A 36 weeks gestation client at risk for preterm labor presents to the clinic. The nurse understands the indication to perform an amniocentesis at this time is to assess for what?
Fetal lung maturity
Fetal size and weight
Fetal glucose levels
Genetic abnormalities
The Correct Answer is A
A. Fetal lung maturity is the primary indication for performing an amniocentesis in a client at or near term who is at risk for preterm delivery. The procedure allows analysis of amniotic fluid for lecithin-sphingomyelin (L/S) ratio and presence of phosphatidylglycerol (PG), which are markers of pulmonary maturity. This information helps the provider determine whether it is safe to deliver the fetus or if interventions are needed to reduce the risk of neonatal respiratory distress.
B. Amniocentesis is not used to determine fetal size or weight. These assessments are typically done through ultrasound measurements, not amniotic fluid analysis.
C. Fetal glucose levels are not routinely measured via amniocentesis. Maternal blood glucose control and fetal well-being are monitored through maternal labs and noninvasive fetal assessments rather than direct glucose measurement in amniotic fluid.
D. Genetic abnormalities are typically assessed via amniocentesis earlier in pregnancy (15–20 weeks). At 36 weeks, the focus shifts from genetic testing to evaluating lung maturity and readiness for safe delivery, not chromosomal analysis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. December 7, 2025: This date is over a year late, likely due to miscalculation in applying Naegele’s Rule.
B. To calculate the expected date of birth (EDB), use Naegele’s Rule, which estimates a 40-week gestation from the first day of the last menstrual period:
- Start with the LMP: March 14, 2024
- Add 1 year: March 14, 2025
- Subtract 3 months: December 14, 2024
- Add 7 days: December 21, 2024
This calculation assumes a 28-day menstrual cycle and provides a standard method for estimating the due date.
C. December 17, 2024: This is four days early, possibly due to an arithmetic error in adding 7 days.
D. November 17, 2024: This is too early, likely due to subtracting months incorrectly or misinterpreting the rule.
Correct Answer is B
Explanation
A. Retained placental fragments typically cause a soft, boggy uterus and late postpartum hemorrhage rather than a steady trickle of bright red blood with a firm fundus immediately after delivery. This does not match the assessment findings described.
B. Perineal laceration is the most likely cause. When the uterus is firm and midline, it indicates that uterine atony is not the source of bleeding. A steady trickle of bright red blood from the vagina, despite a firm uterus, suggests bleeding from a laceration of the cervix, vagina, or perineum, which is common after vaginal delivery. This finding matches the clinical scenario.
C. Subinvolution refers to the delayed return of the uterus to pre-pregnancy size, often occurring weeks after delivery. It usually presents with prolonged lochial discharge rather than immediate postpartum bleeding with a firm uterus.
D. A hematoma is a collection of blood within the soft tissues of the perineum or vulva. It usually presents with localized swelling, pain, and sometimes vaginal pressure, rather than a continuous, visible trickle of bright red blood. The absence of a firm, localized swelling makes this less likely in this scenario.
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