NSG 432 Final Exam questions well
answered
A woman arrives at the clinic seeking confirmation that she is pregnant. The following
information is obtained: She is 24 years old with a body mass index (BMI) of 17.5. She admits to
having used cocaine ―several times‖ during the past year and drinks alcohol occasionally. Her
blood pressure (BP) is 108/70 mm Hg, her pulse rate is 72 beats/min, and her respiratory rate is
16 breaths/min. The family history is positive for diabetes mellitus and cancer. Her sister
recently gave birth to an infant with a neural tube defect (NTD). Which characteristics place the
woman in a high risk category?
a. Blood pressure, age, and BMI
b. Drug/alcohol use, age, and family history
c. Family history, blood pressure, and BMI
d. Family history, BMI, and drug/alcohol abuse - correct answer ✔✔ Family history, BMI, and
drug/alcohol abuse
Her family history of NTD, low BMI, and substance abuse all are high risk factors of pregnancy.
The woman's BP is normal, and her age does not put her at risk. Her BMI is low and may
indicate poor nutritional status, which would be a high risk. The woman's drug/alcohol use and
family history put her in a high risk category, but her age does not. The woman's family history
puts her in a high risk category. Her BMI is low and may indicate poor nutritional status, which
would be high risk. Her BP is normal.
A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had
irregular menstrual periods all her life. She has a history of smoking approximately one pack of
cigarettes a day, but she tells you that she is trying to cut down. Her laboratory data are within
normal limits. What diagnostic technique could be used with this pregnant woman at this time?
a. Ultrasound examination
b. Maternal serum alpha-fetoprotein (MSAFP) screening
c. Amniocentesis
,d. Nonstress test (NST) - correct answer ✔✔ Ultrasound examination
An ultrasound examination could be done to confirm the pregnancy and determine the
gestational age of the fetus. It is too early in the pregnancy to perform MSAFP screening,
amniocentesis, or NST. MSAFP screening is performed at 16 to 18 weeks of gestation, followed
by amniocentesis if MSAFP levels are abnormal or if fetal/maternal anomalies are detected. NST
is performed to assess fetal well-being in the third trimester.
The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has
smoked throughout the pregnancy, and fundal height measurements now are suggestive of
growth restriction in the fetus. In addition to ultrasound to measure fetal size, what other tool
would be useful in confirming the diagnosis?
a. Doppler blood flow analysis
b. Contraction stress test (CST)
c. Amniocentesis
d. Daily fetal movement counts - correct answer ✔✔ Doppler blood flow analysis
Doppler blood flow analysis allows the examiner to study the blood flow noninvasively in the
fetus and the placenta. It is a helpful tool in the management of high risk pregnancies because
of intrauterine growth restriction (IUGR), diabetes mellitus, multiple fetuses, or preterm labor.
Because of the potential risk of inducing labor and causing fetal distress, CST is not performed
on a woman whose fetus is preterm. Indications for amniocentesis include diagnosis of genetic
disorders or congenital anomalies, assessment of pulmonary maturity, and diagnosis of fetal
hemolytic disease, not IUGR. Fetal kick count monitoring is performed to monitor the fetus in
pregnancies complicated by conditions that may affect fetal oxygenation. Although this may be
a useful tool at some point later in this woman's pregnancy, it is not used to diagnose IUGR.
A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test
indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool
would yield more detailed information about the fetus?
a. Ultrasound for fetal anomalies
b. Biophysical profile (BPP)
,c. Maternal serum alpha-fetoprotein (MSAFP) screening
d. Percutaneous umbilical blood sampling (PUBS) - correct answer ✔✔ Biophysical profile (BPP)
Real-time ultrasound permits detailed assessment of the physical and physiologic characteristics
of the developing fetus and cataloging of normal and abnormal biophysical responses to stimuli.
BPP is a noninvasive, dynamic assessment of a fetus that is based on acute and chronic markers
of fetal disease. An ultrasound for fetal anomalies would most likely have been performed
earlier in the pregnancy. It is too late in the pregnancy to perform MSAFP screening. Also,
MSAFP screening does not provide information related to fetal well-being. Indications for PUBS
include prenatal diagnosis or inherited blood disorders, karyotyping of malformed fetuses,
detection of fetal infection, determination of the acid-base status of a fetus with IUGR, and
assessment and treatment of isoimmunization and thrombocytopenia in the fetus.
A 40-year-old woman is 10 weeks pregnant. Which diagnostic tool would be appropriate to
suggest to her at this time?
a. Biophysical profile (BPP)
b. Amniocentesis
c. Maternal serum alpha-fetoprotein (MSAFP) screening
d. Transvaginal ultrasound - correct answer ✔✔ Transvaginal ultrasound
Ultrasound would be performed at this gestational age for biophysical assessment of the infant.
BPP would be a method of biophysical assessment of fetal well-being in the third trimester.
Amniocentesis is performed after the 14th week of pregnancy. MSAFP screening is performed
from week 15 to week 22 of gestation (weeks 16 to 18 are ideal).
A patient asks her nurse, ―My doctor told me that he is concerned with the grade of my
placenta because I am overdue. What does that mean?‖ The best response by the nurse is
a. ―Your placenta changes as your pregnancy progresses, and it is given a score that indicates
the amount of calcium deposits it has. The more calcium deposits, the higher the grade, or
number, that is assigned to the placenta. It also means that less blood and oxygen can be
delivered to your baby.‖
, b. ―Your placenta isn't working properly, and your baby is in danger.‖
c. ―This means that we will need to perform an amniocentesis to detect if you have any
placental damage.‖
d. ―Don't worry about it. Everything is fine.‖ - correct answer ✔✔ Your placenta changes as
your pregnancy progresses, and it is given a score that indicates the amount of calcium deposits
it has. The more calcium deposits, the higher the grade, or number, that is assigned to the
placenta. It also means that less blood and oxygen can be delivered to your baby.‖
An accurate and appropriate response is, ―Your placenta changes as your pregnancy
progresses, and it is given a score that indicates the amount of calcium deposits it has. The
more calcium deposits, the higher the grade, or number, that is assigned to the placenta. It also
means that less blood and oxygen can be delivered to your baby.‖ Although ―Your placenta
isn't working properly, and your baby is in danger‖ may be valid, it does not reflect therapeutic
communication techniques and is likely to alarm the patient. An ultrasound, not an
amniocentesis, is the method of assessment used to determine placental maturation. The
response ―Don't worry about it. Everything is fine‖ is not appropriate and discredits the
patient's concerns.
A woman is undergoing a nipple-stimulated contraction stress test (CST). She is having
contractions that occur every 3 minutes. The fetal heart rate (FHR) has a baseline of
approximately 120 beats/min without any decelerations. The interpretation of this test is said to
be
a. negative.
b. positive.
c. satisfactory.
d. unsatisfactory. - correct answer ✔✔ negative.
Adequate uterine activity necessary for a CST consists of the presence of three contractions in a
10-minute time frame. If no decelerations are observed in the FHR pattern with the
contractions, the findings are considered to be negative. A positive CST indicates the presence
of repetitive later FHR decelerations. Satisfactory and unsatisfactory are not applicable terms.
answered
A woman arrives at the clinic seeking confirmation that she is pregnant. The following
information is obtained: She is 24 years old with a body mass index (BMI) of 17.5. She admits to
having used cocaine ―several times‖ during the past year and drinks alcohol occasionally. Her
blood pressure (BP) is 108/70 mm Hg, her pulse rate is 72 beats/min, and her respiratory rate is
16 breaths/min. The family history is positive for diabetes mellitus and cancer. Her sister
recently gave birth to an infant with a neural tube defect (NTD). Which characteristics place the
woman in a high risk category?
a. Blood pressure, age, and BMI
b. Drug/alcohol use, age, and family history
c. Family history, blood pressure, and BMI
d. Family history, BMI, and drug/alcohol abuse - correct answer ✔✔ Family history, BMI, and
drug/alcohol abuse
Her family history of NTD, low BMI, and substance abuse all are high risk factors of pregnancy.
The woman's BP is normal, and her age does not put her at risk. Her BMI is low and may
indicate poor nutritional status, which would be a high risk. The woman's drug/alcohol use and
family history put her in a high risk category, but her age does not. The woman's family history
puts her in a high risk category. Her BMI is low and may indicate poor nutritional status, which
would be high risk. Her BP is normal.
A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had
irregular menstrual periods all her life. She has a history of smoking approximately one pack of
cigarettes a day, but she tells you that she is trying to cut down. Her laboratory data are within
normal limits. What diagnostic technique could be used with this pregnant woman at this time?
a. Ultrasound examination
b. Maternal serum alpha-fetoprotein (MSAFP) screening
c. Amniocentesis
,d. Nonstress test (NST) - correct answer ✔✔ Ultrasound examination
An ultrasound examination could be done to confirm the pregnancy and determine the
gestational age of the fetus. It is too early in the pregnancy to perform MSAFP screening,
amniocentesis, or NST. MSAFP screening is performed at 16 to 18 weeks of gestation, followed
by amniocentesis if MSAFP levels are abnormal or if fetal/maternal anomalies are detected. NST
is performed to assess fetal well-being in the third trimester.
The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has
smoked throughout the pregnancy, and fundal height measurements now are suggestive of
growth restriction in the fetus. In addition to ultrasound to measure fetal size, what other tool
would be useful in confirming the diagnosis?
a. Doppler blood flow analysis
b. Contraction stress test (CST)
c. Amniocentesis
d. Daily fetal movement counts - correct answer ✔✔ Doppler blood flow analysis
Doppler blood flow analysis allows the examiner to study the blood flow noninvasively in the
fetus and the placenta. It is a helpful tool in the management of high risk pregnancies because
of intrauterine growth restriction (IUGR), diabetes mellitus, multiple fetuses, or preterm labor.
Because of the potential risk of inducing labor and causing fetal distress, CST is not performed
on a woman whose fetus is preterm. Indications for amniocentesis include diagnosis of genetic
disorders or congenital anomalies, assessment of pulmonary maturity, and diagnosis of fetal
hemolytic disease, not IUGR. Fetal kick count monitoring is performed to monitor the fetus in
pregnancies complicated by conditions that may affect fetal oxygenation. Although this may be
a useful tool at some point later in this woman's pregnancy, it is not used to diagnose IUGR.
A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test
indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool
would yield more detailed information about the fetus?
a. Ultrasound for fetal anomalies
b. Biophysical profile (BPP)
,c. Maternal serum alpha-fetoprotein (MSAFP) screening
d. Percutaneous umbilical blood sampling (PUBS) - correct answer ✔✔ Biophysical profile (BPP)
Real-time ultrasound permits detailed assessment of the physical and physiologic characteristics
of the developing fetus and cataloging of normal and abnormal biophysical responses to stimuli.
BPP is a noninvasive, dynamic assessment of a fetus that is based on acute and chronic markers
of fetal disease. An ultrasound for fetal anomalies would most likely have been performed
earlier in the pregnancy. It is too late in the pregnancy to perform MSAFP screening. Also,
MSAFP screening does not provide information related to fetal well-being. Indications for PUBS
include prenatal diagnosis or inherited blood disorders, karyotyping of malformed fetuses,
detection of fetal infection, determination of the acid-base status of a fetus with IUGR, and
assessment and treatment of isoimmunization and thrombocytopenia in the fetus.
A 40-year-old woman is 10 weeks pregnant. Which diagnostic tool would be appropriate to
suggest to her at this time?
a. Biophysical profile (BPP)
b. Amniocentesis
c. Maternal serum alpha-fetoprotein (MSAFP) screening
d. Transvaginal ultrasound - correct answer ✔✔ Transvaginal ultrasound
Ultrasound would be performed at this gestational age for biophysical assessment of the infant.
BPP would be a method of biophysical assessment of fetal well-being in the third trimester.
Amniocentesis is performed after the 14th week of pregnancy. MSAFP screening is performed
from week 15 to week 22 of gestation (weeks 16 to 18 are ideal).
A patient asks her nurse, ―My doctor told me that he is concerned with the grade of my
placenta because I am overdue. What does that mean?‖ The best response by the nurse is
a. ―Your placenta changes as your pregnancy progresses, and it is given a score that indicates
the amount of calcium deposits it has. The more calcium deposits, the higher the grade, or
number, that is assigned to the placenta. It also means that less blood and oxygen can be
delivered to your baby.‖
, b. ―Your placenta isn't working properly, and your baby is in danger.‖
c. ―This means that we will need to perform an amniocentesis to detect if you have any
placental damage.‖
d. ―Don't worry about it. Everything is fine.‖ - correct answer ✔✔ Your placenta changes as
your pregnancy progresses, and it is given a score that indicates the amount of calcium deposits
it has. The more calcium deposits, the higher the grade, or number, that is assigned to the
placenta. It also means that less blood and oxygen can be delivered to your baby.‖
An accurate and appropriate response is, ―Your placenta changes as your pregnancy
progresses, and it is given a score that indicates the amount of calcium deposits it has. The
more calcium deposits, the higher the grade, or number, that is assigned to the placenta. It also
means that less blood and oxygen can be delivered to your baby.‖ Although ―Your placenta
isn't working properly, and your baby is in danger‖ may be valid, it does not reflect therapeutic
communication techniques and is likely to alarm the patient. An ultrasound, not an
amniocentesis, is the method of assessment used to determine placental maturation. The
response ―Don't worry about it. Everything is fine‖ is not appropriate and discredits the
patient's concerns.
A woman is undergoing a nipple-stimulated contraction stress test (CST). She is having
contractions that occur every 3 minutes. The fetal heart rate (FHR) has a baseline of
approximately 120 beats/min without any decelerations. The interpretation of this test is said to
be
a. negative.
b. positive.
c. satisfactory.
d. unsatisfactory. - correct answer ✔✔ negative.
Adequate uterine activity necessary for a CST consists of the presence of three contractions in a
10-minute time frame. If no decelerations are observed in the FHR pattern with the
contractions, the findings are considered to be negative. A positive CST indicates the presence
of repetitive later FHR decelerations. Satisfactory and unsatisfactory are not applicable terms.
