NURS 320 Chapter 26: Assessment of High Risk Pregnancy
Lowdermilk: Maternity & Women’s Health Care, 12th Edition
MULTIPLE CHOICE
1. A woman
... [Show More] 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?
2. A 39-year-old primigravida woman believes that she is approximately 8 weeks pregnant, although she has had irreguNlaUr RmSenIstNruGaTl pBer.ioCdOs aMll 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?
3. 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?
4. A 41-week pregnant multigravida arrives at the labor and delivery unit after testing indicated that her fetus couNld bRe exIperGiencBin.gCsomMe difficulties in utero. Which diagnostic tool yields more detailed information about the condition of the fetus?
5. 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?
6. 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?
7. An Maternal Serum Alpha-Fetoprotein Screening (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?
8. 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 heart rate of approximately 120 beats per minute without any decelerations. What is the correct interpretation of this test?
9. In comparing the abdominal and transvaginal methods of ultrasound examination, which information should the nurse provide to the client?
PTS: 1 DIF: Cognitive Level: Remember TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
10. Which clinical finding is a major use of ultrasonography in the first trimester?
a. Amniotic fluid volume
b. Presence of maternal abnormalities
c. Placental location and maturity
d. Cervical length
ANS: B
Ultrasonography can detect certain uterine abnormalities such as bicornuate uterus, fibroids, and ovarian cysts. Amniotic fluid volume, placental location and maturity, and cervical length are not available via ultrasonography until the second or third trimester.
PTS: 1 DIF: Cognitive Level: Remember
TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
11. Which information is the highest priority for the nurse to comprehend regarding the biophysical profile (BPP)?
12. A client in the third trimester has just undergone an amniocentesis to determine fetal lung maturity. Which statement regarding this testing is important for the nurse in formulating a care plan?
13. Which information is an important consideration when comparing the contraction stress test (CST) with the nonstress test (NST)?
14. The nurse is planning the cNare Rfor aIlabGoriBng.cClienMt with diabetes mellitus. This client is at greater risk for which clinical finding?
15. Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy. Which statement regarding monitoring techniques is the most accurate?
a. Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis. [Show Less]