Pregnancy Assessment Questions

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The nurse reports a nonreactive NST to the physician. The physician orders vibroacoustic stimulation. Which does the nurse understand the appropriate application for the vibroacoustic stimulation to be? Select all that apply.

  • A. Clap loudly by the fetal head
  • B. Apply a sterile drape to abdomen prior to stimulation
  • C. Apply the artificial larynx stimulus by the fetal head
  • D. Limit the use of the artificial larynx stimulus to three times
Correct Answer: C

Rationale: The correct answer is C: Apply the artificial larynx stimulus by the fetal head. Vibroacoustic stimulation involves using sound waves to stimulate the fetus and provoke a response, particularly in cases of nonreactive nonstress test (NST). By applying the artificial larynx stimulus near the fetal head, the nurse ensures direct and effective stimulation of the fetus. This method has been found to be safe and effective in improving fetal heart rate reactivity.

Incorrect Choices:
A: Clap loudly by the fetal head - This is not an appropriate method for vibroacoustic stimulation as it may not provide the controlled and targeted stimulation needed.
B: Apply a sterile drape to abdomen prior to stimulation - This is not necessary for vibroacoustic stimulation and does not contribute to its effectiveness.
D: Limit the use of the artificial larynx stimulus to three times - There is no specific limit to the number of times vibroacoustic stimulation can be applied, as it depends on the

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In preparing a pregnant patient for a nonstress test (NST), which of the following should be included in the plan of care?

  • A. Have the patient void prior to being placed on the fetal monitor because a full bladder will interfere with results.
  • B. Maintain NPO status prior to testing.
  • C. Position the patient for comfort, adjusting the tocotransducer belt to locate fetal heart rate.
  • D. Have an infusion pump prepared with oxytocin per protocol for evaluation.
Correct Answer: C

Rationale: The correct answer is C because positioning the patient for comfort and adjusting the tocotransducer belt to locate fetal heart rate are essential steps in preparing a pregnant patient for a nonstress test (NST). This allows for proper monitoring of fetal heart rate without interference.

A: Having the patient void prior to the test is not necessary for an NST as a full bladder does not interfere with the results.
B: Maintaining NPO status is not required for an NST, as it does not involve any invasive procedures that would necessitate fasting.
D: Preparing an infusion pump with oxytocin is not part of the standard preparation for an NST and is not needed for evaluation.

A nurse is providing prenatal education to a patient who is 8 weeks pregnant. The nurse informs the patient that the developing fetus is most vulnerable to teratogens during what trimester of pregnancy?

  • A. first
  • B. second
  • C. third
  • D. fourth
Correct Answer: A

Rationale: The correct answer is A (first trimester). During the first trimester (weeks 1-12), the developing fetus is most vulnerable to teratogens as major organs are forming. Exposure to teratogens during this critical period can lead to severe birth defects. In contrast, the second trimester (weeks 13-26) is a period of rapid growth and development, but most major organs have already formed. The third trimester (weeks 27-birth) focuses on further growth and maturation, with reduced risk of teratogen-related birth defects. The fourth trimester is not a valid option as pregnancy only consists of three trimesters.

A certified nursing assistant (CNA) is working with a registered nurse (RN) in the neonatal nursery. It would be appropriate for the nurse to delegate which of the following actions to the assistant?

  • A. Admission assessment on a newly delivered baby.
  • B. Patient teaching of a neonatal sponge bath.
  • C. Placement of a bag on a baby for urine collection.
  • D. Hourly neonatal blood glucose assessments.
Correct Answer: C

Rationale: CNAs can perform tasks such as placing a urine collection bag, which does not require advanced assessment or teaching skills. Admission assessments and blood glucose monitoring require the expertise of an RN.

The clinic nurse is obtaining a health history on a newly pregnant patient. Which is an indication for fetal diagnostic procedures if present in the health history?

  • A. Maternal diabetes
  • B. Weight gain of 25 lb
  • C. Maternal age older than 30 years
  • D. Previous infant weighing more than 3000 g at birth
Correct Answer: A

Rationale: The correct answer is A, maternal diabetes. Maternal diabetes increases the risk of fetal anomalies, so fetal diagnostic procedures may be indicated for early detection. Weight gain, maternal age over 30, and previous infant weight do not necessarily indicate a need for fetal diagnostic procedures. Weight gain and older age are common in pregnancy, while the previous infant's weight alone is not a direct indicator of fetal health.

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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