A nurse is reviewing the results of an Alpha-fetoprotein Test (AFP) with a pregnant client.

What does a low level of AFP (<0.5 MoM) potentially indicate?

Neural tube defect.

Chromosomal abnormality.

Maternal weight-related factors.

Fetal demise.

Answer and Explanation

The Correct Answer is B

A low level of AFP (<0.5 MoM) in a pregnant woman can indicate that the fetus has a chromosomal abnormality, such as Down syndrome or Edwards syndrome.

This is because these conditions affect the development of the fetal liver, which produces AFP.

Choice A is wrong because neural tube defects, such as spina bifida, are associated with high levels of AFP (>2.5 MoM) in the maternal blood.

This is because AFP can leak from the open spinal canal of the fetus into the amniotic fluid and then into the maternal blood.

Choice C is wrong because maternal weight-related factors do not affect the level of AFP in the maternal blood.

However, they can affect the interpretation of the AFP test results, as the test needs to be adjusted for maternal weight, age, ethnicity, and gestational age.

Choice D is wrong because fetal demise (death) can also cause high levels of AFP in the maternal blood, as the AFP from the dead fetus can leak into the amniotic fluid and then into the maternal blood.

Normal ranges of AFP in pregnant women vary depending on the gestational age and the method of measurement.

Generally, normal levels of AFP are below 10 ng/ml in nonpregnant adults and below 2.5 MoM in pregnant women.

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Correct Answer is C

Explanation

According to the ACOG guidelines on antepartum fetal surveillance, one of the components of the biophysical profile is fetal breathing movements, which are scored as 2 points if there is one or more episodes of rhythmic fetal breathing movements of 30 seconds or more within 30 minutes.

Choice A is wrong because 0 points are given for absent or no breathing episode for ≥30 seconds within a 30 minute observation period.

Choice B is wrong because there is no 1 point score for this variable.

Choice D is wrong because there is no 3 point score for this variable.

The maximum score for each variable is 2 points.

A. Gestational diabetes. B. Mild preeclampsia. C. Preterm labor. D. Ruptured membranes.

Correct Answer is D

Explanation

This is a contraindication for the Contraction Stress Test (CST) because it increases the risk of infection and umbilical cord prolapse.

A CST is a test that measures the baby’s heart rate during uterine contractions induced by oxytocin or nipple stimulation.

Choice A is wrong because gestational diabetes is not a contraindication for the CST.

It is a condition that affects how the body processes glucose during pregnancy and may cause complications such as macrosomia (large baby), hypoglycemia (low blood sugar) or preeclampsia (high blood pressure and protein in urine).

Choice B is wrong because mild preeclampsia is not a contraindication for the CST.

It is a condition that causes high blood pressure and protein in urine after 20 weeks of pregnancy and may affect the placenta, kidneys, liver or brain.

Choice C is wrong because preterm labor is a relative contraindication for the CST, not an absolute one.

It means that the test may be performed if the benefits outweigh the risks, but it should be avoided if possible because it may trigger early labor or delivery.

Preterm labor is defined as regular uterine contractions with cervical changes before 37 weeks of pregnancy.

Normal ranges for blood pressure are below 120/80 mmHg, for glucose are 70-100 mg/dL (fasting) or below 140 mg/dL (2 hours after eating), and for protein in urine are less than 300 mg/24 hours.

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A nurse is reviewing the results of an Alpha-fetoprotein Test (AFP) with a pregnant client. What does a low level of AFP (<0.5 MoM) potentially indicate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is observing fetal breathing movements on an ultrasound for a client who is undergoing a biophysical profile (BPP). The nurse should document how many points for this variable if the fetus has at least one episode of breathing lasting for 20 seconds within a 30-minute period?

Correct Answer is C

Explanation

A nurse is reviewing the contraindications for a Contraction Stress Test (CST) with a pregnant client. Which condition would be a contraindication for the test?

Correct Answer is D

Explanation

A nurse is discussing the risks associated with a Contraction Stress Test (CST) with a pregnant client. Which complication should the nurse mention?

A nurse is providing education to a client who is scheduled to undergo chorionic villus sampling (CVS). Which statement by the client indicates an understanding of this test?

A nurse is caring for a client who is scheduled for chorionic villus sampling (CVS). Which of the following statements should indicate to the nurse that the client understands the procedure?

A nurse is caring for a client who is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation. The nurse provides which of the following explanations about this test to the client?

A nurse is caring for a patient who had an amniocentesis performed at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later which action should be taken first?

During a Non-Stress Test (NST), the client needs to press a button whenever they feel the fetus move. What is the purpose of this action?

A nurse is caring for a patient who had an amniocentesis performed at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later. Which action should be taken first?

A nurse is discussing the factors that can affect Alpha-fetoprotein Test (AFP) results with a pregnant client. Which factor should the nurse mention?

A nurse is reviewing the results of an Alpha-fetoprotein Test (AFP) with a pregnant client.

What does a low level of AFP (<0.5 MoM) potentially indicate?