Deck 13: Assessment of Fetal Well-Being

Question 1

A client at 20 weeks' gestation is scheduled for a transabdominal ultrasound. What should the nurse instruct this client about the examination? Select all that apply.
1) "The entire procedure takes between 20 and 30 minutes."
2) "Arrive 30 minutes before the examination so pain medication will be effective."
3) "Transmission gel will be spread over the abdomen during the examination."
4) "Use an over-the-counter enema to empty the colon before the examination."
5) "Drink 1.5 quarts of water 2 hours before the exam and refrain from voiding."

Answer 1

1, 3, 5

Question 2

During a home visit the nurse observes a pregnant client assess fetal activity. Which observations indicate that the client understands the correct process for this count? Select all that apply.
1) Sits in a chair
2) Assumes a side-lying position
3) Counts the same time every day
4) Watches television while counting
5) Begins counting 1 hour after a meal

Answer 2

2, 3, 5

Question 3

A woman who is at 15 weeks' gestation received normal chorionic villus sampling (CVS) results and abnormal quadruple screen test results. For detection of congenital anomalies, which test should the nurse expect the woman to be offered next?
1) Ultrasound
2) Amniocentesis
3) Non-stress test (NST)
4) Contraction stress test (CST)

Answer 3

2

Question 4

The nurse is preparing a client in her second trimester for a three-dimensional ultrasound examination. Which statement indicates that teaching had been effective?
1) "I might be able to see who the baby looks like with the ultrasound."
2) "If the ultrasound is normal, it means my baby has no abnormalities."
3) "The nuchal translucency measurement will diagnose Down syndrome."
4) "Measuring the length of my cervix will determine if I will deliver early."

Question 5

The nurse is responding to phone calls. Which call should the nurse return first?
1) 29 weeks' gestation, reports increased fetal movement
2) 37 weeks' gestation, reports no fetal movement for 24 hours
3) 32 weeks' gestation, reports decreased fetal movement for 2 days
4) 35 weeks' gestation, reports decreased fetal movement for 4 hours

Question 6

A client's amniocentesis results indicate that the fetus is at risk for respiratory distress. What testing values support this clinical decision? Select all that apply.
1) Amniotic glucose level 50 mg/dL
2) Phosphatidylglycerol (PG) negative
3) Lecithin/sphingomyelin (L/S) ratio 1:6
4) Amniotic fluid red blood cell count 5 mg/dL
5) Lamellar body counts (LBCs) 5000/counts/mcL

Question 7

How should the nurse interpret a pregnant client's lecithin/sphingomyelin (L/S) ratio finding of 2:1 on amniotic fluid?
1) Fetal lungs are mature.
2) Fetal lungs are still immature.
3) The fetus has a congenital anomaly.
4) The fetus is small for gestational age.

Question 8

The nurse is reviewing nursing documentation related to the care of a client who had an amniocentesis. Which nursing note reflects appropriate client care?
1) Prior to discharge, the client demonstrated vaginal spotting.
2) An Rh-positive client received RhoGAM after the amniocentesis.
3) The client was monitored for 30 minutes after completion of the test.
4) The client reported that she takes insulin before each meal and at bedtime.

Question 9

A pregnant client is receiving the results of perinatal testing. Which statement indicates that the client understands the test result?
1) "Because my contraction stress test was positive, we know that my baby will tolerate labor well."
2) "The reactive non-stress test means that my baby is not growing because of a lack of oxygen."
3) "My biophysical profile score of 6 points indicates everything being normal and healthy for my baby."
4) "The normal Doppler velocimetry wave result indicates my placenta is getting enough blood to the baby."

Question 10

What should the nurse do when assisting a pregnant client who is having an abdominal ultrasound to determine fetal age?
1) Has the woman empty her bladder before the test begins
2) Assists the woman into a supine position on the examining table
3) Asks the woman to sign an operative consent form prior to the procedure
4) Instructs the woman to eat a fat-free meal 2 hours before the scheduled test time

Question 11

The nurse is reviewing amniocentesis with a pregnant client. In which order should the nurse explain the steps that will occur during this procedure?
1) Conduct an ultrasound
2) Fetal heart rate assessed
3) Local anesthetic provided
4) Skin cleansed with antiseptic solution
5) Insertion site observed for fluid streaming
6) 22-gauge needle inserted to withdraw amniotic fluid

Question 12

A woman at 28 weeks' gestation reports not feeling the baby move for over 30 minutes. How should the nurse respond first?
1) "When did you eat last?"
2) "Have you been smoking?"
3) "Your baby might be asleep."
4) "You need to go to the emergency room immediately for further evaluation."

Question 13

A pregnant client's fundal height is 26 cm at 32 weeks' gestation. Why would the healthcare provider schedule this client for sonograms every 2 weeks?
1) Evaluate fetal growth
2) Determine fetal presentation
3) Assess for congenital anomalies
4) Rule out a suspected hydatidiform mole

Question 14

A pregnant woman is having a nipple-stimulated contraction stress test. Which result indicates hyperstimulation?
1) There are more than five fetal movements in a 10-minute period.
2) There are more than three uterine contractions in a 6-minute period.
3) The fetal heart rate accelerates when contractions last up to 60 seconds.
4) The fetal heart rate decelerates when three contractions occur within a 10-minute period.

Question 15

During a non-stress 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. What should the nurse expect the outcome of this test will be?
1) A reactive test
2) A negative test
3) An equivocal test
4) A nonreactive test

Question 16

A woman who is at 12 weeks' gestation asks the nurse if she can undergo chorionic villus sampling (CVS) testing in order to determine whether her baby has a neural tube defect. Which response is best?
1) "No, because CVS testing is not performed until after 20 weeks' gestation."
2) "No, because CVS testing alone at any stage cannot detect neural tube defects."
3) "Yes, at 12 weeks' gestation, CVS can be used to diagnose a neural tube defect."
4) "Yes, at 12 weeks' gestation, CVS is combined with amniocentesis to diagnose neural tube defects."

Question 17

The nurse is preparing teaching material on chorionic villus sampling (CVS) for a client who is entering the 10th week of gestation. What risks should the nurse include with this material? Select all that apply.
1) Bleeding
2) Embryonic puncture
3) Intrauterine infection
4) Inability to obtain a tissue sample
5) Inadvertent rupture of the membranes

Question 18

The nurse is reviewing clients who would benefit from a biophysical profile (BPP). Which clients should the nurse identify as a priority? Select all that apply.
1) A gravida who is postterm
2) A gravida with intrauterine growth restriction
3) A gravida with mild hypertension of pregnancy
4) A gravida who is experiencing nausea and vomiting
5) A gravida who complains of decreased fetal movement for 2 days

Question 19

A pregnant client is hesitant to have nuchal translucency testing. What should the nurse explain as being the advantages of having this test? Select all that apply.
1) It has a high false-positive rate.
2) It is performed early in the pregnancy.
3) There is no risk of spontaneous abortion.
4) It provides reassurance of the fetus's development.
5) It accurately detects 90% of Down syndrome fetuses.

Question 20

At 32 weeks' gestation, a woman is scheduled for a second non-stress test. Which client response indicates an adequate understanding of this procedure?
1) "I'll have an IV started before the test."
2) "I need to have a full bladder for this test."
3) "I cannot get up and walk around during the test."
4) "I must avoid drinks containing caffeine for 24 hours before the test."