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?
0 points.
1 point.
2 points.
3 points.
The Correct Answer is C
According to the ACOG guidelines on antepartum fetal surveillance, one of the components of the biophysical profile is fetal breathing movements, which are scored as 2 points if there is one or more episodes of rhythmic fetal breathing movements of 30 seconds or more within 30 minutes.
Choice A is wrong because 0 points are given for absent or no breathing episode for ≥30 seconds within a 30 minute observation period.
Choice B is wrong because there is no 1 point score for this variable.
Choice D is wrong because there is no 3 point score for this variable.
The maximum score for each variable is 2 points.
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Correct Answer is B
Explanation
Each of the five variables in a biophysical profile (BPP) is assigned a score of either 0 or 2 points, depending on whether it meets the criteria or not.
The five variables are:
Fetal breathing: 2 points if there is at least one episode of rhythmic breathing lasting at least 30 seconds within 30 minutes, 0 points otherwise.
Fetal movement: 2 points if there are at least three discrete body or limb movements within 30 minutes, 0 points otherwise.
Fetal tone: 2 points if there is at least one episode of extremity extension and subsequent return to flexion, 0 points otherwise.
Amniotic fluid volume: 2 points if there is a pocket of amniotic fluid measuring at least 2 cm in two perpendicular planes, 0 points otherwise.
Nonstress test: 2 points if there are at least two accelerations of fetal heart rate with or without fetal movement within 20 minutes, 0 points otherwise.
Choice A is wrong because each variable can have a score of either 0 or 2, not 0 or.
Choice C is wrong because there is no score of 1 for any variable.
Choice D is wrong because it is incomplete and does not provide the full range of possible scores.
Correct Answer is D
Explanation
This is a contraindication for the Contraction Stress Test (CST) because it increases the risk of infection and umbilical cord prolapse.
A CST is a test that measures the baby’s heart rate during uterine contractions induced by oxytocin or nipple stimulation.
Choice A is wrong because gestational diabetes is not a contraindication for the CST.
It is a condition that affects how the body processes glucose during pregnancy and may cause complications such as macrosomia (large baby), hypoglycemia (low blood sugar) or preeclampsia (high blood pressure and protein in urine).
Choice B is wrong because mild preeclampsia is not a contraindication for the CST.
It is a condition that causes high blood pressure and protein in urine after 20 weeks of pregnancy and may affect the placenta, kidneys, liver or brain.
Choice C is wrong because preterm labor is a relative contraindication for the CST, not an absolute one.
It means that the test may be performed if the benefits outweigh the risks, but it should be avoided if possible because it may trigger early labor or delivery.
Preterm labor is defined as regular uterine contractions with cervical changes before 37 weeks of pregnancy.
Normal ranges for blood pressure are below 120/80 mmHg, for glucose are 70-100 mg/dL (fasting) or below 140 mg/dL (2 hours after eating), and for protein in urine are less than 300 mg/24 hours.
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