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
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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Related Questions
Correct Answer is A
Explanation
Place the device over the fetal back for 3 seconds.This is because vibroacoustic stimulation (VAS) is the application of a vibratory sound stimulus to the abdomen of a pregnant woman to induce fetal heart rate (FHR) accelerations.The presence of FHR accelerations reliably predicts the absence of fetal metabolic acidemia.VAS is typically used during a nonstress test (NST) to assess fetal well-being.The device should be placed over the fetal back for 3 seconds, as this is the optimal duration and location to elicit a fetal response.
Choice B is wrong because holding the device firmly against the maternal abdomen for 10 seconds may be too long and too strong for the fetus, and may cause discomfort or distress.
Choice C is wrong because moving the device around the maternal abdomen until fetal movement is detected may not be effective or efficient, as the device may not reach the optimal location or duration to stimulate the fetus.
Choice D is wrong because applying the device intermittently over the fundus for 15 seconds may not target the fetal auditory system, which is located near the fetal back, and may also be too long and too strong for the fetus.
Normal ranges for FHR are between 110 and 160 beats per minute, and FHR accelerations are defined as an increase of at least 15 beats per minute above baseline for at least 15 seconds.
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.
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