A pregnant client is at the prenatal clinic for a fetal nuchal translucency test.
What does the nurse understand about this test?
It’s a screening test for trisomy 21.
It’s a diagnostic test for neural tube defects.
It’s only available in the second trimester.
It’s considered normal when greater than 3mm.
It’s considered normal when greater than 3mm.
The Correct Answer is A
Choice A rationale:
Trisomy 21, also known as Down syndrome, is a genetic condition caused by the presence of an extra copy of chromosome 21.
The nuchal translucency test (NT) is a non-invasive ultrasound screening test that measures the thickness of the fluid-filled space at the back of a developing baby's neck.
Evidence suggests that fetuses with Down syndrome tend to have increased fluid accumulation in this area, resulting in a larger-than-average nuchal translucency measurement.
Therefore, an increased NT measurement can be a marker for an increased risk of Down syndrome.
It's important to emphasize that the NT test is a screening tool, not a diagnostic test.
This means it can only indicate an increased risk of Down syndrome; it cannot definitively diagnose the condition.
To confirm a diagnosis, further testing, such as chorionic villus sampling (CVS) or amniocentesis, is required.
Choice B rationale:
Neural tube defects (NTDs) are birth defects that affect the brain, spine, or spinal cord.
The most common NTDs are spina bifida and anencephaly.
The NT test is not a diagnostic test for NTDs, although it might detect some cases of open spina bifida.
However, it's not specifically designed for this purpose, and other tests, such as alpha-fetoprotein (AFP) screening or detailed ultrasound, are more reliable for diagnosing NTDs.
Choice C rationale:
The NT test is typically performed in the first trimester of pregnancy, between 11 and 14 weeks gestation.
It's not available in the second trimester because the nuchal translucency measurement becomes less reliable after this point in pregnancy.
Choice D rationale:
A nuchal translucency measurement of 3mm or less is generally considered normal.
Measurements greater than 3mm are associated with an increased risk of Down syndrome and other chromosomal abnormalities.
The higher the measurement, the greater the risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Naloxone is an opioid antagonist. It works by binding to opioid receptors in the brain and body, reversing the effects of opioids. This includes respiratory depression, which is a major concern in neonates exposed to opioids during labor.
Nalbuphine is an opioid agonist-antagonist. This means that it has both agonist and antagonist effects at opioid receptors. At low doses, it acts primarily as an agonist, providing pain relief. However, at higher doses, it can also act as an antagonist, blocking the effects of other opioids.
Naloxone can effectively reverse the respiratory depression caused by nalbuphine in neonates. It is a safe and effective medication that is commonly used for this purpose.
Naloxone should be readily available whenever opioids are administered to a laboring woman. This is to ensure that it can be administered promptly if the neonate experiences respiratory depression.
Choice B rationale:
Ephedrine is a sympathomimetic drug. It works by stimulating the sympathetic nervous system. This can cause a number of effects, including increased heart rate, blood pressure, and respiratory rate.
Ephedrine is not effective in reversing the respiratory depression caused by opioids. It may even worsen the situation by increasing the neonate's oxygen demand.
Ephedrine is not a safe or effective medication for use in neonates. It can cause serious side effects, such as tachycardia, hypertension, and arrhythmias.
Choice C rationale:
Promethazine is a phenothiazine antiemetic. It is commonly used to treat nausea and vomiting.
Promethazine does not have any effects on opioid receptors. It is not effective in reversing the respiratory depression caused by opioids.
Promethazine can cause sedation and respiratory depression in neonates. It should be used with caution in this population.
Choice D rationale:
Fentanyl is a potent opioid analgesic. It is similar to nalbuphine in that it is an opioid agonist.
Fentanyl would not be effective in reversing the respiratory depression caused by nalbuphine. In fact, it would likely worsen the situation by further depressing the neonate's respiratory system.
Correct Answer is D
Explanation
A rationale:
Incorrect. Nitrous oxide can be used during any stage of labor, not just the second stage. It is often used during the first stage to help manage early labor pain.
Evidence: Studies have shown that nitrous oxide is effective for pain relief during both the first and second stages of labor.
Additional information: The timing of nitrous oxide administration is typically based on the individual's preferences and needs. Some people prefer to use it as soon as labor begins, while others wait until contractions become more intense.
Choice B rationale:
Incorrect. Nitrous oxide is not a prelude to cesarean birth. It is a method of pain relief that can be used during vaginal or cesarean birth.
Evidence: Cesarean birth is a major surgical procedure that is typically performed under regional or general anesthesia. Nitrous oxide is not a type of anesthesia that would be used for this purpose.
Additional information: Cesarean birth is usually only performed when there is a medical reason why a vaginal birth is not possible or safe.
Choice C rationale:
Incorrect. Nitrous oxide is still a commonly used method of pain relief during labor. It is safe and effective, and it has a good safety profile.
Evidence: Nitrous oxide is one of the most widely used methods of pain relief during labor in many countries around the world.
Additional information: The use of nitrous oxide during labor has been increasing in recent years, as more people have become aware of its benefits.
Choice D rationale:
Correct. The procedure described in the question is an application of nitrous oxide. Nitrous oxide is a colorless, odorless gas that has analgesic and anxiolytic properties. It is often used during labor to help manage pain and anxiety.
Evidence: Nitrous oxide is a well-established method of pain relief during labor. It has been used for this purpose for over a century.
Additional information: Nitrous oxide is a safe and effective option for pain relief during labor. It is easy to administer and has few side effects.
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