NURS 313 Exam 4 UPDATED ACTUAL Questions and CORRECT
Answers
Question: Ultrasound
Correct Answer: accuracy dependent on individual performing exam - produes images called sonograms -
only identifies certain compoonents - standard in the 2nd or 3rd trimester - specialized or detailed when
anomaly suspected
Question: Transabdominal ultrasound
Correct Answer: full bladdeer to assess more structures - painless procedure over 20-30 minutes
Question: Transvaginal ultrasound
Correct Answer: can identify cervical length, funneling (any cervical insufficiencies) - lithotomy position
- most women do not feel discomfort, as probe is smaller than speculum - empty bladder
Question: Structures identified in a transvaginal ultrasound
Correct Answer: gestational sac - pressence or absence of yolk sack or embryo - crown rump length (CRL)
for accurate gestational age dating - presence of cardiac activity - fetal number - maternal anatomy (uterus,
cervix, and adnexal structures)
Question: Structures identified in a transabdominal ultrasound
Correct Answer: vagina - cervix - bladder
Question: Purpose of transvaginal ultrasound
Correct Answer: facilitate chorionic villus sampling (CVS) - identify serial cervical insufficiency -
cervical length and cervical funneling (a cone-shaped indentation in the cervical os
Question: Purpose of transabdominal ultrasound
Correct Answer: amniocentesis - routine fetal assessment of anatomy
Question: Alpha-fetoprotein (AFP)
Correct Answer: elevated AFP levels indicate an increased risk of neural tube defects (NTD) - folic acid
can prevent NTD: all pregnant take 400mcg daily, at risk take up to 4000mcg
Question: What kind of patients are at risk for neural tube defects?
Correct Answer: hx of previous child with NTD or other family hx - type 1 DM - seizure disorders
Question: Nonstress test
Correct Answer: accelerations imply intact CNS - accelerations affected by gestational age - accelerations
must be 15 beats/minute above baseline, lasting 15 seconds if >32 weeks; <32 weeks 10 beats/minute above
baseline lasting 10 seconds - procedure performed during daytime hours to a nonfasting woman in
semi-fowler's position with the right hip up - bladder should be voided before procedure
Question: Interpretation of NST
Correct Answer: reactive: 2 or more accelerations within 20 minutes - nonreactive: insufficient
accelerations over 40 minutes
Question: Contraction stress tet
, Correct Answer: evaluates uteroplacental function - identifies intrauterine hypoxia - observes FHR
response to contractions
Question: What is the desired contraction stress test with NST result?
Correct Answer: negative CST with reactive NST
Question: What could a positive CST with a nonreactive NST result in?
Correct Answer: fetus would probably not withstand labor - needs to be verified
Question: Biophysical profile
Correct Answer: done in the US for a high-risk pregnancy or when there is a concern: - fetal heart rate
acceleration - fetal breathing - fetal movements - fetal tones - amniotic fluid volume
Question: BPP
Correct Answer: fetal breathing movements score: - Normal (2): greater than or equal to one episode of
rhythmic breathing lasting greater than or equal to 30 seconds within 30 minutes - Abnormal (0): less than
30 seconds of breathing in 30 minutes
Question: BPP
Correct Answer: gross body movements score: - Normal (2): greater than or equal to 3 discrete body or
limb movements in 30 minutes (episodes of active continuous movement considered as single movement) -
Abnormal (0): Less than or equal to 2 movements in 30 minutes
Question: BPP
Correct Answer: fetal tone score: - Normal (2): greater than or equal to 1 episode of extension of a fetal
extremity with return to flexion, or opening or closing of the hand - Abnormal (0): no movements or
extension/flexion
Question: BPP
Correct Answer: reactive fetal heart rate nonstress test score: - Normal (2): greater than or equal to 2
accelerations of greater than or equal to 15 beats/min for greater than or equal to 15 seconds in 20-40
minutes - Abnormal (0): 0 or 1 acceleration in 20-40 minutes
Question: BPP
Correct Answer: amniotic fluid volume score: - Normal (2): at least one pocket of amniotic fluid of at least
2 cm AFI>5 - Abnormal (0): Less than one pocket of amniotic fluid measuring less than 2 cm
Question: BPP interpretation and recommended management
Correct Answer: score : - reactive NST - normal nonasphxiated fetus - less than - no fetal indication for
intervention; repeat test weekly except in patients with diabetes and pregnancies that are postterm (2 times
weekly)
Question: BPP interpretation and recommended management
Correct Answer: score (normal fluid): - risk of fetal asphyxia extremely rare - less than - no fetal
indication for intervention; repeat test weekly except in patients with diabetes and pregnancies that are
postterm (2 times weekly)
Question: BPP interpretation and recommended management
Correct Answer: score (abnormal fluid): - chronic fetal asphyxia suspected - - management: induce birth
Answers
Question: Ultrasound
Correct Answer: accuracy dependent on individual performing exam - produes images called sonograms -
only identifies certain compoonents - standard in the 2nd or 3rd trimester - specialized or detailed when
anomaly suspected
Question: Transabdominal ultrasound
Correct Answer: full bladdeer to assess more structures - painless procedure over 20-30 minutes
Question: Transvaginal ultrasound
Correct Answer: can identify cervical length, funneling (any cervical insufficiencies) - lithotomy position
- most women do not feel discomfort, as probe is smaller than speculum - empty bladder
Question: Structures identified in a transvaginal ultrasound
Correct Answer: gestational sac - pressence or absence of yolk sack or embryo - crown rump length (CRL)
for accurate gestational age dating - presence of cardiac activity - fetal number - maternal anatomy (uterus,
cervix, and adnexal structures)
Question: Structures identified in a transabdominal ultrasound
Correct Answer: vagina - cervix - bladder
Question: Purpose of transvaginal ultrasound
Correct Answer: facilitate chorionic villus sampling (CVS) - identify serial cervical insufficiency -
cervical length and cervical funneling (a cone-shaped indentation in the cervical os
Question: Purpose of transabdominal ultrasound
Correct Answer: amniocentesis - routine fetal assessment of anatomy
Question: Alpha-fetoprotein (AFP)
Correct Answer: elevated AFP levels indicate an increased risk of neural tube defects (NTD) - folic acid
can prevent NTD: all pregnant take 400mcg daily, at risk take up to 4000mcg
Question: What kind of patients are at risk for neural tube defects?
Correct Answer: hx of previous child with NTD or other family hx - type 1 DM - seizure disorders
Question: Nonstress test
Correct Answer: accelerations imply intact CNS - accelerations affected by gestational age - accelerations
must be 15 beats/minute above baseline, lasting 15 seconds if >32 weeks; <32 weeks 10 beats/minute above
baseline lasting 10 seconds - procedure performed during daytime hours to a nonfasting woman in
semi-fowler's position with the right hip up - bladder should be voided before procedure
Question: Interpretation of NST
Correct Answer: reactive: 2 or more accelerations within 20 minutes - nonreactive: insufficient
accelerations over 40 minutes
Question: Contraction stress tet
, Correct Answer: evaluates uteroplacental function - identifies intrauterine hypoxia - observes FHR
response to contractions
Question: What is the desired contraction stress test with NST result?
Correct Answer: negative CST with reactive NST
Question: What could a positive CST with a nonreactive NST result in?
Correct Answer: fetus would probably not withstand labor - needs to be verified
Question: Biophysical profile
Correct Answer: done in the US for a high-risk pregnancy or when there is a concern: - fetal heart rate
acceleration - fetal breathing - fetal movements - fetal tones - amniotic fluid volume
Question: BPP
Correct Answer: fetal breathing movements score: - Normal (2): greater than or equal to one episode of
rhythmic breathing lasting greater than or equal to 30 seconds within 30 minutes - Abnormal (0): less than
30 seconds of breathing in 30 minutes
Question: BPP
Correct Answer: gross body movements score: - Normal (2): greater than or equal to 3 discrete body or
limb movements in 30 minutes (episodes of active continuous movement considered as single movement) -
Abnormal (0): Less than or equal to 2 movements in 30 minutes
Question: BPP
Correct Answer: fetal tone score: - Normal (2): greater than or equal to 1 episode of extension of a fetal
extremity with return to flexion, or opening or closing of the hand - Abnormal (0): no movements or
extension/flexion
Question: BPP
Correct Answer: reactive fetal heart rate nonstress test score: - Normal (2): greater than or equal to 2
accelerations of greater than or equal to 15 beats/min for greater than or equal to 15 seconds in 20-40
minutes - Abnormal (0): 0 or 1 acceleration in 20-40 minutes
Question: BPP
Correct Answer: amniotic fluid volume score: - Normal (2): at least one pocket of amniotic fluid of at least
2 cm AFI>5 - Abnormal (0): Less than one pocket of amniotic fluid measuring less than 2 cm
Question: BPP interpretation and recommended management
Correct Answer: score : - reactive NST - normal nonasphxiated fetus - less than - no fetal indication for
intervention; repeat test weekly except in patients with diabetes and pregnancies that are postterm (2 times
weekly)
Question: BPP interpretation and recommended management
Correct Answer: score (normal fluid): - risk of fetal asphyxia extremely rare - less than - no fetal
indication for intervention; repeat test weekly except in patients with diabetes and pregnancies that are
postterm (2 times weekly)
Question: BPP interpretation and recommended management
Correct Answer: score (abnormal fluid): - chronic fetal asphyxia suspected - - management: induce birth
