A nurse explains why fetal monitoring is increased in hypertension. What is the best rationale?
Normal protocol
Increased fetal movement
Risk of fetal hypoxia
Increased amniotic fluid
The Correct Answer is C
Maternal hypertension causes systemic vasospasms that reduce blood flow to the uterine spiral arteries. This chronic hypoperfusion leads to placental insufficiency, characterized by villous infarction and reduced nutrient transfer. Frequent assessment via non-stress tests or biophysical profiles is required to monitor fetal reserve.
A. Normal protocol: While monitoring is part of the clinical pathway, this rationale does not explain the underlying pathophysiology that necessitates the intervention. Protocols are designed to mitigate specific physiological threats like decreased placental perfusion. A scientific explanation must address the vascular compromise.
B. Increased fetal movement: Hypertensive states often lead to decreased fetal movement as the fetus attempts to conserve energy in a low-oxygen environment. Excessive activity is not a typical characteristic of placental compromise. Reduced movement is a danger sign that requires immediate clinical evaluation.
C. Risk of fetal hypoxia: Compromised placental blood flow limits the amount of oxygen available for fetal hemoglobin saturation. This can lead to intrauterine growth restriction, late decelerations, and fetal distress during labor. Monitoring detects early signs of asphyxiation to prevent permanent neurological injury.
D. Increased amniotic fluid: Preeclampsia and chronic hypertension are more commonly associated with oligohydramnios (low fluid) due to reduced fetal renal perfusion. Excess fluid, or polyhydramnios, is typically linked to gestational diabetes or gastrointestinal obstructions. Fluid levels usually decrease in hypertensive pregnancies.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
External genitalia differentiate during the late first trimester as the urogenital tubercle responds to dihydrotestosterone. Sonographic visualization depends on the angle of the genital tubercle and crown-rump length. Accurate identification requires specific morphological development of the phallus or labia.
A. Week 12: Sonographic sex determination becomes reliable at this stage as the genital tubercle angle orients cranially for males or caudally for females. At 12 weeks, the phenotypic differentiation is sufficiently advanced for high-resolution imaging. This milestone correlates with the completion of early organogenesis.
B. Week 10: While the bipotential gonad has begun differentiation, the external genitalia remain in a rudimentary, indistinguishable state. Ultrasound cannot reliably discern the small anatomical variations present at this gestation. Imaging at this stage frequently results in misidentification.
C. Week 6: During this embryonic phase, the embryo is undergoing folding and initial neural tube closure. The primitive streak and urogenital ridge are forming, but external sexual characteristics are non-existent. Visualization is limited to the gestational sac and yolk sac.
D. Week 8: The embryo enters the early fetal period with a bipotential phallus that appears identical in both sexes. Hormonal influences have not yet produced measurable physical changes detectable by standard obstetric transducers. Diagnostic accuracy for sex is impossible at this developmental point.
Correct Answer is D
Explanation
Amniotic fluid is a complex biological solution with a neutral-to-alkaline pH ranging from 7.0 to 7.5. Rupture of membranes alters the acidic environment of the vaginal vault, which typically maintains a pH of 4.5 to 5.5. Determining the fluid chemistry is essential to confirm a diagnosis of premature rupture.
A. Glucose test: While glucose is present in amniotic fluid, its concentration is not specific enough to differentiate it from other vaginal secretions or maternal urine. It is not a standard diagnostic tool for identifying membrane rupture in clinical settings. This test lacks the necessary diagnostic sensitivity.
B. CBC: A complete blood count is used to monitor for systemic infection or chorioamnionitis following a prolonged rupture. It does not provide direct evidence of the presence of amniotic fluid itself. It serves as a secondary assessment for complications rather than a primary confirmatory test.
C. Lipid panel: Serum lipid concentrations have no clinical relevance to the diagnosis of membrane integrity. Testing for cholesterol or triglycerides provides no information regarding the contents of the vaginal pool. This is an inappropriate diagnostic approach for suspected amniotic fluid leakage.
D. pH test with a nitrazine strip: Nitrazine paper changes color from yellow to blue when exposed to the alkaline pH of amniotic fluid. This biochemical shift provides a rapid bedside confirmation of the presence of liquor in the vagina. It is a reliable method for detecting rupture of membranes.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.