A nurse is reviewing the results of an Alpha-fetoprotein Test (AFP) with a pregnant client.
What does a low level of AFP (<0.5 MoM) potentially indicate?
Neural tube defect.
Chromosomal abnormality.
Maternal weight-related factors.
Fetal demise.
The Correct Answer is B
A low level of AFP (<0.5 MoM) in a pregnant woman can indicate that the fetus has a chromosomal abnormality, such as Down syndrome or Edwards syndrome.
This is because these conditions affect the development of the fetal liver, which produces AFP.
Choice A is wrong because neural tube defects, such as spina bifida, are associated with high levels of AFP (>2.5 MoM) in the maternal blood.
This is because AFP can leak from the open spinal canal of the fetus into the amniotic fluid and then into the maternal blood.
Choice C is wrong because maternal weight-related factors do not affect the level of AFP in the maternal blood.
However, they can affect the interpretation of the AFP test results, as the test needs to be adjusted for maternal weight, age, ethnicity, and gestational age.
Choice D is wrong because fetal demise (death) can also cause high levels of AFP in the maternal blood, as the AFP from the dead fetus can leak into the amniotic fluid and then into the maternal blood.
Normal ranges of AFP in pregnant women vary depending on the gestational age and the method of measurement.
Generally, normal levels of AFP are below 10 ng/ml in nonpregnant adults and below 2.5 MoM in pregnant women.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
This means that the baby’s heart rate did not slow down after the contractions induced by oxytocin, which is a sign of normal fetal well-being.
A negative CST is normal and desirable.
Choice A is wrong because no contractions were induced during the test.
This means that the test was inconclusive and could not assess the baby’s response to stress.
Choice B is wrong because late decelerations of the FHR were observed with at least 50% of contractions.
This means that the baby’s heart rate slowed down and stayed slow after the contractions, which is a sign of fetal distress and hypoxia.
A positive CST is abnormal and concerning.
Choice D is wrong because the client experienced mild uterine cramping during the test.
This is not a relevant factor for interpreting the CST results, which depend on the FHR patterns.
Uterine cramping can be a side effect of oxytocin administration or nipple stimulation.
Correct Answer is A
Explanation
An NST is a test that measures the fetal heart rate in response to fetal movement.
It is a non-invasive and simple way to assess fetal well-being.
An NST may be recommended to further evaluate fetal well-being if the CST result is equivocal, meaning that occasional but not persistent late decelerations are present.
Choice B. Amniocentesis is wrong because it is an invasive procedure that involves inserting a needle into the uterus to collect amniotic fluid for genetic testing or fetal lung maturity.
It is not used to evaluate fetal well-being in response to contractions.
Choice C. Magnetic resonance imaging (MRI) is wrong because it is an imaging technique that uses magnetic fields to create detailed pictures of the fetus and the placenta.
It is not used to evaluate fetal well-being in response to contractions.
Choice D. Chorionic villus sampling (CVS) is wrong because it is an invasive procedure that involves inserting a catheter or a needle into the placenta to collect chorionic villi for genetic testing.
It is not used to evaluate fetal well-being in response to contractions.
Normal ranges for CST are negative (normal) or positive (abnormal).
Equivocal and unsatisfactory are special categories of test outcomes that require further testing.
Normal ranges for NST are reactive (reassuring) ornon-reactive (non-reassuring).
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