Chapter 6: Antepartal Tests Nursing School Test Banks

Chapter 6: Antepartal Tests

Multiple Choice

1. Your pregnant patient is in her first trimester and is scheduled for an abdominal ultrasound. When explaining the rationale for early pregnancy ultrasound, the best response is: a. The test will help to determine the babys position.b. The test will help to determine how many weeks you are pregnant.c. The test will help to determine if your baby is growing appropriately.d. The test will help to determine if you have a boy or girl.

ANS: b
Feedback
a. Fetal position during pregnancy changes, and position in the first trimester is not indicative of position later in pregnancy.
b. Fetal growth and size are fairly consistent during the first trimester and are a reliable indicator of the weeks of gestation.
c. Fetal growth is best assessed later in pregnancy.
d. The primary rationale for ultrasounds is not to determine gender.

KEY: Integrated Process: Teaching and Learning | Cognitive Level: Application | Content Area: Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Difficult
2. Your pregnant patient is having maternal alpha-fetoprotein (AFP) screening. She does not understand how a test on her blood can indicate a birth defect in the fetus. The best reply by the nurse is:a. We have done this test for a long time.b. If babies have a neural tube defect, alpha-fetoprotein leaks out of the fetus and is absorbed into your blood, causing your level to rise. This serum blood test detects that rise.c. Neural tube defects are a genetic anomaly, and we examine the amount of alpha-fetoprotein in your DNA.d. If babies have a neural tube defect, this results in a decrease in your level of alpha-fetoprotein.

ANS: b
Feedback
a. This response does not explain AFP screening.
b. When a neural tube defect is present, AFP is absorbed in the maternal circulation, resulting in a rise in the maternal AFP level.
c. AFP testing is not related to DNA.
d. Fetal neural tube defects result in an increase in maternal AFP.
KEY: Integrated Process: Teaching and Learning | Cognitive Level: Application | Content Area: Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Difficult
3. The primary complications of amniocentesis are:a. Damage to fetal organsb. Puncture of umbilical cordc. Maternal paind. Infection

ANS: d
Feedback
a. Amniocentesis is done under ultrasound guidance, and damage to fetal organs is very rare.
b. Amniocentesis is done under ultrasound guidance, and damage to the umbilical cord is very rare.
c. Amniocentesis is done under local anesthesia, and maternal pain is generally minimal.
d. Amniocentesis involves insertion of a needle into the amniotic sac, and infection is the primary complication.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Knowledge | Content Area: Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Easy
4. Your patient is 34 weeks pregnant and during a regular prenatal visit tells you she does not understand how to do kick counts. The best response by the nurse would be to explain:a. Here is an information sheet on how to do kick counts.b. It is not important to do kick counts because you have a low-risk pregnancy.c. Fetal kick counts are not a reliable indicator of fetal well-being in the third trimester.d. Fetal movements are an indicator of fetal well-being. You should count twice a day, and you should feel 10 fetal movements in 2 hours.

ANS: d
Feedback
a. Providing written information may not be enough, and the patient may need a verbal explanation.
b. Kick counts are indicated for all pregnancies.
c. Kick counts are a reliable indicator of fetal well-being after 32 to 34 weeks gestation.
d. This response provides the patient with information on how to do kick counts and the rationale for doing kick counts and criteria for normal fetal movement.

KEY: Integrated Process: Teaching and Learning | Cognitive Level: Application | Content Area: Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Moderate

5. Your patient is a 37-year-old pregnant woman who is 5 weeks pregnant and is considering genetic testing. During your discussion, the woman asks the nurse what the advantages of chorionic villus sampling (CVS) are over amniocentesis. The best response is:a. You will need anesthesia for amniocentesis, but not for CVS.b. CVS is a faster procedure.c. CVS provides more detailed information than amniocentesis.d. CVS can be done earlier in your pregnancy, and the results are available more quickly.

ANS: d
Feedback
a. Anesthesia is not done for either procedure.
b. The length of time for either procedure is similar.
c. Both amniocentesis and CVS provide the same information.
d. CVS can be done earlier in gestation.
KEY: Integrated Process: Teaching and Learning | Cognitive Level: Analysis | Content Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Moderate
6. The clinic nurse meets with Rebecca, a 30-year-old woman who is experiencing her first pregnancy. Rebeccas quadruple marker screen result is positive at 17 weeks gestation. The nurse explains that Rebecca needs a referral to:
a. A genetics counselor/specialist
b. An obstetrician
c. A gynecologist
d. A social worker

ANS: a
Feedback
a. All women should be offered screening with maternal serum markers. The Triple Marker screen and the Quadruple Marker screen test for the presence of alpha-fetoprotein (AFP), estradiol, human chorionic gonadotropin (hCG), and other markers. These tests screen for potential neural tube defects, Down syndrome, and Trisomy 18. If the screen is positive, the woman should be referred to a genetics specialist for counseling, and further testing, such as chorionic villus sampling (CVS) or amniocentesis, should be performed.
b. If genetic screening is positive, the woman should be referred to a genetics specialist for counseling, and further testing, such as chorionic villus sampling (CVS) or amniocentesis, should be performed.
c. If genetic screening is positive, the woman should be referred to a genetics specialist for counseling, and further testing, such as chorionic villus sampling (CVS) or amniocentesis, should be performed.
d. If genetic screening is positive, the woman should be referred to a genetics specialist for counseling, and further testing, such as chorionic villus sampling (CVS) or amniocentesis, should be performed.

KEY: Integrated Process: Teaching and Learning | Cognitive Level: Analysis | Content Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Difficult

7. A 37-year-old woman who is 17 weeks pregnant has had an amniocentesis. Before discharge, the nurse teaches the woman to call her doctor if she experiences which of the following side effects?
a. Pain at the puncture site
b. Macular rash on the abdomen
c. Decrease in urinary output
d. Cramping of the uterus

ANS: d
Feedback
a. It is normal for the patient to experience pain at the puncture site.
b. A rash is not an expected complication.
c. Oliguria is not an expected complication.
d. The woman should report any uterine cramping. Although rare, amniocentesis could stimulate preterm labor.
KEY: Integrated Process: Nursing Process: Implementation; Teaching and Learning | Cognitive Level: Application | Content Area: Maternity | Client Need: Health Promotion and Maintenance; Physiological Integrity: Reduction of Risk Potential | Difficulty Level: Moderate

8. A laboratory report indicates the L/S ratio (lecithin/sphingomyelin) results from an amniocentesis of a gravid patient with preeclampsia are 2:1. The nurse interprets the result as which of the following?
a. The babys lung fields are mature.
b. The mother is high risk for hemorrhage.
c. The babys kidneys are functioning poorly.
d. The mother is high risk for eclampsia.

ANS: a
Feedback
a. An L/S ratio of 2:1 usually indicates that the fetal lungs are mature.
b. L/S ratios are unrelated to maternal blood loss.
c. L/S ratios are unrelated to fetal renal function.
d. L/S ratios are unrelated to maternal risk for becoming eclamptic.

KEY: Integrated Process: Nursing Process: Teaching and Learning | Cognitive Level: Application | Content Area: Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Moderate

Leave a Reply