A pregnant woman undergoes a triple/quadruple screen at 16 to 18 weeks' gestation. What would the nurse suspect if the woman's alpha-fetoprotein (AFP) level is decreased?
Sickle-cell anemia
Cardiac defects
Down syndrome
Respiratory disorders
The Correct Answer is C
Choice A Reason: This is incorrect because sickle-cell anemia is a genetic disorder that affects the shape and function of the red blood cells. It is not related to the AFP level, which is a protein produced by the fetal liver and yolk sac.
Choice B Reason: This is incorrect because cardiac defects are abnormalities in the structure or function of the heart. They are not related to the AFP level, which is a marker of neural tube defects and abdominal wall defects.
Choice C Reason: This is correct because Down syndrome is a chromosomal disorder that results from an extra copy of chromosome 21. It is associated with a decreased AFP level, as well as increased levels of human chorionic gonadotropin (hCG) and unconjugated estriol (uE3).
Choice D Reason: This is incorrect because respiratory disorders are problems that affect the lungs and breathing. They are not related to the AFP level, which reflects the fetal development and integrity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason: This is incorrect because difficulty in arousing is a sign of magnesium toxicity, which is a serious complication of magnesium sulfate therapy. Magnesium toxicity can cause central nervous system depression, muscle weakness, and cardiac arrest. The nurse should monitor the client's level of consciousness and stop the infusion if the client becomes lethargic or unresponsive.
Choice B Reason: This is correct because deep tendon reflexes 2+ indicate a normal and expected response to magnesium sulfate therapy. Magnesium sulfate is a muscle relaxant that can reduce the risk of seizures in gestational hypertension. The nurse should assess the client's deep tendon reflexes regularly and maintain them at 2+ or slightly diminished.
Choice C Reason: This is incorrect because urinary output of 30 mL per hour is below the normal range of 40 to 80 mL per hour and may indicate renal impairment or dehydration. Magnesium sulfate can cause renal toxicity or fluid retention, which can affect the urinary output. The nurse should monitor the client's urinary output and fluid balance and report any abnormalities to the doctor.
Choice D Reason: This is incorrect because respiratory rate of 10 breaths/minute is below the normal range of 12 to 20 breaths/minute and may indicate respiratory depression. Magnesium sulfate can cause respiratory depression or failure, which can be life-threatening. The nurse should monitor the client's respiratory rate and oxygen saturation and administer oxygen or antidote if needed.
Correct Answer is C
Explanation
Choice A Reason: This is incorrect because administering Rho(D) immune globulin 24 hours before delivery is too early and may not provide adequate protection for the fetus. Administering it 24 hours after delivery is too late and may not prevent the mother from developing antibodies against the fetal Rh-positive blood cells.
Choice B Reason: This is incorrect because administering Rho(D) immune globulin in the first trimester is unnecessary and may not be effective, as the risk of Rh isoimmunization is very low before 28 weeks of gestation. Administering it within 2 hours of delivery is appropriate, but not sufficient, as it should be repeated within 72 hours after delivery.
Choice C Reason: This is correct because administering Rho(D) immune globulin at 28 weeks gestation and again within 72 hours after delivery is the recommended schedule for preventing Rh isoimmunization in Rh-negative pregnant women who have Rh-positive partners. This regimen can prevent up to 99% of cases of Rh isoimmunization by blocking the maternal immune response to the fetal Rh-positive blood cells.
Choice D Reason: This is incorrect because administering Rho(D) immune globulin at 32 weeks gestation is too late and may not prevent Rh isoimmunization if there has been any fetal-maternal hemorrhage before that time. Administering it immediately before discharge is also too late and may not prevent the mother from developing antibodies against the fetal Rh-positive blood cells.
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