A nurse is providing education to a client who is scheduled to undergo chorionic villus sampling (CVS).
Which statement by the client indicates an understanding of this test?
“This test can detect neural tube defects.”.
“This test can detect genetic disorders.”.
“This test can detect chromosomal abnormalities.”.
“This test can detect Rh sensitization.”.
The Correct Answer is B
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 caused by an extra copy of chromosome 21, but it 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 type.
Rh sensitization can be detected by a blood test that measures the level of antibodies in the mother’s blood.
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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.
Correct Answer is C
Explanation
. The client’s cervix is dilated.
This indicates that the client may be in preterm labor, which is a contraindication for amniocentesis.
Amniocentesis is a procedure that involves inserting a needle into the amniotic sac to obtain a sample of amniotic fluid for genetic testing or other purposes.
It is usually performed between 15 and 20 weeks of gestation.
Choice A is wrong because the client’s bladder should be full for amniocentesis.
This helps to push the uterus upward and away from the bladder, reducing the risk of injury and making it easier to visualize the fetus and the needle.
Choice B is wrong because the client’s uterus should be above the symphysis pubis at 16 weeks of gestation.
This is a normal finding and does not affect the procedure.
Choice D is wrong because the client’s fundal height should measure around 16 cm at 16 weeks of gestation.
A fundal height of 20 cm may indicate a large for gestational age fetus, multiple gestation, or polyhydramnios (excess amniotic fluid), but these are not absolute contraindications for amniocentesis.
However, they may require further evaluation and adjustment of the technique.
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