(GCU) NSG-432 NURSING CARE OF THE CHILD BEARING
FAMILY COMPREHENSIVE EXAM GUIDE GUARANTEED
SUCCESS
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
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.
, (GCU) NSG-432 NURSING CARE OF THE CHILD BEARING
FAMILY COMPREHENSIVE EXAM GUIDE GUARANTEED
SUCCESS
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)
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
, (GCU) NSG-432 NURSING CARE OF THE CHILD BEARING
FAMILY COMPREHENSIVE EXAM GUIDE GUARANTEED
SUCCESS
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
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
, (GCU) NSG-432 NURSING CARE OF THE CHILD BEARING
FAMILY COMPREHENSIVE EXAM GUIDE GUARANTEED
SUCCESS
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)
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
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