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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Related Questions
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.
Correct Answer is A
Explanation
An equivocal CST indicates late decelerations of the FHR with less than 50% of contractions.
This means that the fetus may have some degree of hypoxia or distress, but not enough to warrant immediate delivery.
An equivocal CST may also result from hyperstimulation of the uterus, which can cause excessive contractions and reduce blood flow to the placenta.
Choice B is wrong because late decelerations of the FHR with at least 50% of contractions is a positive CST, which indicates a high risk of fetal death due to hypoxia and is a contraindication to labor.
Choice C is wrong because no late decelerations of the FHR during contractions is a negative CST, which indicates a good fetal wellbeing and tolerance of labor.
Choice D is wrong because variable decelerations of the FHR with or without contractions are not related to uterine activity and may indicate cord compression or other fetal problems.
Variable decelerations are not used to interpret CST results.
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