A nurse is caring for a client in an antepartum clinic following a maternal serum alpha-fetoprotein screening.
The nurse should recognize that an elevated alpha-fetoprotein level is suggestive of which of the following?
Neural tube defects.
Phenylketonuria.
Trisomy 21.
Hemophilia.
The Correct Answer is A
Choice A rationale
An elevated maternal serum alpha-fetoprotein (MSAFP) level is a significant biomarker that can suggest an increased risk of open neural tube defects (NTDs), such as spina bifida or anencephaly. Alpha-fetoprotein is a protein produced by the fetal liver and yolk sac; in cases of open NTDs, larger amounts leak into the amniotic fluid and subsequently cross into the maternal bloodstream, resulting in higher MSAFP levels. Further diagnostic tests like ultrasound or amniocentesis are typically recommended to confirm the diagnosis.
Choice B rationale
Phenylketonuria (PKU) is an inherited metabolic disorder characterized by the inability to metabolize the amino acid phenylalanine. This condition is diagnosed through newborn screening tests that measure phenylalanine levels in the blood, not by maternal serum alpha-fetoprotein screening. MSAFP is not a marker for metabolic disorders like PKU, as it is primarily indicative of fetal structural anomalies, particularly neural tube defects.
Choice C rationale
Trisomy 21, also known as Down syndrome, is a chromosomal disorder caused by the presence of an extra copy of chromosome 21. While MSAFP is part of the "triple screen" or "quad screen" used for aneuploidy screening, an elevated MSAFP level alone is typically associated with neural tube defects. In cases of Trisomy 21, MSAFP levels are usually *lower* than normal, in conjunction with altered levels of other markers like human chorionic gonadotropin (hCG) and unconjugated estriol.
Choice D rationale
Hemophilia is a genetic bleeding disorder caused by a deficiency in specific clotting factors, primarily factors VIII or IX. This condition is inherited in an X-linked recessive pattern and is diagnosed through specialized blood tests that measure clotting factor activity. Maternal serum alpha-fetoprotein screening is not used to detect hemophilia, as it is a marker for fetal structural integrity, particularly concerning neural tube and abdominal wall defects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Soft bumper pads in a crib are generally discouraged due to the risk of suffocation or strangulation for newborns. The American Academy of Pediatrics recommends a bare crib environment to reduce the risk of sudden infant death syndrome (SIDS). Airflow around the infant is paramount.
Choice B rationale
Setting the water heater temperature to 48.8° C (120° F) is a recommended safety precaution to prevent accidental scalding in infants and young children. Water temperatures higher than this can cause full-thickness burns very rapidly, as a newborn's skin is much more delicate and thinner than an adult's.
Choice C rationale
Washing a newborn's face with a warm, soapy washcloth is generally not recommended for daily care. Plain warm water is usually sufficient for cleansing a newborn's delicate skin. Soaps, especially perfumed ones, can be drying and irritating, potentially disrupting the natural skin barrier and leading to dermatitis.
Choice D rationale
Placing a pillow under a newborn's head during naps increases the risk of suffocation and SIDS. Pillows can obstruct the airway and pose a rebreathing hazard. The safest sleep environment for an infant is on their back on a firm, flat surface without pillows, blankets, or toys.
Correct Answer is A
Explanation
Choice A rationale
Progestin-only birth control pills are preferred during lactation because they do not contain estrogen, which can decrease milk supply. Progestin-only pills provide effective contraception without negatively impacting the quality or quantity of breast milk. This allows the client to continue breastfeeding while effectively preventing unintended pregnancy, promoting both maternal and infant health.
Choice B rationale
While breastfeeding can delay the return of ovulation, it is not a reliable method of contraception on its own, especially as the frequency of feedings decreases or if supplements are introduced. Lactational amenorrhea is only highly effective under strict conditions, and relying solely on it for birth control carries a significant risk of unintended pregnancy.
Choice C rationale
Birth control pills are not absolutely contraindicated for breastfeeding clients. Certain types, specifically progestin-only pills, are safe and recommended. Estrogen-containing pills are generally avoided due to their potential to reduce milk supply. Therefore, stating all birth control pills are contraindicated is an inaccurate and overly broad statement.
Choice D rationale
There is no scientific evidence to suggest that taking birth control pills while breastfeeding increases the risk for breast cancer. The impact of hormonal contraception on breast cancer risk is complex and generally linked to combined oral contraceptives, with no clear association for progestin-only pills. This statement is a misinformation that can cause undue alarm.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.