A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.

Which of the following actions should the nurse take first?

Administer Rho(D) immune globulin.

Monitor fetal heart rate

Assess maternal vital signs

Obtain an order for an ultrasound exam.

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. Monitor fetal heart rate.

This is because cramping and vaginal bleeding after amniocentesis are signs of possible complications such as miscarriage, preterm labor, or injury to the fetus.

Monitoring fetal heart rate can help assess the well-being of the fetus and detect any signs of distress.

Choice A is wrong because administering Rho(D) immunoglobulin is only necessary if the mother has Rh-negative blood and the baby has Rh-positive blood, which can cause Rh sensitization.

This is not given routinely to all women who have amniocentesis.

Choice C is wrong because assessing maternal vital signs is not the first priority when there is a risk of fetal compromise.

Maternal vital signs can be affected by many factors and are not specific indicators of fetal health.

Choice D is wrong because obtaining an order for an ultrasound exam is not the first action to take.

An ultrasound exam can help confirm the diagnosis of complications such as placental abruption or fetal demise, but it requires time and equipment that might delay immediate intervention.

Monitoring fetal heart rate can be done quickly and easily at the bedside.

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Correct Answer is A

Explanation

This is because AFP levels vary according to the gestational age of the fetus, and reporting them as multiples of the median (MoM) allows for a standardized comparison.

Choice B is wrong because AFP results do not differentiate between neural tube defects and chromosomal abnormalities.

They only indicate an increased risk for these conditions, which need further testing to confirm.

Choice C is wrong because AFP results do not assess the risk of fetal demise or multiple gestation.

They only measure the amount of AFP in the maternal blood, which can be affected by various factors such as maternal weight, race, diabetes, and fetal anomalies.

Choice D is wrong because AFP results are reported as MoM regardless of factors such as maternal weight and race.

These factors are taken into account when calculating the MoM value, which adjusts for the expected variation in AFP levels among different populations.

Normal ranges for AFP MoM vary depending on the laboratory and the method used, but generally they are between 0.5 and 2.52.

Values above or below this range may indicate an increased risk for certain fetal conditions or complications.

A. An ultrasound and a nonstress test. B. An ultrasound and a contraction stress test. C. A Doppler ultrasound and a nonstress test. D. A Doppler ultrasound and a contraction stress test.

Correct Answer is A

Explanation

The test involves an ultrasound and a nonstress test.

A biophysical profile (BPP) is a way to check on the overall fetal health by observing the fetus’s heart rate, breathing, movement, muscle tone, and the amount of amniotic fluid surrounding the fetus in the uterus.

It is typically performed after 28 weeks of pregnancy, especially for high-risk pregnancies or if there is a chance of complications.

Choice B is wrong because a contraction stress test is not part of a BPP.

A contraction stress test measures how the fetus’s heart rate changes during contractions induced by oxytocin or nipple stimulation.

It is a different test from a nonstress test, which measures the fetus’s heart rate while moving and at rest without any stimulation.

Choice C is wrong because a Doppler ultrasound is not part of a BPP.

A Doppler ultrasound uses sound waves to measure the blood flow in the umbilical cord and other blood vessels.

It is a different type of ultrasound from the one used in a BPP, which uses sound waves to create images of the fetus and the amniotic fluid.

Choice D is wrong because it combines two incorrect components from choices B and C. A BPP does not involve a Doppler ultrasound or a contraction stress test.

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A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later. Which of the following actions should the nurse take first?

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Naxlex Comprehensive Predictor Exams

A nurse is educating a pregnant client about the Alpha-fetoprotein Test (AFP). What should the nurse include as a reason why AFP results are reported as multiples of the median (MoM)?

Correct Answer is A

Explanation

A nurse is preparing a client for a biophysical profile (BPP). The nurse should instruct the client that the test involves which of the following procedures?

Correct Answer is A

Explanation

A client's Alpha-fetoprotein Test (AFP) result is reported as 1.2 MoM. How should the nurse interpret this result?

A nurse is explaining the purpose of a nuchal translucency (NT) ultrasound to a pregnant client. What does this ultrasound measure?

A nurse is caring for a client who is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation. The nurse provides which of the following explanations about this test to the client?

A nurse is caring for a client who is scheduled for chorionic villus sampling (CVS). Which of the following statements should indicate to the nurse that the client understands the procedure?

A nurse is educating a pregnant client about the Non-Stress Test (NST). Which statement by the client indicates understanding of the test?

A nurse is observing fetal breathing movements on an ultrasound for a client who is undergoing a biophysical profile (BPP). The nurse should document how many points for this variable if the fetus has at least one episode of breathing lasting for 20 seconds within a 30-minute period?

A client asks the nurse about the risks and complications associated with prenatal ultrasound. Which of the following responses by the nurse is accurate?

A nurse is caring for a client who had chorionic villus sampling (CVS) performed at 12 weeks’ gestation and asks when she can expect results from this test. The nurse should inform her that results are typically available within which timeframe?

A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.

Which of the following actions should the nurse take first?