustic stimulation.
B) is an invasive test; however, contractions are stimulated.
C) is considered negative if no late decelerations are observed with the contractions.
D) is more effective than nonstress test (NST) if the membranes have already been ruptured.

Question 15

The nurse sees a woman for the first time when she is 30 weeks pregnant.The woman has smoked throughout the pregnancy,and fundal height measurements now are suggestive of growth restriction in the fetus.In addition to ultrasound to measure fetal size,what other tool would be useful in confirming the diagnosis?

A) Doppler blood flow analysis
B) Contraction stress test (CST)
C) Amniocentesis
D) Daily fetal movement counts

Question 16

In the first trimester,ultrasonography can be used to gain information on:

A) amniotic fluid volume.
B) location of gestational sacs.
C) placental location and maturity.
D) cervical length.

Question 17

A woman is undergoing a nipple-stimulated contraction stress test (CST).She is having contractions that occur every 3 minutes.The fetal heart rate (FHR)has a baseline of approximately 120 beats/min without any decelerations.The interpretation of this test is said to be:

A) negative.
B) positive.
C) satisfactory.
D) unsatisfactory.

Question 18

Intrauterine growth restriction (IUGR)is associated with numerous pregnancy-related risk factors.(Select all that apply.)

A) Poor material weight gain
B) Chronic maternal infections
C) Gestational hypertension
D) Premature rupture of membranes
E) Smoking

Question 19

The nurse recognizes that a nonstress test (NST)in which two or more fetal heart rate (FHR)accelerations of 15 beats/min or more occur with fetal movement in a 20-minute period is:

A) nonreactive.
B) positive.
C) negative.
D) reactive.

Question 20

Nurses should be aware that the biophysical profile (BPP):

A) is an accurate indicator of impending fetal death.
B) is a compilation of health risk factors of the mother during the later stages of pregnancy.
C) consists of a Doppler blood flow analysis and an amniotic fluid index.
D) involves an invasive form of ultrasound examination.

Question 21

MATCHING
Biophysical risks include factors that originate with either the mother or the fetus and affect the functioning of either one or both. The nurse who provides prenatal care should have an understanding of these risk factors. Match the specific pregnancy problem with the related risk factor.

Abnormal placenta development

A)Polyhydramnios
B)Intrauterine growth restriction (maternal cause)
C)Oligohydramnios
D)Chromosomal abnormalities
E)Intrauterine growth restriction (fetoplacental cause)

Question 22

MATCHING
Biophysical risks include factors that originate with either the mother or the fetus and affect the functioning of either one or both. The nurse who provides prenatal care should have an understanding of these risk factors. Match the specific pregnancy problem with the related risk factor.

Fetal congenital anomalies

A)Polyhydramnios
B)Intrauterine growth restriction (maternal cause)
C)Oligohydramnios
D)Chromosomal abnormalities
E)Intrauterine growth restriction (fetoplacental cause)

Question 23

MATCHING
Biophysical risks include factors that originate with either the mother or the fetus and affect the functioning of either one or both. The nurse who provides prenatal care should have an understanding of these risk factors. Match the specific pregnancy problem with the related risk factor.

Advanced maternal age

A)Polyhydramnios
B)Intrauterine growth restriction (maternal cause)
C)Oligohydramnios
D)Chromosomal abnormalities
E)Intrauterine growth restriction (fetoplacental cause)

Question 24

MATCHING
Biophysical risks include factors that originate with either the mother or the fetus and affect the functioning of either one or both. The nurse who provides prenatal care should have an understanding of these risk factors. Match the specific pregnancy problem with the related risk factor.

Smoking,alcohol,and illicit drug use

A)Polyhydramnios
B)Intrauterine growth restriction (maternal cause)
C)Oligohydramnios
D)Chromosomal abnormalities
E)Intrauterine growth restriction (fetoplacental cause)

Question 25

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 indicated for a number of situations.(Select all that apply)

A) Establish gestational age
B) Obesity
C) Fetal abnormalities
D) Amniotic fluid volume
E) Ectopic pregnancy

Question 26

MATCHING
Biophysical risks include factors that originate with either the mother or the fetus and affect the functioning of either one or both. The nurse who provides prenatal care should have an understanding of these risk factors. Match the specific pregnancy problem with the related risk factor.

Premature rupture of membranes

A)Polyhydramnios
B)Intrauterine growth restriction (maternal cause)
C)Oligohydramnios
D)Chromosomal abnormalities
E)Intrauterine growth restriction (fetoplacental cause)