A client’s maternal serum alpha-fetoprotein level is elevated at 17 weeks.
What condition should the nurse identify as the likely cause of this increase?
Multiple gestation.
Fetal hypoxia.
Down syndrome.
Neural tube defect.
The Correct Answer is D
Choice A rationale
While multiple gestation can cause an increase in maternal serum alpha-fetoprotein (MS-AFP) levels, it is not the most likely cause of an elevated MS-AFP level at 17 weeks.
Choice B rationale
Fetal hypoxia, or lack of oxygen to the fetus, is not typically associated with an increase in MSAFP levels.
Choice C rationale
Down syndrome is typically associated with lower, not higher, levels of MS-AFP891011.
Choice D rationale
An elevated level of MS-AFP at 17 weeks is most commonly associated with a neural tube defect. Neural tube defects are birth defects of the brain, spine, or spinal cord that occur during the first month of pregnancy.
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Related Questions
Correct Answer is C
Explanation
Choice A rationale
Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the liver and kidneys. While it can have serious implications for the mother and baby, it is not directly linked to the development of spina bifida occulta in the newborn.
Choice B rationale
Tobacco use during pregnancy can lead to several complications, including low birth weight, preterm birth, and certain birth defects. However, it is not identified as a significant risk factor for spina bifida occulta.
Choice C rationale
Folic acid deficiency during pregnancy is a well-known risk factor for neural tube defects, including spina bifida. Spina bifida occulta is a mild form of spina bifida caused by a gap forming between the vertebrae in the spinal cord during fetal development. Adequate intake of folic acid, especially during the early stages of pregnancy, can help prevent such defects.
Choice D rationale
Short interval pregnancy refers to pregnancies that are closely spaced. While they can lead to complications such as preterm birth and low birth weight, they are not directly associated with an increased risk of spina bifida occulta.
Correct Answer is A
Explanation
Choice A rationale
Disseminated intravascular coagulation (DIC) is a serious complication that can occur after severe postpartum hemorrhage. It involves an abnormal activation of the clotting cascade, leading to the formation of small blood clots in the vessels and can result in organ damage.
Choice B rationale
Postpartum psychosis is a rare psychiatric emergency that typically presents with delirium and mood disturbances, and it is not directly related to postpartum hemorrhage.
Choice C rationale
While hard, painful uterine afterpains can occur after childbirth, they are not the highest priority for assessment in a client who experienced a severe postpartum hemorrhage.
Choice D rationale
Placenta accreta is a condition where the placenta attaches too deeply into the uterine wall. However, it is typically identified during pregnancy or at the time of delivery, not after a postpartum hemorrhage.
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