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?
It is a diagnostic test for spinal defects in the fetus.
It is a screening test for spinal defects in the fetus.
It is a diagnostic test for chromosomal abnormalities in the fetus.
It is a screening test for chromosomal abnormalities in the fetu.
The Correct Answer is B
A maternal serum alpha-fetoprotein test is a type of prenatal blood test that measures the levels of MSAFP in the blood of a pregnant person. The test helps the healthcare provider assess the baby’s risk of certain medical conditions, such as neural tube defects and chromosomal abnormalities. The test is usually done between 15 and 20 weeks of pregnancy.
A screening test means that it does not diagnose any health conditions, but only indicates the probability of having them.
A positive test means that the baby has a higher risk of having a birth defect, but it does not confirm it.
A negative test means that the baby has a lower risk of having a birth defect, but it does not rule it out. Further tests are needed to confirm or exclude the diagnosis.
A diagnostic test means that it can provide a definite diagnosis of a health condition. A maternal serum alpha-fetoprotein test is not a diagnostic test for spinal defects or chromosomal abnormalities in the fetus.
Statement A is wrong because it says that the test is a diagnostic test for spinal defects in the fetus, which is not true.
Statement C is wrong because it says that the test is a diagnostic test for chromosomal abnormalities in the fetus, which is not true.
Statement D is wrong because it says that the test is a screening test for chromosomal abnormalities in the fetus, which is only partially true. The test can screen for some chromosomal abnormalities, such as Down syndrome, but not all of them.
The test also screens for neural tube defects, which are not chromosomal abnormalities.
Normal ranges for MSAFP vary depending on the gestational age and the laboratory methods used. Generally, MSAFP levels increase until about 32 weeks of pregnancy and then decrease until delivery.
High levels of MSAFP may indicate neural tube defects, multiple pregnancies, incorrect dating of pregnancy, or other conditions. Low levels of MSAFP may indicate Down syndrome, other chromosomal abnormalities, or other conditions.
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Correct Answer is B
Explanation
This test can detect genetic disorders.
Chorionic villus sampling (CVS) is a prenatal test that involves taking a sample of tissue from the placenta to test for chromosomal abnormalities and certain other genetic problems.
The placenta is a structure in the uterus that provides blood and nutrients from the mother to the fetus.
Choice A is wrong because CVS does not provide information on neural tube defects, such as spina bifida.
For this reason, women who undergo CVS also need a follow-up blood test between 16 to 18 weeks of their pregnancy to screen for neural tube defects.
Choice C is wrong because CVS can detect chromosomal abnormalities, but not all chromosomal abnormalities are genetic disorders.
For example, Down syndrome is a chromosomal abnormality that occurs randomly and is not inherited from the parents.
Choice D is wrong because CVS cannot detect Rh sensitization, which is a condition where the mother’s immune system produces antibodies against the fetus’s blood cells.
Rh sensitization can be detected by a blood test that measures the level of antibodies in the mother’s blood.
Correct Answer is C
Explanation
The level of AFP in a pregnant woman’s blood depends on how far along she is in her pregnancy.
AFP levels are normally high in the early weeks of pregnancy and then decline as the pregnancy progresses.
If the AFP level is too high or too low for the gestational age, it may indicate a problem with the baby’s development.
Choice A is wrong because maternal weight does not affect AFP levels.
Choice B is wrong because fetal heart rate does not affect AFP levels.
Choice D is wrong because the placental function does not affect AFP levels directly, but it may affect the levels of other hormones that are measured along with AFP in a quad screen.
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