A pregnant client is undergoing a quad screen test and inquires about the possible results.
Which of the following responses is most appropriate?
The test examines fetal DNA to determine the fetus’s gender.
The test uses fetal tissue to examine the fetus’s genetic makeup for potential anomalies.
The test examines maternal alpha-fetoprotein to assess maternal liver function.
The test examines maternal alpha-fetoprotein to determine if the levels are high or low, indicating specific disorders.
The test examines maternal alpha-fetoprotein to determine if the levels are high or low, indicating specific disorders.
The Correct Answer is D
Choice A rationale:
Incorrect. The quad screen test does not examine fetal DNA to determine gender. That is the role of other tests, such as amniocentesis or chorionic villus sampling (CVS).
Gender determination is not a primary objective of the quad screen test.
Focusing on gender unnecessarily narrows the scope of the test's potential findings.
Choice B rationale:
Incorrect. The quad screen test does not use fetal tissue. It is a non-invasive blood test that measures levels of four substances in the mother's blood: alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin A.
Fetal tissue sampling is more invasive and carries risks, while the quad screen is a safer alternative.
Clarifying the non-invasive nature of the test is crucial for informed consent and patient understanding.
Choice C rationale:
Incorrect. While AFP levels can be affected by maternal liver function, that is not the primary focus of the quad screen test.
Liver function tests are specifically designed to assess liver health, and they are not part of the quad screen panel.
Distinguishing between liver function assessment and AFP's role in screening for fetal anomalies is essential for accurate interpretation.
Choice D rationale:
Correct. The quad screen test measures levels of AFP, hCG, uE3, and inhibin A in the mother's blood. These substances can provide information about the risk of certain fetal chromosomal abnormalities and neural tube defects.
Elevated AFP levels can indicate an increased risk for neural tube defects such as spina bifida or anencephaly.
Low AFP levels can be associated with Down syndrome or other chromosomal abnormalities.
Understanding the specific disorders that can be indicated by AFP levels is crucial for patient counseling and further testing decisions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D"]
Explanation
Choice A rationale:
Prostaglandins:
Mechanism of action: Prostaglandins are hormone-like substances that play a crucial role in labor initiation. They act by softening and ripening the cervix, stimulating uterine contractions, and rupturing the amniotic sac.
Types: Prostaglandins used for labor induction include:
Dinoprostone (Cervidil, Prepidil): Inserted into the vagina as a gel or pessary.
Misoprostol (Cytotec): Administered orally or vaginally.
Effectiveness: Generally effective in initiating labor within 24 hours, with success rates ranging from 60-85%.
Advantages:
Can be used when the cervix is unfavorable (not ripe).
Can be administered in a variety of ways to suit the patient's preferences.
May have a lower risk of uterine hyperstimulation compared to oxytocin.
Disadvantages:
Can cause side effects such as nausea, vomiting, diarrhea, and fever.
May increase the risk of uterine rupture, especially in women with a history of cesarean delivery.
Choice D rationale:
Amnioinfusion:
Procedure: Involves the infusion of sterile saline solution into the amniotic sac through a small catheter.
Mechanism of action: Not fully understood, but it's thought to work by:
Increasing amniotic fluid volume, which can help to stimulate contractions.
Stretching the uterine walls, which may trigger the release of prostaglandins.
Reducing pressure on the umbilical cord, which can improve fetal oxygenation.
Effectiveness: Usually used in conjunction with other induction methods, such as oxytocin or prostaglandins. Has a success rate of about 50-60% in initiating labor within 24 hours.
Advantages:
May be helpful in cases of low amniotic fluid (oligohydramnios).
Can decrease the risk of umbilical cord compression.
Disadvantages:
Requires the insertion of a catheter into the uterus, which carries a small risk of infection.
May cause discomfort for the mother.
Correct Answer is D
Explanation
Choice A rationale:
Fetal lung maturity is not assessed through chorionic villus sampling (CVS). It's primarily evaluated through amniocentesis, a different prenatal diagnostic procedure that involves sampling amniotic fluid.
CVS focuses on placental tissue, not lung development.
It's essential for clients to understand the specific purposes of each prenatal test to make informed decisions and have accurate expectations.
Choice B rationale:
While a non-stress test (NST) might be recommended after CVS in some cases, it's not a routine part of the procedure.
The decision to conduct an NST is based on individual risk factors and assessment by healthcare providers.
It's essential for clients to understand the potential need for additional testing but not assume it's always required.
Choice C rationale:
CVS is considered an invasive procedure, as it involves entering the uterus to collect placental tissue.
Non-invasive prenatal testing (NIPT) methods, which analyze fetal DNA in maternal blood, are available for screening purposes.
It's crucial for clients to differentiate between invasive and non-invasive prenatal testing options to make informed choices based on their preferences and risk factors.
Choice D rationale:
This statement accurately reflects the primary purpose of CVS.
It's a diagnostic procedure that can detect various genetic abnormalities, such as Down syndrome, cystic fibrosis, and TaySachs disease, during the first trimester of pregnancy.
Understanding the ability to detect genetic abnormalities early in pregnancy allows clients to make informed decisions about their pregnancy management and prepare for potential outcomes.
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