A client’s maternal serum alpha-fetoprotein level is elevated at 17 weeks.
What condition should the nurse identify as the likely cause of this increase?

Multiple gestation.

Fetal hypoxia.

Down syndrome.

Neural tube defect.

Answer and Explanation

The Correct Answer is D

Choice A rationale

While multiple gestation can cause an increase in maternal serum alpha-fetoprotein (MS-AFP) levels, it is not the most likely cause of an elevated MS-AFP level at 17 weeks.

Choice B rationale

Fetal hypoxia, or lack of oxygen to the fetus, is not typically associated with an increase in MSAFP levels.

Choice C rationale

Down syndrome is typically associated with lower, not higher, levels of MS-AFP891011.

Choice D rationale

An elevated level of MS-AFP at 17 weeks is most commonly associated with a neural tube defect. Neural tube defects are birth defects of the brain, spine, or spinal cord that occur during the first month of pregnancy.

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Correct Answer is D

Explanation

Choice A rationale
Placing a pulse oximeter on the heel of a newborn can help monitor oxygen saturation levels. However, the symptoms described, such as jitteriness, hypotonicity, and a weak cry, are more indicative of hypoglycemia, a condition that would not be detected by a pulse oximeter.
Choice B rationale
Swaddling the infant in a warm blanket can help maintain body temperature, but it does not address the underlying cause of the symptoms, which are suggestive of hypoglycemia.
Choice C rationale
Documenting the findings in the record is an important part of nursing care, but it does not provide immediate intervention for the symptoms observed.
Choice D rationale
Obtaining a heel stick blood glucose level is the appropriate action given the symptoms described. Jitteriness, hypotonicity, and a weak cry can be signs of neonatal hypoglycemia. Prompt diagnosis and treatment are essential to prevent potential complications.

Correct Answer is {"dropdown-group-1":"C"}

Explanation

A. Croup

Rationale: Croup is a condition characterized by a barking cough and stridor (a high-pitched breathing sound), often accompanied by noisy breathing. It is a common cause of respiratory distress in children and can present with symptoms similar to those described.

B. Asthma

Rationale: Asthma can present in young children with symptoms such as wheezing, shortness of breath, and rapid breathing. However, diagnosing asthma in very young children can be challenging due to the variability of symptoms and the overlap with other respiratory conditions.

C. Bronchiolitis

Rationale: The child’s symptoms of “fast and noisy breathing” could be indicative of bronchiolitis, a common lung infection in young children. This condition is often preceded by symptoms of a common cold, such as sneezing and a runny nose, which the child had the previous week.

D. Foreign Body Aspiration

Rationale: Foreign body aspiration should be considered in young children who present with sudden onset of respiratory symptoms, including noisy or rapid breathing, particularly if there is a history of coughing or choking.

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A client’s maternal serum alpha-fetoprotein level is elevated at 17 weeks. What condition should the nurse identify as the likely cause of this increase?

Choice A rationale

Choice B rationale

Choice D rationale

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Correct Answer is D

Explanation

A 3-year-old male was brought into the emergency room this morning with a sudden onset of “fast and noisy breathing”. After reading the history and physical, the nurse suspects the child has dropdown.

Correct Answer is {"dropdown-group-1":"C"}

Explanation

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A client’s maternal serum alpha-fetoprotein level is elevated at 17 weeks.
What condition should the nurse identify as the likely cause of this increase?