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N164 Final Exam Questions And Correct Answers
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N164 Final Exam Questions And Correct AnswersWhat diagnostic testing is done on maternal blood? (3) - Answer Coomb's test: testing
for Rh antibodies; if higher than 1:8 or 1:32, Rho-gam administered
Cell-free DNA: risk screening done in order to evaluate for suspected aneuploidies
AFP-- suspicion of NTD
What diagnostic testing is done on amniotic fluid? (8) - Answer Evaluation of fetal lung
maturity:
L/S ratio: less than 2.0:1 not good-usually indicates immature lungs
Presence of phosphatidylglycerol-present indicates mature lungs
Lamellar Body Count (LBC). greater than 50,000/uL indicates mature lungs
Gestational Age:
Creatinine > 2 mg/dL, gestational age > 36 weeks
Lipid cells > 10%, gestational age > 35 weeks
Osmolality declines after 20 weeks
AFP, alpha-fetoprotein A-high level after 15 wks, associated with neural tube defects
Genetic testing-if appropriate; requires cultured cells for karyotype and enzymatic
activity, counseling may be necessary.
Explain the purpose of the biophysical profile. How is it scored? -Answer Noninvasive,
reliable fetal assessment performed in the late 2nd & 3rd trimesters based on acute and
chronic markers of fetal disease via ultrasound to predict fetal well-being.
,Scored (2 or 0) by assessing fetal breath movements, fetal movements, fetal tone,
amniotic fluid level, non-stress test
How is BPP scoring interpreted? -Answer BPP of 8 or 10 with a NORMAL AFV, is
considered a normal, healthy fetus
A score 8 and above requires repeat testing weekly or twice weekly
**look at chart for other scoring
What are the advantages and disadvantages of a non-stress test? -Answer advantages:
- non-invasive
- easy to perform and interpret
- quick
- relatively inexpensive
- no known contraindications
Disadvantages:
- twice weekly testin g
- high false +
- low false -
- less sensitive than BPP
What would be observed in a non-stress test of a normal, healthy fetus ("reactive"
result)? What should be interpreted form a non-reactive (abnormal) result? - Answer
Fetus produces characteristic HR patterns in response to fetal movement, uterine
contractions, or stimulation
, Non-reactive result typically doesn't indicate compromise-- could be fetus is in a quiet
sleep state
Should assess about medications and if mom is smoking which an adversely affect the
test
Explain the difference in results from a contraction stress test? - Answer Negative: No
late decels with contractions *desired*
Positive: Repetitive late decels
Equivocal-Suspicious: Intermittent late decels or significant variable decels
Equivocal: Decels that occur in the presence of contractions occurring more often than
every 2 mins OR lasting longer than 90 seconds
Unsatisfactory: Failure to produce three contractions within a 10-minute window or an
uninterpretable tracing
What does the screening process look like for GDM? -Answer If a pt has high T2DM risk
factors, such as high BMI, family hx of T2DM, and a previous pregnancy with GDM,
testing for preexisting diabetes is done at the initial prenatal visit. If negative, repeat at
24-28 weeks
At 24-28 weeks, 1 hour glucose test performed--if blood glucose is 130-140 g/dL or
higher, pt needs to come back another day for 3-hour oral glucose tolerance test
(OGTT)
OGTT performed 3 days of unrestricted diet and activity and after an overnight fast. pt
comes in fasting blood glucose, 100g glucose load, blood glucose tested at 1, 2, and 3
hours
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