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Maternity and Women's Health Care

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Maternity and Women's Health Care

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  • September 3, 2024
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TEST BANK - Maternity and Women's Health Care 13th
Edition by Lowdermilk & Perry


. 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.

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