Pregnancy Assessment Questions

Pregnancy Assessment Questions Related

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A client with diabetes mellitus is at 37 weeks gestation. She has had weekly NSTs for the last 3 weeks, and the results have been reactive. This week, the NST was nonreactive after 40 minutes. The nurse anticipates which of the following will be performed for the client based on these results?

  • A. Scheduled for an immediate ultrasound
  • B. Scheduled for a biophysical profile
  • C. Admitted to the hospital for induction of labor
  • D. Scheduled for a follow-up appointment for NST in 2 days
Correct Answer: B

Rationale: The correct answer is B: Scheduled for a biophysical profile. At 37 weeks gestation, a nonreactive NST after 40 minutes indicates a need for further evaluation with a biophysical profile to assess fetal well-being comprehensively. This test includes NST along with ultrasound evaluation of amniotic fluid volume, fetal tone, fetal breathing movements, and gross body movements. Biophysical profile provides a more detailed assessment of fetal status compared to NST alone.

Choice A is incorrect because an immediate ultrasound is not the next step after a nonreactive NST. Choice C is incorrect because hospital admission for labor induction is premature based on one nonreactive NST result. Choice D is incorrect because waiting for 2 days for a follow-up NST is not recommended due to the urgency of assessing fetal well-being promptly.

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The nurse in the obstetrician’s office is caring for four 25-week-gestation prenatal clients who are carrying singleton pregnancies. With which of the following clients should the nurse carefully review the signs and symptoms of preterm labor?

  • A. African American, 15 years old, with newly diagnosed gestational diabetes.
  • B. Asian American, 23 years old, with five-year-old twins who were born at term.
  • C. Jewish, 25 years old, working as a certified public accountant.
  • D. Mormon, 33 years old, who recently moved into a new apartment.
Correct Answer: A

Rationale: Young age and gestational diabetes are risk factors for preterm labor, making it important to educate this client.

In 2000, the perinatal mortality rate in one county was 16. The nurse interprets that information as which of the following?

  • A. 16 babies died between 28 and 40 weeks' gestation per 1,000 full-term pregnancies.
  • B. 16 babies died between 28 weeks' gestation and 28 days of age per 1,000 live births.
  • C. 16 babies died between birth and 1 month of life per 1,000 full-term pregnancies.
  • D. 16 babies died between 1 month of life and 1 year of life per 1,000 live births.
Correct Answer: B

Rationale: The perinatal mortality rate includes deaths from 28 weeks of gestation to 28 days after birth per 1,000 live births.

The nurse is teaching a patient at 28 weeks of gestation how to perform fetal movement counts. What statement by the patient indicates the patient understands teaching?

  • A. I need to count the baby's movements for 1 hour every day.
  • B. I should wait to count the baby's movements after work.
  • C. If the baby moves less than 10 times in 2 hours, I need to call the midwife.
  • D. Once the baby moves 5 times, I can stop counting the movements.
Correct Answer: C

Rationale: The correct answer is C because it accurately reflects the recommended protocol for fetal movement counts. By counting fetal movements over a 2-hour period and contacting the midwife if fewer than 10 movements are felt, the patient demonstrates understanding of the importance of monitoring fetal well-being. This approach aligns with the standard practice of assessing fetal activity as a crucial indicator of fetal health.

Choice A is incorrect because counting for 1 hour may not provide a comprehensive assessment. Choice B is incorrect as it suggests delaying monitoring, which could be dangerous if there are concerns about fetal movement. Choice D is incorrect as it implies stopping the count prematurely, potentially missing crucial information about the baby's activity level.

The nurse has admitted a client who is 30 weeks gestation with suspected intrauterine growth restriction. The physician has ordered a Doppler blood flow study. What does the nurse suspect if the results show an S/D ratio above the 95th percentile for the gestational age, a ratio above 3, or end-diastolic blood flow that is absent or reversed?

  • A. Decreased blood pressure
  • B. Placental insufficiency
  • C. Increased amniotic fluid
  • D. Decreased fetal movement
Correct Answer: B

Rationale: The correct answer is B: Placental insufficiency. An elevated S/D ratio (>95th percentile for gestational age or >3) and absent/reversed end-diastolic blood flow on Doppler study indicate impaired placental blood flow, leading to decreased oxygen and nutrient delivery to the fetus. This can result in intrauterine growth restriction (IUGR) and compromise fetal well-being. Decreased blood pressure (A) is not directly related to these Doppler findings. Increased amniotic fluid (C) is more commonly associated with conditions like fetal anomalies or maternal diabetes. Decreased fetal movement (D) may be a sign of fetal distress but is not specifically indicated by Doppler findings in IUGR.

The health care practitioner caring for a pregnant client diagnosed with gonorrhea writes the following order: ceftriaxone 250 mg IM × one dose. The medication is available in 1-gram vials. The nurse adds 8 mL of normal saline to the vial. How many mL of the medication should the nurse administer? Calculate to the nearest whole.

  • A. 2 mL
  • B. 3 mL
  • C. 4 mL
  • D. 5 mL
Correct Answer: A

Rationale: The nurse should administer 2 mL of the medication. The calculation is based on the concentration of the medication after dilution.

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