A nurse is reviewing the findings of a biophysical profile (BPP) for a client who is at 40 weeks of gestation.

The BPP score is 6 out of 10 points.

Which of the following components are included in this score? (Select all that apply.)

Fetal breathing movement

Fetal tone

Reactive fetal heart rate

Amniotic fluid volume

Fetal position

Answer and Explanation

Correct Answer : A,B,C,D

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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Correct Answer is B

Explanation

Lecithin/sphingomyelin (L/S) ratio.

This is a test that measures the amount of two phospholipids in the amniotic fluid that are important for the production of surfactant, a substance that helps the lungs expand and prevents them from collapsing.A higher L/S ratio indicates more surfactant and greater fetal lung maturity.The normal range for L/S ratio is 2:1 or higher at term.

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Choice A is wrong because alpha-fetoprotein (AFP) is a protein produced by the fetus that can be measured in the amniotic fluid or maternal blood.It is used to screen for neural tube defects and other abnormalities, not for fetal lung maturity.

Choice C is wrong because Kleihauer-Betke test is a blood test that detects fetal red blood cells in the maternal circulation.It is used to diagnose fetomaternal hemorrhage, a condition where fetal blood leaks into the mother’s blood, not for fetal lung maturity.

Choice D is wrong because indirect Coombs’ test is a blood test that detects antibodies in the mother’s blood that may attack the fetal red blood cells.It is used to screen for Rh incompatibility or other blood group sensitization, not for fetal lung maturity.

A. Category I. B. Category II. C. Category III. D. Category IV.

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.

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A nurse is reviewing the findings of a biophysical profile (BPP) for a client who is at 40 weeks of gestation. The BPP score is 6 out of 10 points. Which of the following components are included in this score? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is scheduled for an amniocentesis at 35 weeks of gestation to assess fetal lung maturity. Which of the following laboratory tests will provide this information?

Correct Answer is B

Explanation

A nurse is assessing a fetal heart rate (FHR) tracing for a client who is in active labor. The nurse notes that the baseline FHR is 150 bpm with absent variability and recurrent variable decelerations with slow return to baseline. What category of FHR tracing does this represent?

Correct Answer is C

Explanation

A nurse is using vibroacoustic stimulation (VAS) to stimulate fetal movement during a nonstress test (NST). What action should the nurse take when applying VAS?

A nurse is caring for a client who is undergoing an oxytocin-stimulated contraction stress test (CST). The nurse observes three contractions in 10 minutes with no late decelerations of the fetal heart rate (FHR). Which of the following actions should the nurse take?

(Select all that apply) A nurse is performing a nonstress test (NST) for a client who is at 32 weeks of gestation and has gestational diabetes mellitus. The nurse uses vibroacoustic stimulation to elicit fetal movement and acceleration of FHR. What are the indications for using this method?

A nurse is caring for a client in labor who has an internal fetal scalp electrode applied for continuous fetal heart rate (FHR) monitoring. The nurse notes a pattern of late decelerations on the FHR tracing. What is the priority nursing intervention?

A nurse is caring for a client who is pregnant and undergoing a contraction stress test (CST). The nurse observes three uterine contractions in 10 minutes, with no late or significant variable decelerations of the fetal heart rate (FHR). How should the nurse interpret this finding?

A nurse is reviewing the findings of a biophysical profile (BPP) for a client who is at 40 weeks of gestation.

The BPP score is 6 out of 10 points.

Which of the following components are included in this score? (Select all that apply.)