1. A pregnant woman’s biophysical profile score is 8. She asks the nurse to explain the results.
The nurse’s best response is
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.”
ANS: A
Feedback
A 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
patients. Delivery can be delayed if fetal well-being is indicated.
B Scores less than 4 should be investigated, and delivery could be initiated sooner
than planned.
C This score is within normal range, and no further testing is required at this time.
D The results of the biophysical profile are usually available immediately after the
procedure is performed.
PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 313 | Table 15-1
OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
2. Which analysis of maternal serum may predict chromosomal abnormalities in the fetus?
a. Multiple-marker screening
b. Lecithin/sphingomyelin (L/S) ratio
c. Biophysical profile
d. Type and crossmatch of maternal and fetal serum
ANS: A
Feedback
A Maternal serum can be analyzed for abnormal levels of alpha-fetoprotein, human
chorionic gonadotropin, and estriol. The multiple-marker screening may predict
chromosomal defects in the fetus.
B The L/S ratio is used to determine fetal lung maturity.
C A biophysical profile is used for evaluating fetal status during the antepartum
period. Five variables are used, but none is concerned with chromosomal
problems.
D The blood type and crossmatch will not predict chromosomal defects in the
fetus.
3. The nurse providing care for the pregnant woman understands that a factor indicating the
need for fetal diagnostic procedures is
a. Maternal diabetes
b. Maternal age older than 30 years
c. Previous infant more than 3000 g at birth
d. Weight gain of 25 pounds
ANS: A
Feedback
A Diabetes is a risk factor in pregnancy because of possible impairment of
placental perfusion.
B A maternal age greater than 35 years is an indication for testing.
C Having had another infant weighing greater than 4000 g at birth is an indication
for testing.
D Excessive weight gain is an indication for testing. Normal weight gain is 15 to
35 pounds.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 302 | Box 15-1
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
4. When is the best time to determine gestational age based on biparietal diameter
through ultrasound?
a. 4 to 6 weeks
b. 5 to 7 weeks
c. 7 to 10 weeks
d. 12 to 20 weeks
ANS: D
Feedback
A During this time frame, the gestational age is determined by measuring the
crown-rump length.
B During this time frame, the gestational age is determined by measuring the
crown-rump length.
C During this time frame, the gestational age is determined by measuring the
crown-rump length.
D The biparietal diameter, a method of assessing gestational age during the last
half of pregnancy, is most accurate from 12 to 20 weeks.
PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 303
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
5. The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to
determine if the fetus has
a. Hemophilia
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