ADVANCED WOMEN'S HEALTH
FINAL EXAM TEST BANK
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 occasionally drinks alcohol. Her blood pressure is 108/70 mm
Hg. 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 places this client in a high-risk category?
a. Blood pressure, age, BMI
b. Drug and alcohol use, age, family history
c. Family history, blood pressure (BP), BMI
d. Family history, BMI, drug and alcohol abuse
- CORRECT ANSWER -d. Family history, BMI, drug and alcohol abuse
A 39-year-old primigravida woman believes that she is approximately 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; however, she tells the nurse that she is trying to cut down. Her laboratory data are
within normal limits. What diagnostic technique would be useful at this time?
a. Ultrasound examination
b. Maternal serum alpha-fetoprotein (MSAFP) screening
c. Amniocentesis
d. Nonstress test (NST)
- CORRECT ANSWER -a. Ultrasound examination
,The nurse sees a woman for the first time when she is 30 weeks pregnant. The client has smoked
throughout the pregnancy, and fundal height measurements now are suggestive of intrauterine growth
restriction (IUGR) in the fetus. In addition to ultrasound to measure fetal size, what is another tool
useful in confirming the diagnosis?
a. Doppler blood flow analysis
b. Contraction stress test (CST)
c. Amniocentesis
d. Daily fetal movement counts
- CORRECT ANSWER -a. Doppler blood flow analysis
A 41-week pregnant multigravida arrives at the labor and delivery unit after a NST indicated that her
fetus could be experiencing some difficulties in utero. Which diagnostic tool yields more detailed
information about the condition of the fetus?
a. Ultrasound for fetal anomalies
b. Biophysical profile (BPP)
c. MSAFP screening
d. Percutaneous umbilical blood sampling (PUBS) - CORRECT ANSWER -b. Biophysical profile (BPP)
At 35 weeks of pregnancy, a woman experiences preterm labor. Although tocolytic medications are
administered and she is placed on bed rest, she continues to experience regular uterine contractions
and her cervix is beginning to dilate and efface. What is an important test for fetal well-being at this
time?
a. PUBS
b. Ultrasound for fetal size
c. Amniocentesis for fetal lung maturity
d. NST
- CORRECT ANSWER -c. Amniocentesis for fetal lung maturity
,A 30-year-old gravida 3, para 2-0-0-2 is at 18 weeks of gestation. Which screening test should the nurse
recommend be ordered for this client?
a. BPP
b. Chorionic villi sampling
c. MSAFP screening
d. Screening for diabetes mellitus
- CORRECT ANSWER -c. MSAFP screening
The biochemical assessment MSAFP test is performed from week 15 to week 20 of gestation (weeks 16
to 18 are ideal). A BPP is a method of biophysical assessment of fetal well-being in the third trimester.
Chorionic villi sampling is a biochemical assessment of the fetus that should be performed from the 10th
to 12th weeks of gestation. Screening for diabetes mellitus begins with the first prenatal visit.
An MSAFP screening indicates an elevated level of alpha-fetoprotein. The test is repeated, and again the
level is reported as higher than normal. What is the next step in the assessment sequence to determine
the well-being of the fetus?
a. PUBS
b. Ultrasound for fetal anomalies
c. BPP for fetal well-being
d. Amniocentesis for genetic anomalies
- CORRECT ANSWER -b. Ultrasound for fetal anomalies
If MSAFP findings are abnormal, then follow-up procedures include genetic counseling for families with
a history of NTD, repeated MSAFP screenings, an ultrasound examination, and possibly amniocentesis.
Indications for the use of PUBS include prenatal diagnosis of inherited blood disorders, karyotyping of
malformed fetuses, detection of fetal infection, determination of the acid-base status of fetuses with
IUGR, and assessment and treatment of isoimmunization and thrombocytopenia in the fetus. A BPP is a
method of assessing fetal well-being in the third trimester. Before an amniocentesis, the client would
have an ultrasound for direct visualization of the fetus.
, A client 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?" What is the nurse's best response?
a. "Your placenta changes as your pregnancy progresses, and it is given a score that indicates how well it
is functioning."
b. "Your placenta isn't working properly, and your baby is in danger."
c. "We need to perform an amniocentesis to detect if you have any placental damage."
d. "Don't worry about it. Everything is fine." - CORRECT ANSWER -a. "Your placenta changes as your
pregnancy progresses, and it is given a score that indicates how well it is functioning."
A woman is undergoing a nipple-stimulated CST. She is having contractions that occur every 3 minutes.
The fetal heart rate (FHR) has a baseline heart rate of approximately 120 beats per minute without any
decelerations. What is the correct interpretation of this test?
a. Negative
b. Positive
c. Satisfactory
d. Unsatisfactory
- CORRECT ANSWER -a. Negative
Adequate uterine activity necessary for a CST consists of three contractions in a 10-minute time frame. If
no decelerations are observed in the FHR pattern with the contractions, then the findings are
considered to be negative. A positive CST indicates the presence of repetitive late FHR decelerations.
The terms satisfactory or unsatisfactory are not applicable.
Of these psychosocial factors, which has the least negative effect on the health of the mother and/or
fetus?
a. Moderate coffee consumption
b. Moderate alcohol consumption
c. Cigarette smoke
d. Emotional distress
FINAL EXAM TEST BANK
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 occasionally drinks alcohol. Her blood pressure is 108/70 mm
Hg. 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 places this client in a high-risk category?
a. Blood pressure, age, BMI
b. Drug and alcohol use, age, family history
c. Family history, blood pressure (BP), BMI
d. Family history, BMI, drug and alcohol abuse
- CORRECT ANSWER -d. Family history, BMI, drug and alcohol abuse
A 39-year-old primigravida woman believes that she is approximately 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; however, she tells the nurse that she is trying to cut down. Her laboratory data are
within normal limits. What diagnostic technique would be useful at this time?
a. Ultrasound examination
b. Maternal serum alpha-fetoprotein (MSAFP) screening
c. Amniocentesis
d. Nonstress test (NST)
- CORRECT ANSWER -a. Ultrasound examination
,The nurse sees a woman for the first time when she is 30 weeks pregnant. The client has smoked
throughout the pregnancy, and fundal height measurements now are suggestive of intrauterine growth
restriction (IUGR) in the fetus. In addition to ultrasound to measure fetal size, what is another tool
useful in confirming the diagnosis?
a. Doppler blood flow analysis
b. Contraction stress test (CST)
c. Amniocentesis
d. Daily fetal movement counts
- CORRECT ANSWER -a. Doppler blood flow analysis
A 41-week pregnant multigravida arrives at the labor and delivery unit after a NST indicated that her
fetus could be experiencing some difficulties in utero. Which diagnostic tool yields more detailed
information about the condition of the fetus?
a. Ultrasound for fetal anomalies
b. Biophysical profile (BPP)
c. MSAFP screening
d. Percutaneous umbilical blood sampling (PUBS) - CORRECT ANSWER -b. Biophysical profile (BPP)
At 35 weeks of pregnancy, a woman experiences preterm labor. Although tocolytic medications are
administered and she is placed on bed rest, she continues to experience regular uterine contractions
and her cervix is beginning to dilate and efface. What is an important test for fetal well-being at this
time?
a. PUBS
b. Ultrasound for fetal size
c. Amniocentesis for fetal lung maturity
d. NST
- CORRECT ANSWER -c. Amniocentesis for fetal lung maturity
,A 30-year-old gravida 3, para 2-0-0-2 is at 18 weeks of gestation. Which screening test should the nurse
recommend be ordered for this client?
a. BPP
b. Chorionic villi sampling
c. MSAFP screening
d. Screening for diabetes mellitus
- CORRECT ANSWER -c. MSAFP screening
The biochemical assessment MSAFP test is performed from week 15 to week 20 of gestation (weeks 16
to 18 are ideal). A BPP is a method of biophysical assessment of fetal well-being in the third trimester.
Chorionic villi sampling is a biochemical assessment of the fetus that should be performed from the 10th
to 12th weeks of gestation. Screening for diabetes mellitus begins with the first prenatal visit.
An MSAFP screening indicates an elevated level of alpha-fetoprotein. The test is repeated, and again the
level is reported as higher than normal. What is the next step in the assessment sequence to determine
the well-being of the fetus?
a. PUBS
b. Ultrasound for fetal anomalies
c. BPP for fetal well-being
d. Amniocentesis for genetic anomalies
- CORRECT ANSWER -b. Ultrasound for fetal anomalies
If MSAFP findings are abnormal, then follow-up procedures include genetic counseling for families with
a history of NTD, repeated MSAFP screenings, an ultrasound examination, and possibly amniocentesis.
Indications for the use of PUBS include prenatal diagnosis of inherited blood disorders, karyotyping of
malformed fetuses, detection of fetal infection, determination of the acid-base status of fetuses with
IUGR, and assessment and treatment of isoimmunization and thrombocytopenia in the fetus. A BPP is a
method of assessing fetal well-being in the third trimester. Before an amniocentesis, the client would
have an ultrasound for direct visualization of the fetus.
, A client 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?" What is the nurse's best response?
a. "Your placenta changes as your pregnancy progresses, and it is given a score that indicates how well it
is functioning."
b. "Your placenta isn't working properly, and your baby is in danger."
c. "We need to perform an amniocentesis to detect if you have any placental damage."
d. "Don't worry about it. Everything is fine." - CORRECT ANSWER -a. "Your placenta changes as your
pregnancy progresses, and it is given a score that indicates how well it is functioning."
A woman is undergoing a nipple-stimulated CST. She is having contractions that occur every 3 minutes.
The fetal heart rate (FHR) has a baseline heart rate of approximately 120 beats per minute without any
decelerations. What is the correct interpretation of this test?
a. Negative
b. Positive
c. Satisfactory
d. Unsatisfactory
- CORRECT ANSWER -a. Negative
Adequate uterine activity necessary for a CST consists of three contractions in a 10-minute time frame. If
no decelerations are observed in the FHR pattern with the contractions, then the findings are
considered to be negative. A positive CST indicates the presence of repetitive late FHR decelerations.
The terms satisfactory or unsatisfactory are not applicable.
Of these psychosocial factors, which has the least negative effect on the health of the mother and/or
fetus?
a. Moderate coffee consumption
b. Moderate alcohol consumption
c. Cigarette smoke
d. Emotional distress
