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.

Answer and Explanation

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.

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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.

A. Notify the healthcare provider immediately B. Administer pain medication to the patient C. Encourage the patient to rest and elevate her legs D. Offer emotional support and reassurance to the patient

Correct Answer is A

Explanation

The correct answer is choice A. Notify the health care provider immediately.

This is because cramping and vaginal bleeding 24 hours after amniocentesis are signs of possible complications, such as injury to the baby or mother, leaking of amniotic fluid, infection, Rh sensitization, preterm labor, or miscarriage.

These complications are rare, but they can be serious and require immediate medical attention.

Choice B is wrong because administering pain medication to the patient does not address the underlying cause of the cramping and bleeding, and may delay seeking help.

Choice C is wrong because encouraging the patient to rest and elevate her legs may not prevent further complications, and may also delay seeking help.

Choice D is wrong because offering emotional support and reassurance to the patient is not enough to ensure the safety of the baby and the mother, and may give a false sense of security.

Normal ranges for amniocentesis are:

No chromosomal defects detected in the fetus and no abnormal proteins present in amniotic fluid

No signs of infection or other illness in the baby

Fetal lungs mature enough for birth if delivery is planned sooner than 39 weeks

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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?

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Naxlex Comprehensive Predictor Exams

A nurse is educating a pregnant client about the Alpha-fetoprotein Test (AFP). What should the nurse include as a reason why AFP results are reported as multiples of the median (MoM)?

Correct Answer is A

Explanation

A nurse is caring for a patient who had an amniocentesis performed at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later. Which action should be taken first?

Correct Answer is A

Explanation

A nurse is performing an abdominal ultrasound for a client who is at 28 weeks of gestation. The nurse should instruct the client to do which of the following before the procedure?

A nurse is caring for a client scheduled for a CST. Which statement indicates the client understands the test procedure?

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A client's CST result is interpreted as equivocal. What additional diagnostic test may be recommended to further evaluate fetal well-being?

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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?