A nurse is providing discharge instructions to a client who had a nonreactive nonstress test (NST) followed by a biophysical profile (BPP) with a score of 8/10.
Which of the following statements by the client indicates an understanding of the teaching?
“I will need to have another BPP in a week.”
“I will need to count my baby’s kicks every day.”
“I will need to have an amniocentesis as soon as possible.”
“I will need to deliver my baby by cesarean section.”.
The Correct Answer is B
The client should count the baby’s kicks every day to monitor fetal well-being. A nonreactive nonstress test (NST) indicates that the fetal heart rate did not increase adequately with fetal movement, which may suggest fetal hypoxia or distress. A biophysical profile (BPP) is a combination of NST and ultrasound that assesses five parameters: fetal breathing, movement, tone, amniotic fluid volume, and NST.
Each parameter is scored 0 or 2, and the total score ranges from 0 to 10. A score of 8/10 or 10/10 is considered normal, while a score of 6/10 is equivocal and ≤ 4/10 is abnormal. A BPP score of 8/10 with a nonreactive NST means that the fetus has normal biophysical activities but may have chronic hypoxia.
Choice A is wrong because the client does not need to have another BPP in a week unless there are other indications of fetal compromise. The BPP may be repeated once or twice a week depending on the clinical situation.
Choice C is wrong because the client does not need to have an amniocentesis as soon as possible.
Amniocentesis is an invasive procedure that involves inserting a needle into the uterus to obtain amniotic fluid for analysis. It is usually done for prenatal diagnosis of genetic disorders or fetal lung maturity, not for fetal well-being.
Choice D is wrong because the client does not need to deliver the baby by cesarean section. Cesarean section is a surgical delivery that may be indicated for various maternal or fetal conditions, such as placenta previa, breech presentation, fetal distress, or failure to progress in labor. A BPP score of 8/10 with a nonreactive NST does not warrant a cesarean section unless there are other risk factors or complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Category III.This category of FHR tracing represents an abnormal pattern that is predictive of fetal acidemia and requires prompt evaluation and intervention.A category III pattern is defined by any of the following criteria:
• Absent baseline FHR variability and any of the following:
➤ Recurrent late decelerations
➤ Recurrent variable decelerations
➤ Bradycardia
• Sinusoidal pattern
Choice A is wrong because category I is a normal pattern that is predictive of normal fetal acid-base balance at the time of observation.A category I pattern is defined by all of the following criteria:
• Baseline rate of 110 to 160 bpm
• Moderate baseline FHR variability
• No late or variable decelerations
• Early decelerations may be present or absent
• Accelerations may be present or absent
Choice B is wrong because category II is an indeterminate pattern that is not predictive of abnormal fetal acid-base balance but requires continued surveillance and reevaluation.A category II pattern includes all FHR tracings that are not category I or III.
Choice D is wrong because there is no category IV in the NICHD classification system for FHR tracings.
Correct Answer is D
Explanation
Notify the provider and prepare for delivery.Oligohydramnios is a condition where the amniotic fluid volume is less than expected for gestational age and it is associated with maternal and fetal complications.
The nonstress test (NST) is a method of fetal surveillance that measures the fetal heart rate response to fetal movement.A reactive NST is defined as at least two accelerations of 15 beats per minute or more above the baseline, lasting 15 seconds or more, within a 20-minute period.
A nonreactive NST indicates fetal hypoxia or acidosis and requires further evaluation.An acoustic stimulator can be used to elicit fetal movement and accelerations, but it should not be repeated more than once in a 10-minute period.
Therefore, choice A is wrong because repeating the acoustic stimulation after 1 minute is too soon and may cause fetal distress.
Choice B is wrong because documenting the finding as a nonreactive NST is not enough to address the situation.Choice C is wrong because performing a contraction stress test (CST) is contraindicated in oligohydramnios because it may cause umbilical cord compression and fetal compromise.
The CST involves inducing uterine contractions with oxytocin or nipple stimulation and monitoring the fetal heart rate for signs of intolerance.
A negative CST means that there
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