Assessment of High Risk Pregnancy NCLEX Questions

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The nurse is reviewing the procedure for alpha-fetoprotein (AFP) screening with a patient at 16 weeks' gestation. The nurse determines that the patient understands the teaching when she states that will be collected for the initial screening process?

  • A. Urine
  • B. Blood
  • C. Saliva
  • D. Amniotic fluid
Correct Answer: B

Rationale: The correct answer is B: Blood. Alpha-fetoprotein (AFP) screening is a test that measures the level of AFP in the mother's blood to screen for certain fetal abnormalities. AFP is a protein produced by the fetus and can be detected in the mother's blood. Blood is the most appropriate sample for this screening as it directly reflects the fetal AFP levels. Urine (A), saliva (C), and amniotic fluid (D) do not contain AFP in levels that can be accurately measured for this screening, making them incorrect choices. Blood is the standard and most reliable sample for AFP screening due to its direct correlation with fetal AFP levels.

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A nurse is teaching the staff about managed care. Which information should the nurse include in the teaching session?

  • A. Managed care insures full coverage of health care costs.
  • B. Managed care only assumes the financial risk involved.
  • C. Managed care allows providers to focus on illness care.
  • D. Managed care causes providers to focus on prevention.
Correct Answer: D

Rationale: Managed care describes health care systems in which the provider or the health care system receives a predetermined capitated (fixed amount) payment for each patient enrolled in the program. Therefore, the focus of care shifts from individual illness care to prevention, early intervention, and outpatient care.

The nurse documents a woman’s gravidity and parity as G6 P3214. Which of the following obstetric histories is consistent with this notation?

  • A. The woman is currently pregnant, has 3 living children.
  • B. The woman is currently pregnant, had 2 full-term pregnancies.
  • C. The woman is not currently pregnant, had 4 preterm babies.
  • D. The woman is not currently pregnant, had 1 abortion.
Correct Answer: A

Rationale: G6 indicates the woman is currently pregnant for the 6th time, and P3214 indicates 3 term births, 2 preterm births, 1 abortion, and 4 living children.

A nurse is completing a minimum data set. Which area is the nurse working?

  • A. Nursing center
  • B. Psychiatric facility
  • C. Rehabilitation center
  • D. Adult day care center
Correct Answer: A

Rationale: Nurses who work in a nursing center (nursing home or nursing facility) are required to complete a minimum data set on each patient. Minimum data set is not needed for psychiatric, rehabilitation, or adult day care centers.

The nurse is caring for a pregnant client who was sent to the hospital for a biophysical profile. She is 37 weeks gestation with her second child, has gestational diabetes, and complains of decreased fetal movement for the last 24 hours. Which action should the nurse take first?

  • A. Perform vital signs
  • B. Call physician
  • C. Perform glucose
  • D. Place on fetal monitor
Correct Answer: D

Rationale: The correct answer is D: Place on fetal monitor. This action is crucial to assess the fetal well-being and monitor the baby's heart rate and movements. It helps in determining if the baby is in distress and requires immediate intervention. Performing vital signs (A) is important but not the priority in this situation. Calling the physician (B) can be done after the initial assessment on the fetal monitor. Performing glucose (C) is not the priority when the main concern is the well-being of the baby.

Which of the patient health behaviors in the first trimester would the nurse identify as a risk factor in pregnancy?

  • A. Sexual intercourse two or three times weekly
  • B. Moderate exercise for 30 minutes daily
  • C. Working 40 hours a week as a secretary in a travel agency
  • D. Relaxing in a hot tub for 30 minutes a day, several days a week
Correct Answer: D

Rationale: The correct answer is D because relaxing in a hot tub for 30 minutes a day, several days a week can increase the body temperature, which is harmful during the first trimester and can lead to birth defects. Choice A is not a risk factor as it promotes a healthy sexual relationship. Choice B is beneficial as moderate exercise is recommended during pregnancy. Choice C is not necessarily a risk factor unless it involves exposure to harmful substances or excessive stress.

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