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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
NST is less time-consuming and more comfortable than CST.This is because NST does not require any external stimulation of the uterus, while CST involves giving oxytocin to induce contractions.NST also does not pose any risk of preterm labor or fetal distress, which are possible complications of CST.
Choice A is wrong because NST does not provide more information about fetal status than CST.In fact, CST can detect fetal hypoxia more accurately than NST.
Choice C is wrong because NST does not have fewer contraindications than CST.Both tests have similar contraindications, such as placenta previa, multiple gestation, and previous cesarean section.
Choice D is wrong because NST does not have higher sensitivity and specificity than CST.
Sensitivity refers to the ability of a test to correctly identify positive cases, while specificity refers to the ability of a test to correctly identify negative cases.
NST has a high sensitivity but a low specificity, meaning it can detect most fetuses with hypoxia but also has many false positives.CST has a low sensitivity but a high specificity, meaning it can miss some fetuses with hypoxia but also has few false negatives.
Correct Answer is ["A","B","C","D"]
Explanation
The correct answer is choice A, B, C and D.These are the four components of a biophysical profile (BPP) that are scored as 2 (normal) or 0 (abnormal) based on ultrasound examination.The fifth component is the nonstress test (NST) that measures the fetal heart rate reactivity.A total score of 8 or 10 is normal, 6 is equivocal, and 4 or less is abnormal.
Choice E is wrong because fetal position is not a part of the BPP score.Fetal position is determined by ultrasound but it does not affect the score.
Normal ranges for each component are:
• Fetal breathing movement: One or more episodes of fetal breathing lasting at least 30 seconds within 30 minutes.
• Fetal tone: One or more episodes of active extension and flexion of a fetal extremity or opening and closing of the hand within 30 minutes.
• Reactive fetal heart rate: Two or more fetal heart rate accelerations that peak at least 15 beats per minute above the baseline and last at least 15 seconds from baseline to baseline during 20 minutes of observation.
• Amniotic fluid volume: A single deepest vertical pocket of amniotic fluid that measures at least 2 centimeters.
• Gross body movement: Three or more discrete body or limb movements within 30 minutes.
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