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 B

Explanation

The client should not eat a light meal before an abdominal ultrasound because it can interfere with the quality of the images.

The client should fast for 8 to 12 hours before the procedure.

Some additional information about the other choices are:

Choice A is correct.

The client should drink plenty of fluids before an appointment for an abdominal ultrasound because it helps to fill the bladder and push the uterus up for better visualization.

Choice C is correct.

The client should wear comfortable clothing that can be easily removed or lifted up to expose the abdomen.

Choice D is correct.

The client should arrive at the appointment with a full bladder because it acts as an acoustic window and improves the quality of the ultrasound images.

Normal ranges for fetal growth and development during pregnancy vary depending on the gestational age, but some general parameters are:

Fetal heart rate: 110 to 160 beats per minute

Biparietal diameter: 2.4 to 9.5 cm

Crown-rump length: 0.8 to 8.4 cm

Femur length: 1.0 to 7.8 cm

Abdominal circumference: 9.4 to 35.6 cm

A. "NST is performed after 28 weeks of gestation or earlier if there are risk factors.". B. "A nonreactive NST means that the fetal heart rate increases by at least 15 beats per minute for at least 15 seconds twice or more in a 20-minute period.". C. . "NST requires placing two belts with sensors on my abdomen: one to monitor the fetal heart rate and one to monitor the uterine contractions.". D. "A reactive NST may indicate fetal hypoxia, distress, sleep, medication effect, or neurological abnormality.".

Correct Answer is A

Explanation

"NST is performed after 28 weeks of gestation or earlier if there are risk factors."12 This statement indicates that the client understands when and why an NST is done.

Choice B is wrong because it describes a reactive NST, not a nonreactive one.

A reactive NST means that the fetal heart rate increases by at least 15 beats per minute for at least 15 seconds twice or more in a 20-minute period.2

Choice C is wrong because it confuses NST with contraction stress test (CST), which requires monitoring uterine contractions.

NST does not involve contractions.2

Choice D is wrong because it describes possible causes of a nonreactive NST, not a reactive one.

A nonreactive NST may indicate fetal hypoxia, distress, sleep, medication effect, or neurological abnormality.2

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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 client is scheduled for an abdominal ultrasound in two weeks to assess fetal growth and development during pregnancy. Which of these statements made by the client indicates that further teaching is needed?

Correct Answer is B

Explanation

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

Correct Answer is A

Explanation

A nurse is reviewing the results of an Alpha-fetoprotein Test (AFP) with a pregnant client. What does a low level of AFP (<0.5 MoM) potentially indicate?

A nurse is performing an abdominal ultrasound for a client who is at 28 weeks of gestation. The nurse should instruct the client to do which of the following before the procedure?

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 nurse is explaining the purpose of a Doppler ultrasound blood flow analysis to a client who has intrauterine growth restriction (IUGR). The nurse should inform the client that this test measures which of the following?

A nurse is discussing the factors that can affect Alpha-fetoprotein Test (AFP) results with a pregnant client. Which factor should the nurse mention?

A nurse is reviewing the contraindications for a Contraction Stress Test (CST) with a pregnant client. Which condition would be a contraindication for the test?

A nurse is caring for a client who is scheduled for an amniocentesis. Which of the following should the nurse report to the provider?

A client is scheduled for an abdominal ultrasound in two weeks. The client asks the nurse what they should do to prepare for the test. What is the best response by the nurse?

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?