ATI Maternal Newborn Test 2 Exam Study Guide

1) A standard ultrasound examination is performed during the second or third trimester and includes an evaluation of which of the following? Select all that apply. A) Confirm fetal heart activity. B) Evaluate the cervix. C) Determine fetal presentation. D) Assess amniotic fluid volume. E) Determine fetal number. Answer: C, D, E Explanation: A) A limited ultrasound may be used to address a specific question or determine specific information including confirming fetal heart activity. B) A limited ultrasound may be used to address a specific question or determine specific information including evaluating the cervix. C) A standard ultrasound examination is performed during the second or third trimester and includes an evaluation to determine fetal presentation. D) A standard ultrasound e amination is performed during the second or third trimester and includes an evaluation of amniotic fluid volume. E) A standard ultrasound examination is performed during the second or third trimester and includes an evaluation of fetal number. Page Ref: 325 2) When assisting with a transabdominal ultrasound sampling, which of the following would the nurse do? A) Obtain preliminary urinary samples. B) Have the woman empty her bladder before the test begins. C) Assist the woman into a supine position on the examining table. D) Instruct the woman to eat a fat-free meal 2 hours before the scheduled test time. Answer: C Explanation: A) Preliminary blood work may be obtained, not urinary samples. B) The morning of the procedure, the woman is asked to drink fluids to fill her bladder because displacement of an anteverted uterus by a full bladder may aid in positioning the uterus for catheter insertion. C) Clients are placed in a supine position on the table. D) Dietary intake is not relevant to this procedure. Page Ref: 328 3) The nurse is preparing a client in her second trimester for a three-dimensional ultrasound examination. Which statement indicates that teaching has been effective? A) "If the ultrasound is normal, it means my baby has no abnormalities." B) "The nuchal translucency measurement will diagnose Down syndrome." C) "I might be able to see who the baby looks like with the ultrasound." D) "Measuring the length of my cervix will determine whether I will deliver early." Answer: C Explanation: A) Not all fetal anomalies are detectable by ultrasound. B) Nuchal translucency measurements are for detection, not diagnosis, of trisomies 13, 18, and 21. C) Three-dimensional ultrasound uses algorithms to vary opacity, transparency, and depth to project an image. This allows curved structures such as the fetal face to be viewed. D) Transvaginal ultrasound can most accurately identify shortened cervical length indicating cervical insufficiency or risk of preterm labor. However, a cervix of normal length does not preclude preterm birth. Page Ref: 326 4) A woman at 28 weeks' gestation is asked to keep a fetal activity record 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 more than 30 minutes. Which of the following would be the nurse's most appropriate initial comment? 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." Answer: D Explanation: A) The mother would need to come to the clinic only if there had been no fetal activity for several hours. B) Certain substances such as tobacco, drugs, alcohol, and caffeine have been shown to affect fetal movements and can increase fetal movement. C) After meals, an infant typically has increased movement. D) Lack of fetal activity for 30 minutes typically is insignificant. Movement varies considerably, but most women feel fetal movement at least 10 times in 3 hours. Page Ref: 335 5) Which of the following tests provides information about the fetal number? A) Amniocentesis B) Standard second-trimester sonogram C) Beta hCG D) Maternal serum alpha-fetoprotein Answer: B Explanation: A) Amniocentesis can make chromosomal and biochemical determinations and can validate abnormalities detected by ultrasound. B) A standard (comprehensive) second trimester sonogram provides information about the fetus, placenta, and uterine conditions, including fetal number. C) Serial quantitative beta hCG testing can be used to distinguish a normally developing fetus from an ectopic pregnancy. D) Maternal serum alpha-fetoprotein (MSAFP) is a component of the screening test, the "quadruple check" that utilizes the multiple markers, including AFP, hCG, diameric inhibin-A, and estriol, to screen pregnancies for NTD, trisomy 21 (Down syndrome), and trisomy 18.