A nurse is reviewing contraception options for four clients.

The nurse should identify that which of the following clients has a contraindication for receiving oral contraceptives?

An alpha-fetoprotein test (AFP) is a blood test that measures the amount of AFP present in blood.

It’s usually part of what’s called a triple screen or quad screen in the second trimester of pregnancy.

The yolk sac, GI tract, and liver of an unborn baby produce AFP.

It then circulates through the fetal and maternal blood.

High levels of AFP in pregnant people can indicate that the baby has a neural tube defect, such as spina bifida or anencephaly.

Choice B is wrong because assessing placental function is not the primary purpose of an AFP test.

However, low levels of AFP can indicate problems with the placenta or the baby’s growth.

Choice C is wrong because determining fetal gender is not the primary purpose of an AFP test.

However, some genetic tests that use a sample of the baby’s DNA from the pregnant person’s blood can reveal the baby’s sex as early as 10 weeks of pregnancy.

Choice D is wrong because diagnosing chromosomal abnormalities is not the primary purpose of an AFP test.

However, an AFP test is usually part of a quad screen that also tests for other markers that can indicate the risk of chromosomal abnormalities, such as Down syndrome.

"It is a screening test for spinal defects in the fetus."

The MSAFP test is a blood test that measures the amount of alpha-fetoprotein (AFP) in the mother’s blood.

AFP is a protein produced by the baby during pregnancy.The test helps to assess the baby’s risk of certain birth defects, such as neural tube defects, which are abnormalities in the development of the brain and spine.

A. “It is a diagnostic test for spinal defects in the fetus.” This statement is wrong because the MSAFP test is not a diagnostic test.

It only indicates the probability of having a spinal defect, but it does not confirm or rule out the condition.A diagnostic test, such as an ultrasound or amniocentesis, is needed to make a definitive diagnosis.

C. “It is a diagnostic test for chromosomal abnormalities in the fetus.” This statement is wrong because the MSAFP test is not a diagnostic test for chromosomal abnormalities either.

It only indicates the probability of having a chromosomal abnormality, such as Down syndrome, but it does not confirm or rule out the condition.A diagnostic test, such as a chorionic villus sampling (CVS) or amniocentesis, is needed to make a definitive diagnosis.

D. “It is a screening test for chromosomal abnormalities in the fetus.” This statement is partially correct, but not the best answer.

The MSAFP test alone is not very accurate for screening chromosomal abnormalities.It is usually combined with other blood tests and an ultrasound to form a more reliable screening test called a quad screen or an integrated screen.

The normal range of MSAFP levels varies depending on the gestational age of the baby and the laboratory methods used.Generally, the MSAFP levels increase until about 15 weeks of pregnancy and then decrease until delivery.The average MSAFP level at 15 weeks of pregnancy is about 38 ng/mL.However, different laboratories may have different reference ranges, so it is important to consult your healthcare provider for your specific results and interpretation.