TEST BANK: Womens Health A Primary Care Clinical Guide 5th Edition Youngkin Schadewald Pritham. All Chapters 1-26. Questions And Answers Plus Rationales in 150 Pages/ Rated A
Test Bank for Women's Health: A Primary Care Clinical Guide 5th Edition By Diane Schadewald; Ursula A. Pritham Chapter 1-26 Complete Guide
WOMENS HEALTH A PRIMARY CARE CLINICAL GUIDE 5TH EDITION YOUNGKIN SCHADEWALD
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Test Bank: Women's Health: A Primary Care Clinical Guide, 5th
Edition by Diane Schadewald - Chapters 1-26, 9780135458624
| Rationals Included
. A pregnant woman's BPP score is 8. She asks the nurse to explain the results. How should the nurse
respond at this time?
a. "The test results are within normal limits."
b. "Immediate delivery by cesarean birth is being considered."
c. "Further testing will be performed to determine the meaning of this score."
d. "An obstetric specialist will evaluate the results of this profile and, within the next week, will inform
you of your options regarding delivery."
- ANSWER: a. "The test results are within normal limits."
The normal biophysical score ranges from 8 to 10 points if the amniotic fluid volume is adequate. A
normal score allows conservative treatment of high-risk clients. Delivery can be delayed if fetal well-
being is indicated. Scores less than 4 should be investigated, and delivery could be initiated sooner
than planned. The results of the BPP are usually available immediately after the procedure is
performed. Since this score is within normal range, no further testing is required at this time.
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)
- 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
- 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) - 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
- 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
- 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
- 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." - 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
- 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
- ANSWER: a. Moderate coffee consumption
Which information should nurses provide to expectant mothers when teaching them how to evaluate
daily fetal movement counts (DFMCs)?
a. Alcohol or cigarette smoke can irritate the fetus into greater activity.
b. Kick counts should be taken every hour and averaged every 6 hours, with every other 6-hour
stretch off.
c. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours.
d. A count of less than four fetal movements in 1 hour warrants future evaluation.
- ANSWER: c. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours.
No movement in a 12-hour period is cause for investigation and possibly intervention. Alcohol and
cigarette smoke temporarily reduce fetal movement. The mother should count fetal activity (kick
counts) two or three times daily for 60 minutes each time. A count of less than 3 in 1 hour warrants
further evaluation by a NST.
In comparing the abdominal and transvaginal methods of ultrasound examination, which information
should the nurse provide to the client?
a. Both require the woman to have a full bladder.
b. The abdominal examination is more useful in the first trimester.
c. Initially, the transvaginal examination can be painful.
d. The transvaginal examination allows pelvic anatomy to be evaluated in greater detail. - ANSWER: d.
The transvaginal examination allows pelvic anatomy to be evaluated in greater detail.
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
- ANSWER: b. Presence of maternal abnormalities
Which information is the highest priority for the nurse to comprehend regarding the BPP?
a. BPP is an accurate indicator of impending fetal well-being.
b. BPP is a compilation of health risk factors of the mother during the later stages of pregnancy.
c. BPP consists of a Doppler blood flow analysis and an amniotic fluid index (AFI).
d. BPP involves an invasive form of an ultrasonic examination.
- ANSWER: a. BPP is an accurate indicator of impending fetal well-being.
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?
a. Because of new imaging techniques, an amniocentesis should have been performed in the first
trimester.
b. Despite the use of ultrasonography, complications still occur in the mother or infant in 5% to 10%
of cases.
c. Administration of Rho(D) immunoglobulin may be necessary.
d. The presence of meconium in the amniotic fluid is always a cause for concern.
- ANSWER: c. Administration of Rho(D) immunoglobulin may be necessary.
Which information is an important consideration when comparing the CST with the NST?
a. The NST has no known contraindications.
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