A nurse is caring for a client scheduled for a CST.
Which statement indicates the client understands the test procedure?
"I will have sensors placed on my abdomen to monitor the FHR and uterine contractions.".
"I will need to fast for 24 hours before the test.".
"I will be sedated during the test to prevent discomfort.".
"I will need to drink plenty of fluids before the test.".
The Correct Answer is A
“I will have sensors placed on my abdomen to monitor the FHR and uterine contractions.” This statement indicates the client understands the test procedure of a CST, which is a test that triggers contractions and registers how the baby’s heart reacts.
The test is done by placing two sensor belts around the abdomen, one to measure the baby’s heartbeat and the other to measure contractions.
The client may receive oxytocin through an IV to induce contractions.
Choice B is wrong because the client does not need to fast for 24 hours before the test.
There is no evidence that fasting is required for a CST.
Choice C is wrong because the client will not be sedated during the test.
Sedation is not necessary for a CST and may interfere with the results.
Choice D is wrong because the client does not need to drink plenty of fluids before the test.
There is no evidence that drinking fluids is required for a CST.
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Correct Answer is C
Explanation
This means that the baby’s heart rate did not slow down after the contractions induced by oxytocin, which is a sign of normal fetal well-being.
A negative CST is normal and desirable.
Choice A is wrong because no contractions were induced during the test.
This means that the test was inconclusive and could not assess the baby’s response to stress.
Choice B is wrong because late decelerations of the FHR were observed with at least 50% of contractions.
This means that the baby’s heart rate slowed down and stayed slow after the contractions, which is a sign of fetal distress and hypoxia.
A positive CST is abnormal and concerning.
Choice D is wrong because the client experienced mild uterine cramping during the test.
This is not a relevant factor for interpreting the CST results, which depend on the FHR patterns.
Uterine cramping can be a side effect of oxytocin administration or nipple stimulation.
Correct Answer is B
Explanation
A low level of AFP (<0.5 MoM) in a pregnant woman can indicate that the fetus has a chromosomal abnormality, such as Down syndrome or Edwards syndrome.
This is because these conditions affect the development of the fetal liver, which produces AFP.
Choice A is wrong because neural tube defects, such as spina bifida, are associated with high levels of AFP (>2.5 MoM) in the maternal blood.
This is because AFP can leak from the open spinal canal of the fetus into the amniotic fluid and then into the maternal blood.
Choice C is wrong because maternal weight-related factors do not affect the level of AFP in the maternal blood.
However, they can affect the interpretation of the AFP test results, as the test needs to be adjusted for maternal weight, age, ethnicity, and gestational age.
Choice D is wrong because fetal demise (death) can also cause high levels of AFP in the maternal blood, as the AFP from the dead fetus can leak into the amniotic fluid and then into the maternal blood.
Normal ranges of AFP in pregnant women vary depending on the gestational age and the method of measurement.
Generally, normal levels of AFP are below 10 ng/ml in nonpregnant adults and below 2.5 MoM in pregnant women.
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