ANS: A
1. A 39-year-old primigravida
An ultrasound examination could be performed to confirm the preg-
woman believes that she
nancy and to determine the gestational age of the fetus. An MSAFP
is approximately 8 weeks
screening is performed at 16 to 18 weeks of gestation; therefore, it is
pregnant, although she
has had irregular menstru- too early in the woman's pregnancy to perform this diagnostic test.
al periods all her life. She An amniocentesis is performed if the MSAFP levels are abnormal or
has a history of smoking if fetal or maternal anomalies are detected. An NST is performed to
approximately one pack of assess fetal well-being in the third trimester.
cigarettes a day; however,
she tells the nurse that she
is trying to cut down. Her
laboratory data are within
normal limits. What diag-
nostic technique would be
useful at this time?
a. Ultrasound examination
b. Maternal serum al-
pha-fetoprotein (MSAFP)
screening
c. Amniocentesis
d. Nonstress test (NST)
2. A pregnant woman was ad- ANS: A
mitted for induction of la- membranes, thick meconi- um-stained
bor at 43 weeks of ges- fluid was not-
tation with sure dates. A
nonstress test (NST) in
the obstetrician's office re-
vealed a nonreactive trac-
ing. On artificial rupture of
, Lowdermilk Final Exam Study Guide Test.
Meconium aspiration, hypoglycemia, and
dry, cracked skin are con- sistent with a
postmature infant. Excessive vernix caseosa,
lethargy, and RDS are consistent with a very
premature infant. The skin may be
meconium stained, but the infant will most
likely have long hair and decreased amounts
of subcutaneous fat. Postmaturity with a
nonreactive NST is indicative of hypoxia.
Signs and symptoms asso- ciated with fetal
hypoxia are hypoglycemia, temperature
instability, and lethargy.
, Lowdermilk Final Exam Study Guide Test.
ed. What should the nurse
caring for the infant after
birth anticipate?
a. Meconium aspiration,
hypoglycemia, and dry,
cracked skin
b. Excessive vernix caseosa
covering the skin, lethargy,
and RDS
c. Golden yellow to
green-stained skin and
nails, absence of scalp hair,
and an increased amount
of subcutaneous fat
d. Hyperglycemia, hyper-
thermia, and an alert,
wide-eyed appearance
3. A woman's obstetric his- ANS: B
tory indicates that she is Using the GTPAL system, 4-1-2-0-4 is the correct calculation of this
pregnant for the fourth woman's gravidity and parity. The numbers reflect the woman's
time, and all of her chil- gravidity and parity information. Her information is calculated as: G
dren from previous preg- reflects the total number of times the woman has been pregnant;
nancies are living. One was she is pregnant for the fourth time. T indicates the number of preg-
born at 39 weeks of gesta- nancies carried to term, not the number of deliveries at term; only
tion, twins were born at 34 one of her pregnancies resulted in a fetus at term. P is the number
weeks of gestation, and an- of pregnancies that resulted in a preterm birth; the woman has had
other child was born at 35 two pregnancies in which she delivered preterm. A signifies whether
weeks of gestation. What is the woman has had any abortions or miscarriages before the period
her gravidity and parity us- of viability; she has not. L signifies the number of children born who
ing the GTPAL system? a. 3-1-1-1-3