NST CHAPTER 9 QUESTIONS & ANSWERS
The nurse is performing a nonstress test (NST) on a patient who is at 37 weeks of
gestation. The nurse notes the fetal heart rate is increased at 12 bpm above the
baseline and stays elevated for 20 seconds with fetal movement. How should the nurse
document this assessment?
1 Accelerations
2 Decelerations
3 Poor fetal reaction
4 Bradycardia - Answers -1 Accelerations
Discharge instructions after a CVS should include avoiding exercise for 24 hours. The
patient should rest for 24 hours, not 72. Sexual intercourse should be avoided for 24
hours, not 2 weeks. Passage of clots from the vagina is an abnormal finding that should
be reported
Which is a complication related to percutaneous umbilical blood sampling (PUBS)?
1 Fetal tachycardia
2 Decreased fetal lung maturity
3 Post-term labor
4 Thrombosis - Answers -4 Thrombosis
PUBS increases the risk of thrombosis formation. Fetal bradycardia, not tachycardia, is
a complication of PUBS. Decreased fetal lung maturity is not a complication of PUBS.
Preterm, not postterm, labor is a complication of PUBS.
The nurse notes a patient had a reactive nonstress test (NST). How should the nurse
interpret this test result?
1 There were two or more fetal heart rate decelerations within a 15-minute period.
2 There was a fetal heart rate deceleration that lasted for at least 1 minute.
3 There was a fetal heart rate acceleration that lasted for 4 minutes.
4 There were two or more fetal heart rate accelerations within a 20-minute period. -
Answers -4 There were two or more fetal heart rate accelerations within a 20-minute
period.
A reactive NST is defined as having two or more fetal heart rate accelerations within a
20-minute period. This is a normal finding. A deceleration, whether over 15 minutes or 1
minute, is when the fetal heart rate decreases; this is not a reactive NST. A 4-minute
fetal heart rate acceleration is not a reactive NST; it is too long.
The nurse is preparing to draw a blood sample for a multiple-marker screening on a
pregnant patient. The nurse understands that which factor predisposes the fetus to the
highest risk of a neural tube defect (NTD), but may have a lower alpha-fetoprotein
(AFP) level?
1
Race
,2
Asthma
3
Systemic lupus
4
Type I diabetes - Answers -4 Type 1 Diabetes
Women with type 1 diabetes have a greater risk for a fetus with an NTD but have a
lower AFP level. Black women have a lower risk for a baby with an NTD but a higher
AFP level than other ethnic groups. Asthma and systemic lupus are not associated with
NTDs or abnormal AFP levels.
The nurse is teaching a patient in the second trimester about fetal kick count. Which
statement by the patient needs correction?
1 "I should count the fetal kicks once a day for 60 minutes."
2 "I may not feel any movements when the fetus is sleeping."
3 "I should count the fetal kicks either after meals or before bedtime."
4 "I should consult an obstetrician if the fetal movements are less than 10 in 1 hour." -
Answers -4 "I should consult an obstetrician if the fetal movements are less than 10 in 1
hour."
The fetal movement count helps monitor the condition of the fetus. If the fetal
movements are less than three in 1 hour, it indicates a risk of abnormality. Therefore,
less than 10 fetal movements in an hour may not be abnormal and the patient may not
need to consult the obstetrician. The patient should count fetal kicks at least once a day
for a period of 60 minutes because it helps assess fetal activity. Fetal movements are
usually not present during the fetal sleep cycle. The patient can count the fetal kicks
either after meals or before bedtime when fetal movements are typically highest.
The nurse is performing a contraction stress test (CST) and notes no late decelerations.
How should the nurse interpret this test result?
1 Negative CST
2 Positive CST
3 Suspicious CST
4 Equivocal CST - Answers -1 Negative CST
A negative CST describes a fetal heart rate response to contractions with no
decelerations. A positive CST describes a fetal heart rate deceleration with a minimum
of 50% of the contractions. A suspicious or equivocal response describes intermittent
late decelerations or a sudden decrease in fetal heart rate that quickly returns to the
baseline.
The levels of which hormones and proteins are measured in a triple screen maternal
serum test? Select all that apply.
1
Human chorionic gonadotropin (hCG)
, 2
Alpha-fetoprotein (AFP)
3
Unconjugated estriol (uE3)
4
Hemoglobin
5
Bilirubin - Answers -1,2,3
The hormones and proteins that are measured in a triple screen are hCG, AFP, and
uE3. Hemoglobin and bilirubin are not measured in a triple screen.
How is percutaneous umbilical blood sampling (PUBS) performed?
1
A long needle is inserted through the abdomen into the umbilical vein.
2
A transducer probe is inserted into the vagina.
3
A Doppler ultrasound transducer is placed on the abdomen.
4
A long needle is inserted through the abdomen into the amniotic sac. - Answers -1 A
long needle is inserted through the abdomen into the umbilical vein.
PUBS is performed by inserting a long needle through the abdomen into the umbilical
vein. Transvaginal ultrasound is performed by inserting a transducer probe into the
vagina. A transabdominal ultrasound transducer is performed by placing a Doppler
ultrasound on the abdomen. An amniocentesis is performed by inserting a long needle
through the abdomen into the amniotic sac.
What does a nurse providing care for the antepartum woman need to understand about
the contraction stress test (CST)?
1
It sometimes uses vibroacoustic stimulation.
2
It is an invasive test; however, contractions are stimulated.
3
It is considered negative if no late decelerations are observed with the contractions.
4
It is more effective than nonstress test (NST) if the membranes have already been
ruptured. - Answers -3 It is considered negative if no late decelerations are observed
with the contractions.
No late decelerations indicate a negative CST. Vibroacoustic stimulation is sometimes
used with NST. CST is invasive if stimulation is by IV oxytocin but not if by nipple
stimulation. CST is contraindicated if the membranes have ruptured.
The nurse is performing a nonstress test (NST) on a patient who is at 37 weeks of
gestation. The nurse notes the fetal heart rate is increased at 12 bpm above the
baseline and stays elevated for 20 seconds with fetal movement. How should the nurse
document this assessment?
1 Accelerations
2 Decelerations
3 Poor fetal reaction
4 Bradycardia - Answers -1 Accelerations
Discharge instructions after a CVS should include avoiding exercise for 24 hours. The
patient should rest for 24 hours, not 72. Sexual intercourse should be avoided for 24
hours, not 2 weeks. Passage of clots from the vagina is an abnormal finding that should
be reported
Which is a complication related to percutaneous umbilical blood sampling (PUBS)?
1 Fetal tachycardia
2 Decreased fetal lung maturity
3 Post-term labor
4 Thrombosis - Answers -4 Thrombosis
PUBS increases the risk of thrombosis formation. Fetal bradycardia, not tachycardia, is
a complication of PUBS. Decreased fetal lung maturity is not a complication of PUBS.
Preterm, not postterm, labor is a complication of PUBS.
The nurse notes a patient had a reactive nonstress test (NST). How should the nurse
interpret this test result?
1 There were two or more fetal heart rate decelerations within a 15-minute period.
2 There was a fetal heart rate deceleration that lasted for at least 1 minute.
3 There was a fetal heart rate acceleration that lasted for 4 minutes.
4 There were two or more fetal heart rate accelerations within a 20-minute period. -
Answers -4 There were two or more fetal heart rate accelerations within a 20-minute
period.
A reactive NST is defined as having two or more fetal heart rate accelerations within a
20-minute period. This is a normal finding. A deceleration, whether over 15 minutes or 1
minute, is when the fetal heart rate decreases; this is not a reactive NST. A 4-minute
fetal heart rate acceleration is not a reactive NST; it is too long.
The nurse is preparing to draw a blood sample for a multiple-marker screening on a
pregnant patient. The nurse understands that which factor predisposes the fetus to the
highest risk of a neural tube defect (NTD), but may have a lower alpha-fetoprotein
(AFP) level?
1
Race
,2
Asthma
3
Systemic lupus
4
Type I diabetes - Answers -4 Type 1 Diabetes
Women with type 1 diabetes have a greater risk for a fetus with an NTD but have a
lower AFP level. Black women have a lower risk for a baby with an NTD but a higher
AFP level than other ethnic groups. Asthma and systemic lupus are not associated with
NTDs or abnormal AFP levels.
The nurse is teaching a patient in the second trimester about fetal kick count. Which
statement by the patient needs correction?
1 "I should count the fetal kicks once a day for 60 minutes."
2 "I may not feel any movements when the fetus is sleeping."
3 "I should count the fetal kicks either after meals or before bedtime."
4 "I should consult an obstetrician if the fetal movements are less than 10 in 1 hour." -
Answers -4 "I should consult an obstetrician if the fetal movements are less than 10 in 1
hour."
The fetal movement count helps monitor the condition of the fetus. If the fetal
movements are less than three in 1 hour, it indicates a risk of abnormality. Therefore,
less than 10 fetal movements in an hour may not be abnormal and the patient may not
need to consult the obstetrician. The patient should count fetal kicks at least once a day
for a period of 60 minutes because it helps assess fetal activity. Fetal movements are
usually not present during the fetal sleep cycle. The patient can count the fetal kicks
either after meals or before bedtime when fetal movements are typically highest.
The nurse is performing a contraction stress test (CST) and notes no late decelerations.
How should the nurse interpret this test result?
1 Negative CST
2 Positive CST
3 Suspicious CST
4 Equivocal CST - Answers -1 Negative CST
A negative CST describes a fetal heart rate response to contractions with no
decelerations. A positive CST describes a fetal heart rate deceleration with a minimum
of 50% of the contractions. A suspicious or equivocal response describes intermittent
late decelerations or a sudden decrease in fetal heart rate that quickly returns to the
baseline.
The levels of which hormones and proteins are measured in a triple screen maternal
serum test? Select all that apply.
1
Human chorionic gonadotropin (hCG)
, 2
Alpha-fetoprotein (AFP)
3
Unconjugated estriol (uE3)
4
Hemoglobin
5
Bilirubin - Answers -1,2,3
The hormones and proteins that are measured in a triple screen are hCG, AFP, and
uE3. Hemoglobin and bilirubin are not measured in a triple screen.
How is percutaneous umbilical blood sampling (PUBS) performed?
1
A long needle is inserted through the abdomen into the umbilical vein.
2
A transducer probe is inserted into the vagina.
3
A Doppler ultrasound transducer is placed on the abdomen.
4
A long needle is inserted through the abdomen into the amniotic sac. - Answers -1 A
long needle is inserted through the abdomen into the umbilical vein.
PUBS is performed by inserting a long needle through the abdomen into the umbilical
vein. Transvaginal ultrasound is performed by inserting a transducer probe into the
vagina. A transabdominal ultrasound transducer is performed by placing a Doppler
ultrasound on the abdomen. An amniocentesis is performed by inserting a long needle
through the abdomen into the amniotic sac.
What does a nurse providing care for the antepartum woman need to understand about
the contraction stress test (CST)?
1
It sometimes uses vibroacoustic stimulation.
2
It is an invasive test; however, contractions are stimulated.
3
It is considered negative if no late decelerations are observed with the contractions.
4
It is more effective than nonstress test (NST) if the membranes have already been
ruptured. - Answers -3 It is considered negative if no late decelerations are observed
with the contractions.
No late decelerations indicate a negative CST. Vibroacoustic stimulation is sometimes
used with NST. CST is invasive if stimulation is by IV oxytocin but not if by nipple
stimulation. CST is contraindicated if the membranes have ruptured.
