Review Practice Exercise 4

Antepartum Diagnostic Testing > Maternal Newborn

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Practice Exercise 4

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Total Questions : 5

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Question 1:

A nurse is educating a patient about the anomaly ultrasound. What is typically assessed during this test?

A. Fetal blood type B. Amniotic fluid volume C. Maternal hormone levels D. Placental blood flow

Answer and Explanation

Choice A:

Fetal blood type cannot be determined by ultrasound. It requires laboratory analysis using maternal or fetal samples (e.g., cell-free DNA, cord blood, or amniocentesis).

Choice B:

Amniotic fluid volume is typically assessed during the anomaly ultrasound. Measurement ensures adequate fetal environment and screens for conditions like oligohydramnios (AFI <5 cm) and polyhydramnios (AFI >24 cm). This is part of the standard anomaly survey.

Choice C:

Maternal hormone levels are not evaluated during ultrasound. Hormone levels such as hCG, estriol, and inhibin A are assessed through serum screening, not imaging.

Choice D:

Placental blood flow is not routinely measured in a standard anomaly scan. It requires Doppler ultrasound, typically reserved for high-risk pregnancies with suspected placental insufficiency.

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Question 2:

Which of the following fetal structures is specifically assessed during an anatomy ultrasound for potential neural tube defects?

A. Four chambers of the heart B. Kidneys and bladder C. Spinal column D. Stomach and bowel

Answer and Explanation

Choice A:

The four chambers of the heart are assessed during the anatomy scan but this evaluates cardiac malformations, not neural tube defects.

Choice B:

Kidneys and bladder are checked to assess urinary tract development and amniotic fluid production, not neural tube closure.

Choice C:

The spinal column is specifically evaluated during the anatomy ultrasound to detect neural tube defects. Ultrasound looks for discontinuity in vertebral arches, abnormal curvature, or associated cranial signs such as “lemon” or “banana” signs.

Choice D:

Stomach and bowel are assessed to evaluate gastrointestinal patency and situs, not defects of the neural tube.

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Question 3:

Which specialized ultrasound assessment is used to evaluate the risk of preterm labor?

A. Doppler ultrasound B. Fetal echocardiography C. Cervical length assessment D. Amniotic fluid index

Answer and Explanation

Choice A:

Doppler ultrasound evaluates blood flow in uteroplacental and fetal vessels. It is used for conditions like intrauterine growth restriction and preeclampsia, not preterm labor risk.

Choice B:

Fetal echocardiography assesses structural and functional abnormalities of the fetal heart. It is indicated when congenital heart disease is suspected, not for prediction of preterm delivery.

Choice C:

Cervical length assessment is the specialized ultrasound used to evaluate risk of preterm labor. A cervical length <25 mm before 24 weeks indicates increased risk of preterm birth. It directly measures structural changes in the cervix that precede labor.

Choice D:

Amniotic fluid index measures fluid volume to assess chronic placental function and fetal well-being. It helps detect oligohydramnios or polyhydramnios but does not predict preterm labor.

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Question 4:

Which of the following are assessed during an anomaly ultrasound? Select all that apply

A. Fetal heart structure B. Placental position C. Maternal blood pressure D. Amniotic fluid volume E. Fetal blood type

Answer and Explanation

Choice A:

Fetal heart structure is assessed, including the four-chamber view and outflow tracts, to detect congenital cardiac defects.

Choice B:

Placental position is evaluated to identify placenta previa, accreta spectrum risk, or abnormal insertion sites.

Choice C:

Maternal blood pressure is not assessed by ultrasound. It is measured clinically as part of maternal monitoring, especially in preeclampsia screening.

Choice D:

Amniotic fluid volume is measured to detect oligohydramnios (AFI <5 cm) or polyhydramnios (AFI >24 cm), which affect fetal development.

Choice E:

Fetal blood type cannot be determined by ultrasound. It requires maternal blood tests for cell-free fetal DNA or invasive testing like amniocentesis.

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Question 5:

Which of the following are indications for performing a specialized ultrasound assessment? Select all that apply

A. Suspected intrauterine growth restriction B. Maternal history of seasonal allergies C. Family history of congenital heart defects D. Routine first-trimester screening E. Abnormal amniotic fluid volume

Answer and Explanation

Choice A:

Suspected intrauterine growth restriction is an indication because specialized ultrasound with Doppler studies evaluates uteroplacental blood flow and fetal well-being.

Choice B:

Maternal history of seasonal allergies is not an indication for specialized ultrasound. Allergies do not impact fetal structural development or hemodynamics.

Choice C:

Family history of congenital heart defects requires fetal echocardiography, a specialized ultrasound, to detect structural cardiac abnormalities.

Choice D:

Routine first-trimester screening involves nuchal translucency and serum markers. It is standard care, not a specialized ultrasound, unless abnormalities are detected.

Choice E:

Abnormal amniotic fluid volume (oligohydramnios <5 cm AFI or polyhydramnios >24 cm AFI) requires detailed ultrasound to identify underlying causes such as renal anomalies or gastrointestinal obstruction.

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Practice Exercise 4

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