A woman is at 32 weeks' gestation. Her fundal height measurement at this clinic appointment is 26 centimeters. After reviewing her ultrasound results, the health care provider asks the nurse to schedule the client for a series of ultrasounds to be done every 2 weeks. The nurse should ensure that the client understands that the main purpose for this is to:
Select one:

Rule out a suspected hydatidiform mole.

Assess for congenital anomalies.

Determine fetal presentation.

Monitor fetal growth.

Answer and Explanation

The Correct Answer is D

Choice A Reason: Rule out a suspected hydatidiform mole. This is an incorrect answer that describes an unlikely condition for this client. A hydatidiform mole is a type of gestational trophoblastic disease where abnormal placental tissue develops instead of a normal fetus. A hydatidiform mole can cause vaginal bleeding, hyperemesis gravidarum (severe nausea and vomiting), preeclampsia, and hyperthyroidism. A hydatidiform mole usually causes a fundal height measurement that is larger than expected for gestational age, not smaller.

Choice B Reason: Assess for congenital anomalies. This is an incorrect answer that implies that the client has not had a previous ultrasound to screen for fetal anomalies. Congenital anomalies are structural or functional defects that are present at birth, such as cleft lip, spina bifida, or Down syndrome. Ultrasound can detect some congenital anomalies by visualizing the fetal anatomy and morphology. However, ultrasound screening for fetal anomalies is usually done between 18 and 22 weeks of gestation, not at 32 weeks.

Choice C Reason: Determine fetal presentation. This is an incorrect answer that suggests that the client has an uncertain fetal presentation. Fetal presentation is the part of the fetus that is closest to the cervix, such as vertex (head), breech (butocks or feet), or transverse (shoulder). Fetal presentation can aﬀect the mode and outcome of delivery. Ultrasound can determine fetal presentation by locating the fetal head and spine. However, fetal presentation can also be assessed by abdominal palpation or vaginal examination, which are simpler and less invasive methods.

Choice D Reason: Monitor fetal growth. This is because fundal height measurement is a method of estimating fetal size and gestational age by measuring the distance from the pubic symphysis to the top of the uterus (fundus) in centimeters. A fundal height measurement that is significantly smaller or larger than expected for gestational age may indicate intrauterine growth restriction (IUGR) or macrosomia, respectively. IUGR means that the fetal growth is slower than expected for gestational age, which can increase the risk of fetal distress, hypoxia, acidosis, and stillbirth. Macrosomia means that the fetal weight is higher than expected for gestational age, which can increase the risk of birth injuries, shoulder dystocia, cesarean delivery, and hypoglycemia. Ultrasound is a more accurate way of assessing fetal size and growth by measuring various parameters such as biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). Ultrasound can also detect other factors that may aﬀect fetal growth such as placental function, amniotic ﬂuid volume, umbilical cord blood ﬂow, and fetal anomalies.

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Correct Answer is A

Explanation

Choice A Reason: Macrosomic fetus is a fetus that weighs more than 4000 grams or 8 pounds 13 ounces at birth. It is not a common complication of teenage pregnancy, but rather of maternal diabetes, obesity, or a history of large babies.

Choice B Reason: Preeclampsia is a condition characterized by high blood pressure and proteinuria in pregnancy. It can cause serious complications for both the mother and the baby, such as seizures, organ damage, growth restriction, and placental abruption. Teenage pregnancy is a risk factor for preeclampsia, especially if the mother is younger than 15 years old.

Choice C Reason: Inadequate nutritional status of mother is a condition where the mother does not consume enough calories, protein, vitamins, minerals, or ﬂuids during pregnancy. It can aﬀect the growth and development of the baby and increase the risk of low birth weight, preterm birth, and birth defects. Teenage pregnancy is a risk factor for inadequate nutritional status of mother, as teenagers may have poor dietary habits, eating disorders, or limited access to food.

Choice D Reason: Cephalopelvic disproportion is a condition where the size or shape of the baby's head or body is too large to fit through the mother's pelvis. It can prevent normal vaginal delivery and require cesarean section. Teenage pregnancy is a risk factor for cephalopelvic disproportion, as teenagers may have smaller or immature pelvises that are not fully developed.

A. "It's okay to want a small baby when you're a teen." B. "You shouldn't be worrying about your figure." C. "Your baby needs adequate nutrition to develop and to be healthy." D. "You are causing harm to your baby."

Correct Answer is C

Explanation

Choice A Reason: "It's okay to want a small baby when you're a teen." This is an incorrect answer that validates the patient's misconception and reinforces her unhealthy behavior. It also implies that there is something wrong with having a normal-sized baby or being a teen mother.

Choice B Reason: "You shouldn't be worrying about your figure." This is an incorrect answer that dismisses the patient's feelings and concerns and may make her defensive or resistant to change. It also does not address the underlying issues or provide any guidance or support.

Choice C Reason: ""Your baby needs adequate nutrition to develop and to be healthy." This is because this response provides factual information and education to the patient about the importance of nutrition during pregnancy. It also conveys empathy and concern for both the mother and the baby without being judgmental or accusatory.

Choice D Reason: "You are causing harm to your baby." This is an incorrect answer that blames and criticizes the patient and may make her feel guilty or ashamed. It also does not oﬀer any help or solutions for her situation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Obstetrical risks to consider for a pregnant teenager would be all of the following, EXCEPT: Select one:

Correct Answer is A

Explanation

An adolescent patient at 20 weeks gestation states that it is important not to have a baby that weighs too much. She states this has been her rationale for limiting calories. Her weight has decreased from 110 pounds to 106 pounds. What would be the best nursing response? Select one:

Correct Answer is C

Explanation

After the birth of a newborn, the nursing intervention that most eﬀectively promotes parental atachment is: Select one:

A term newborn weighs 4 pounds 5 ounces. The nurse assesses that this newborn is small for gestational age (SGA). The nurse knows that teaching has been eﬀective when the parents state: Select one:

A nurse explains to new parents that their newborn has developed respiratory distress syndrome (RDS). Which of the following assessments that the nurse makes would support a diagnosis of RDS? Select one:

Which of the following would be essential to implement to prevent late postpartum hemorrhage? Select one:

Assessment of a pregnant woman reveals a pigmented vertical line between the umbilicus and the pubis. The nurse documents this finding as: Select one:

A woman in her 40th week of pregnancy calls the nurse at the clinic and says she's not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor? Select one:

An nurse explains to new parents that their infant has developed Transient Tachypnea of the Newborn (TTN). The nurse understands that risk factors for TTN include which of the following? Select one: