1.
A 20-year-old female client comes to the clinic due to abdominal cramping. She informs the nurse midwife that it is more than a month and a half past
... [Show More] the date of her expected menstrual period. The client’s human chorionic gonotropin level is 5,500 mIU/mL. Pregnancy is suspected. Which diagnostic test should the nurse midwife order to obtain the most accurate diagnosis of pregnancy at this time?
A. Transabdominal ultrasound
B. Transvaginal ultrasound
C. Serum progesterone
D. Serum estrogen
EXPLANATION
Answer: B - The nurse midwife orders a transvaginal ultrasound to verify the pregnancy. Transvaginal ultrasound or TVU is considered the most accurate means of verifying pregnancy during the early first trimester. Transabdominal ultrasound may be ordered when the hCG level is greater than 6,500 mIU/mL. Intrauterine gestation can only be visualized if the amount of hCG is above the this level. A TVU can detect pregnancy once the hCG level is between 1,000 and 1,500 mIU/mL. Serum progesterone is a useful addition for evaluating abnormal early pregnancies.
2.
A 25-year-old female client at 10 weeks’ gestation comes to the clinic for her first prenatal visit. It is the client’s first pregnancy. The client is concerned about the chances of her child developing Down syndrome. The client’s medical and family history is not remarkable. When the client asks about the risk factors associated with Down syndrome, which of the following statements by the nurse midwife is the most accurate?
A. "The risk of having a baby with Down syndrome is high in women who got pregnant below the age of 18 years."
B. "The age of the father does not affect the child’s risk of developing Down syndrome; it is the age of the mother that mainly influences the child’s risk."
C. "Women who have a history of three first trimester spontaneous abortions not due to hormonal deficiencies or incompetent cervix are at risk of having babies with Down syndrome."
D. "A woman who has a child with Down syndrome neither decreases nor increases her chances of having a child with the same diagnosis."
EXPLANATION
Answer: C - Women who have a history of three first trimester abortions not due to hormonal deficiencie [Show Less]