A 34-year-old patient who is 16 weeks pregnant had a multiple markers screening done. The results came back with an increased risk for trisomy 21. You call the patient to go over the results. How should you respond when the patient asks you if the baby is going to have Down syndrome?
- A. Yes, would you like to continue or terminate your pregnancy?
- B. This screening predicts only the risk of your baby having Down syndrome and cannot diagnose it. Additional testing is needed to determine this.
- C. You will need to discuss this with your provider at your next appointment.
- D. Yes, this test shows your baby has Down syndrome. I’d be happy to send you resources about this condition so that you can be prepared for when your baby is born.
Correct Answer: B
Rationale: Screening tests like multiple marker tests indicate risk but do not confirm a diagnosis. Further tests are needed to determine if the baby has Down syndrome.
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At approximately ___ weeks of gestation, lecithin is forming on the alveolar surfaces, the eyelids open, and the fetus measures approximately 27 cm crown to rump and weighs approximately 1110 g.
- A. 20
- B. 24
- C. 28
- D. 30
Correct Answer: C
Rationale: These milestones of human development occur at approximately 28 weeks.
The nurse is reviewing the hormonal blood work from a patient who is tracking their cycle to try to conceive this month. The patient’s estradiol and progesterone levels are low. What statement would the nurse include in the patient teaching?
- A. “You have already ovulated this month. Let us know if you are not pregnant, and we will try again next month.”
- B. “You should have intercourse tonight and tomorrow. This is the best time to try to conceive.”
- C. “You are at the very beginning of your cycle and will be getting your period very soon.”
- D. “We can’t tell where you are in your cycle from this blood work. You may need to repeat it next week.”
Correct Answer: C
Rationale: Low estradiol and progesterone levels suggest the patient is in the early follicular phase, just before menstruation.
Choose the correct client teaching to follow amniocentesis.
- A. Drink 1 to 2 quarts of clear fluid to replace fluid taken in the procedure.
- B. Resume all normal activities when desired.
- C. Report persistent contractions, vaginal bleeding, fluid leaking, or fever.
- D. Eat a diet with increased iron for the 2 days after amniocentesis.
Correct Answer: C
Rationale: Clients should report any concerning symptoms after amniocentesis, such as contractions, bleeding, or fever.
The nurse is caring for a pregnant person at 28 weeks’ gestation who has started noticing an increase in vaginal discharge that does not have an odor. What is the appropriate response by the nurse to the pregnant person’s concern?
- A. The discharge is because of the weight of the uterus on your bladder.
- B. The discharge means you have a urinary tract infection.
- C. A slight increase in vaginal discharge is expected at 28 weeks of gestation.
- D. There is nothing to worry about.
Correct Answer: C
Rationale: Increased vaginal discharge is normal due to hormonal changes. It does not indicate an infection or bladder issue.
What keeps the endometrium from shedding if conception occurs?
- A. The anterior pituitary temporarily stops producing luteinizing hormone (LH) and follicle stimulating hormone (FSH).
- B. Human chorionic gonadotropin maintains the corpus luteum, keeping estrogen and progesterone levels high.
- C. None
- D. None
Correct Answer: B
Rationale: hCG maintains the corpus luteum which prevents endometrial shedding.