A pregnant client asks the nurse the purpose of the maternal serum alpha-fetoprotein (MSAFP) test.
How would the nurse respond?

It measures maternal liver function.

It is a screening test for placental function.

It tests the ability of her heart to accommodate the pregnancy.

It is a screening test for neural tube defects.

Answer and Explanation

The Correct Answer is D

Choice A rationale

The MSAFP test is primarily a screening tool for fetal anomalies, not a measure of maternal liver function, which is typically assessed by serum enzymes such as alanine transaminase (ALT) and aspartate transaminase (AST). Elevated levels of these enzymes usually indicate hepatocellular damage or disease, with normal ranges for ALT generally being < 45 U/L and AST < 35 U/L. These liver function tests are separate from fetal screening.

Choice B rationale

While alpha-fetoprotein (AFP) is produced by the fetal liver and yolk sac, the maternal serum AFP (MSAFP) test is not a direct screening test for placental function. Placental function is typically assessed via methods like non-stress tests (NSTs), biophysical profiles (BPPs), and sometimes by specific hormonal assays or Doppler blood flow studies.

Choice C rationale

The MSAFP test has no utility in determining the client's cardiac function or its ability to handle the physiological demands of pregnancy. Cardiac accommodation is usually evaluated through baseline physical assessments, possibly an electrocardiogram (ECG), or by an echocardiogram if pre-existing cardiac disease is suspected.

Choice D rationale

Maternal serum alpha-fetoprotein is a glycoprotein produced by the fetal liver and yolk sac, which crosses the placenta into the maternal circulation. Elevated levels are associated with open neural tube defects like spina bifida and anencephaly, while low levels are associated with Down syndrome. It is a key non-invasive screening tool offered between 15 and 20 weeks of gestation.

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Correct Answer is B

Explanation

Step 1 is: Add 7 days to the first day of the last menstrual period (LMP). April 19 + 7 days = April 26.

Step 2 is: Subtract 3 months from the month of the LMP. April (4th month) - 3 months = January (1st month).

Step 3 is: Add 1 year to the year of the LMP. 2024 + 1 year = 2025.

Step 4 is: Combine the new month, day, and year to determine the estimated date of delivery (EDD). The final calculated answer is 01/26/2025.

A. Bradycardia, Moderate variability, Present accelerations, Late decelerations. B. Normal baseline, Moderate variability, Absent accelerations, Early decelerations. C. Normal baseline, Minimal variability, Present accelerations, Early decelerations. D. Normal baseline, Minimal variability, Absent accelerations, Late decelerations.

Correct Answer is D

Explanation

Choice A rationale: This is incorrect because the baseline FHR is approximately 140–145 bpm, which falls within the normal range of 110–160 bpm and is not bradycardia (defined as less than 110 bpm). Although late decelerations are present—an ominous sign of uteroplacental insufficiency and fetal hypoxia—the variability is minimal rather than moderate, and there are no accelerations visible on the tracing.

Choice B rationale: This is incorrect because the baseline FHR variability is minimal, with an amplitude range of ≤5 bpm, not moderate (6–25 bpm). The fluctuations are barely perceptible. In addition, the decelerations are late, not early. Early decelerations are symmetric, gradual dips in FHR that mirror contractions and are generally benign, caused by fetal head compression.

Choice C rationale: This is incorrect because there are no accelerations (abrupt increases of ≥15 bpm lasting ≥15 seconds) present on the strip. Furthermore, the decelerations are late, not early. Late decelerations are symmetric, gradual decreases in FHR that begin after the peak of the contraction and return to baseline only after the contraction ends, which is indicative of uteroplacental insufficiency.

Choice D rationale: This is the most accurate documentation. The baseline FHR is 140–145 bpm, which is normal. The tracing shows minimal variability (≤5 bpm), and when this finding is coupled with late decelerations, it is highly concerning for fetal hypoxemia or acidemia, consistent with a Category III tracing. The absence of accelerations further supports the presence of uteroplacental insufficiency and fetal compromise.

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A pregnant client asks the nurse the purpose of the maternal serum alpha-fetoprotein (MSAFP) test. How would the nurse respond?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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A pregnant client asks the nurse the purpose of the maternal serum alpha-fetoprotein (MSAFP) test.
How would the nurse respond?