A 24-year-old woman arrives at the clinic to confirm her pregnancy.
She has a body mass index (BMI) of 17, admits to occasional cocaine use and alcohol consumption, and has a blood pressure of 108/70 mm Hg. Her family history includes diabetes mellitus and cancer, including a sister who recently gave birth to an infant with a neural tube defect (NTD). Which factors place her in a high-risk category?
Drug/alcohol use, age, and family history.
Blood pressure, age, and BMI.
Family history, BMI, and drug/alcohol abuse.
Age, BMI, and family history.
The Correct Answer is C
Choice A rationale:
Drug/alcohol use: While substance abuse during pregnancy can lead to adverse outcomes such as preterm labor, fetal growth restriction, and birth defects, it is not considered a primary factor in determining high-risk status for this patient. The specific substances involved (cocaine and alcohol) are indeed associated with risks, but they are not as significant as other factors in this case.
Age: The patient's age of 24 is not considered a high-risk factor for pregnancy. Advanced maternal age (typically defined as 35 years or older) is associated with increased risks for chromosomal abnormalities and other complications, but this patient falls below that age threshold.
Family history: Family history of diabetes mellitus, cancer, and neural tube defects can be relevant to pregnancy risk, but in this case, other factors outweigh their significance.
Choice B rationale:
Blood pressure: The patient's blood pressure of 108/70 mm Hg is within the normal range and does not contribute to highrisk categorization. High blood pressure (hypertension) during pregnancy can lead to preeclampsia and other complications, but this patient does not present with hypertension.
Age: As explained in Choice A, the patient's age is not a high-risk factor.
BMI: A BMI of 17 is considered underweight, which can increase the risk of certain pregnancy complications such as preterm birth and low birth weight. However, in this case, other factors are more significant in determining high-risk status.
Choice C rationale:
Family history: The patient's family history of a neural tube defect (NTD) in a close relative is a significant risk factor for NTDs in her own pregnancy. NTDs are serious birth defects that affect the brain and spinal cord, and they can have lifelong implications for the child. This factor alone warrants a high-risk categorization.
BMI: The patient's underweight BMI of 17 further contributes to her high-risk status, as it can increase the likelihood of certain complications as mentioned earlier.
Drug/alcohol abuse: The patient's admission of cocaine and alcohol use, even if occasional, is a concerning factor for pregnancy. Cocaine, in particular, is a potent vasoconstrictor that can negatively impact fetal growth and development. Alcohol consumption during pregnancy can lead to fetal alcohol spectrum disorders (FASDs), which can cause a range of physical, cognitive, and behavioral problems.
Choice D rationale:
Age: As explained previously, the patient's age is not a high-risk factor.
BMI: The patient's BMI is a contributing factor, but not the most significant one in this case.
Family history: The patient's family history is relevant, but the presence of a neural tube defect in a close relative is the most significant aspect of her family history in terms of pregnancy risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is A
Explanation
Choice A rationale:
Fetal position during the first trimester is not definitively determined through ultrasound. While the gestational sac and fetal pole can be visualized, the fetus is still quite small and has ample space to move within the amniotic sac. This makes it challenging to accurately ascertain its position.
Reliable assessment of fetal position typically occurs later in pregnancy, usually between 34 and 36 weeks gestation. At this point, the fetus is larger and less mobile, allowing for a clearer assessment of its position through ultrasound.
The early determination of fetal position in the first trimester is not a primary goal of ultrasound. It is more focused on establishing pregnancy viability, gestational age, and detecting any potential abnormalities.
Choice B rationale:
Ultrasound in the first trimester can reliably detect multiple gestations. It can visualize the presence of multiple gestational sacs or fetal poles, clearly indicating whether a woman is carrying twins, triplets, or more.
Early identification of multiple gestations is crucial for optimal pregnancy management. It allows healthcare providers to tailor prenatal care, monitor for potential complications associated with multiple pregnancies, and plan for appropriate delivery. Choice C rationale:
Ultrasound in the first trimester can assist in detecting certain maternal abnormalities that could impact pregnancy. These may include:
Uterine abnormalities, such as fibroids or structural defects
Ovarian cysts
Ectopic pregnancies (where the embryo implants outside the uterus)
Gestational trophoblastic disease (abnormal growth of tissue inside the uterus)
Early identification of these maternal abnormalities allows for timely intervention and management, ensuring the best possible outcomes for both mother and fetus.
Choice D rationale:
Confirming pregnancy is a primary reason for ultrasound in the first trimester. It can visualize the gestational sac, which contains the developing embryo and confirms the presence of a pregnancy.
Ultrasound can also detect the fetal heartbeat, which typically becomes visible between 6 and 8 weeks gestation. This provides further confirmation of a viable pregnancy.
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