Maternal Child Nursing Care Chapter 10
Assessment of High Risk Pregnancy
questions and answers 2025/2026 version
4
Transvaginal ultrasound is useful for obese women whose thick abdominal layers
cannot be penetrated adequately with the abdominal approach. A biophysical
profile is a method of biophysical assessment of fetal well-being in the third
trimester. An amniocentesis is performed after the fourteenth week of pregnancy. A
MSAFP test is performed from week 15 to week 22 of the gestation (weeks 16 to 18
are ideal). An ultrasound is the method of biophysical assessment of the infant that
is performed at this gestational age. - Answer A 40-year-old woman with a high
body mass index is 10 weeks pregnant. Which diagnostic tool is appropriate to
suggest to her at this time?
1
Biophysical profile
2
Amniocentesis
3
Maternal serum alpha-fetoprotein (MSAFP)
4
Transvaginal ultrasound
2
Meconium is normally stored in the infant's intestines until after birth, but
sometimes (in cases of fetal distress and hypoxia) it is expelled into the amniotic
fluid before birth. The amniotic fluid is then said to be meconium stained. Fewer
than three contractions in 10 minutes or late decelerations occurring with 50% or
more of contractions constitute positive CST results. Positive CST results are
associated with meconium-stained amniotic fluid. Negative CST results indicate that
the fetus is normal. Suspicious or unsatisfactory CST results are not associated with
any other fetal conditions. - Answer The nurse is reviewing the contraction stress
Maternal Child Nursing Care Chapter 10 Assessment of High Risk Pregnancy
questions and answers 2025-2026 version
,test (CST) reports of a pregnant patient. The nurse expects the fetus to have
meconium-stained amniotic fluid. What would be the reason for that conclusion? 1
Negative CST results
2
Positive CST results
3
Suspicious CST results
4
Unsatisfactory CST results
2, 4, 5
The triple marker screen measures the levels of three maternal serum markers:
unconjugated estriol, hCG, and MSAFP. Low values of unconjugated estriol, hCG, and
MSAFP indicate that the fetus has trisomy 18. The quad screen has an additional
serum marker: inhibin-A. A low inhibin-A level indicates the possibility of Down
syndrome. NT is not a serum marker protein. Moreover, elevated NT indicates that
the fetus has a chromosomal abnormality but does not specifically indicate that the
fetus has trisomy 18. - Answer After reviewing the triple marker screen reports of a
patient who is in the second trimester of pregnancy, the nurse concludes that the
fetus has trisomy 18. What factors in the report led to the nurse's conclusion?
Select all that apply.
1
Low level of inhibin-A in the maternal serum
2
Low level of unconjugated estriol in serum
3
Elevated nuchal translucency (NT) in the fetus
4
Low level of maternal human chorionic gonadotrophin (hCG)
5
Low level of maternal serum alpha-fetoprotein (MSAFP)
Maternal Child Nursing Care Chapter 10 Assessment of High Risk Pregnancy
questions and answers 2025-2026 version
, 1, 2
Triple marker screening, which is performed in the first trimester of pregnancy,
includes the measurement of two maternal biomarkers: PAPP-A and free β-hCG.
High levels of free β-hCG and low levels of PAPP-A in the first trimester indicate that
the fetus has Down syndrome, or trisomy 21.InhibinA is a placental hormone. Low
levels of inhibin-A also indicate the possibility of Down syndrome, but inhibin-A
levels are not measured in the triple marker screen; these levels are measured in
quad screening. A low level of MSAFP and unconjugated estriol also indicate Down
syndrome, but these can be measured only in the second and third trimesters. -
Answer A patient in the first trimester of pregnancy undergoes a triple marker
screening test. On reviewing the report, the nurse infers that the fetus may have
Down syndrome. What clinical findings are noted by the nurse in the test reports?
Select all that apply.
1
High levels of beta-human chorionic gonadotropin (β-hCG)
2
Low levels of pregnancy-associated placental protein (PAPP-A)
3
Low levels of inhibin-A in the fetal blood
4
Low levels of maternal serum alpha-fetoprotein (MSAFP)
5
Low levels of unconjugated estriol in the fetal blood
1
Biochemical findings such as an L/S ratio of 2:1, an S/A ratio of 60 mg/g, and the
presence of PG in amniotic fluid indicate that the fetal lungs are well developed. The
gestational age can be predicted only with the help of creatinine and lipid levels in
the amniotic fluid. Creatinine levels greater than 2 mg/dL in amniotic fluid indicate
that the gestational age is more than 36 weeks. The presence of alphafetoprotein
(AFP) in the amniotic fluid indicates a neural tube defect in the fetus. The nurse
needs to assess AFP levels in the amniotic fluid to determine whether the fetus has
an open neural tube defect. A high AFP level in amniotic fluid after 15 weeks'
gestation indicates that the fetus has an open neural tube defect. - Answer
Maternal Child Nursing Care Chapter 10 Assessment of High Risk Pregnancy
questions and answers 2025-2026 version
Assessment of High Risk Pregnancy
questions and answers 2025/2026 version
4
Transvaginal ultrasound is useful for obese women whose thick abdominal layers
cannot be penetrated adequately with the abdominal approach. A biophysical
profile is a method of biophysical assessment of fetal well-being in the third
trimester. An amniocentesis is performed after the fourteenth week of pregnancy. A
MSAFP test is performed from week 15 to week 22 of the gestation (weeks 16 to 18
are ideal). An ultrasound is the method of biophysical assessment of the infant that
is performed at this gestational age. - Answer A 40-year-old woman with a high
body mass index is 10 weeks pregnant. Which diagnostic tool is appropriate to
suggest to her at this time?
1
Biophysical profile
2
Amniocentesis
3
Maternal serum alpha-fetoprotein (MSAFP)
4
Transvaginal ultrasound
2
Meconium is normally stored in the infant's intestines until after birth, but
sometimes (in cases of fetal distress and hypoxia) it is expelled into the amniotic
fluid before birth. The amniotic fluid is then said to be meconium stained. Fewer
than three contractions in 10 minutes or late decelerations occurring with 50% or
more of contractions constitute positive CST results. Positive CST results are
associated with meconium-stained amniotic fluid. Negative CST results indicate that
the fetus is normal. Suspicious or unsatisfactory CST results are not associated with
any other fetal conditions. - Answer The nurse is reviewing the contraction stress
Maternal Child Nursing Care Chapter 10 Assessment of High Risk Pregnancy
questions and answers 2025-2026 version
,test (CST) reports of a pregnant patient. The nurse expects the fetus to have
meconium-stained amniotic fluid. What would be the reason for that conclusion? 1
Negative CST results
2
Positive CST results
3
Suspicious CST results
4
Unsatisfactory CST results
2, 4, 5
The triple marker screen measures the levels of three maternal serum markers:
unconjugated estriol, hCG, and MSAFP. Low values of unconjugated estriol, hCG, and
MSAFP indicate that the fetus has trisomy 18. The quad screen has an additional
serum marker: inhibin-A. A low inhibin-A level indicates the possibility of Down
syndrome. NT is not a serum marker protein. Moreover, elevated NT indicates that
the fetus has a chromosomal abnormality but does not specifically indicate that the
fetus has trisomy 18. - Answer After reviewing the triple marker screen reports of a
patient who is in the second trimester of pregnancy, the nurse concludes that the
fetus has trisomy 18. What factors in the report led to the nurse's conclusion?
Select all that apply.
1
Low level of inhibin-A in the maternal serum
2
Low level of unconjugated estriol in serum
3
Elevated nuchal translucency (NT) in the fetus
4
Low level of maternal human chorionic gonadotrophin (hCG)
5
Low level of maternal serum alpha-fetoprotein (MSAFP)
Maternal Child Nursing Care Chapter 10 Assessment of High Risk Pregnancy
questions and answers 2025-2026 version
, 1, 2
Triple marker screening, which is performed in the first trimester of pregnancy,
includes the measurement of two maternal biomarkers: PAPP-A and free β-hCG.
High levels of free β-hCG and low levels of PAPP-A in the first trimester indicate that
the fetus has Down syndrome, or trisomy 21.InhibinA is a placental hormone. Low
levels of inhibin-A also indicate the possibility of Down syndrome, but inhibin-A
levels are not measured in the triple marker screen; these levels are measured in
quad screening. A low level of MSAFP and unconjugated estriol also indicate Down
syndrome, but these can be measured only in the second and third trimesters. -
Answer A patient in the first trimester of pregnancy undergoes a triple marker
screening test. On reviewing the report, the nurse infers that the fetus may have
Down syndrome. What clinical findings are noted by the nurse in the test reports?
Select all that apply.
1
High levels of beta-human chorionic gonadotropin (β-hCG)
2
Low levels of pregnancy-associated placental protein (PAPP-A)
3
Low levels of inhibin-A in the fetal blood
4
Low levels of maternal serum alpha-fetoprotein (MSAFP)
5
Low levels of unconjugated estriol in the fetal blood
1
Biochemical findings such as an L/S ratio of 2:1, an S/A ratio of 60 mg/g, and the
presence of PG in amniotic fluid indicate that the fetal lungs are well developed. The
gestational age can be predicted only with the help of creatinine and lipid levels in
the amniotic fluid. Creatinine levels greater than 2 mg/dL in amniotic fluid indicate
that the gestational age is more than 36 weeks. The presence of alphafetoprotein
(AFP) in the amniotic fluid indicates a neural tube defect in the fetus. The nurse
needs to assess AFP levels in the amniotic fluid to determine whether the fetus has
an open neural tube defect. A high AFP level in amniotic fluid after 15 weeks'
gestation indicates that the fetus has an open neural tube defect. - Answer
Maternal Child Nursing Care Chapter 10 Assessment of High Risk Pregnancy
questions and answers 2025-2026 version
