TEST BANK For Community and Public Health Nursing

TEST BANK For Community and Public Health Nursing 10th Edition by Rector & Stanley . A pregnant woman's BPP score is 8. She asks the nurse to explain the results. How should the nurse respond at this time?

• "The test results are within normal limits."
• "Immediate delivery by cesarean birth is being considered."
• "Further testing will be performed to determine the meaning of this score."
• "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?

• Ultrasound examination
• Maternal serum alpha-fetoprotein (MSAFP) screening
• Amniocentesis
• 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?

• Doppler blood flow analysis
• Contraction stress test (CST)
• Amniocentesis
• Daily fetal movement counts

- ANSWER: a. Doppler blood flow analysis 1 / 3

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?

• Ultrasound for fetal anomalies
• Biophysical profile (BPP)
• MSAFP screening
• 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?

• PUBS
• Ultrasound for fetal size
• Amniocentesis for fetal lung maturity
• 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?

• BPP
• Chorionic villi sampling
• MSAFP screening
• 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?

• PUBS
• Ultrasound for fetal anomalies
• BPP for fetal well-being
• 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 2 / 3

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?

• "Your placenta changes as your pregnancy progresses, and it is given a score that

indicates how well it is functioning."

• "Your placenta isn't working properly, and your baby is in danger."
• "We need to perform an amniocentesis to detect if you have any placental

damage."

• "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?

• Negative
• Positive
• Satisfactory
• 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?

• Moderate coffee consumption
• Moderate alcohol consumption
• Cigarette smoke
• 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)?

• Alcohol or cigarette smoke can irritate the fetus into greater activity.
• Kick counts should be taken every hour and averaged every 6 hours, with every

other 6-hour stretch off.

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