An 18-week pregnant client was informed this morning that she has an elevated alpha-fetoprotein (AFP) level. After the healthcare provider leaves the room, the client asks about the next steps.
What should the nurse advise?

Reassure the client that the AFP results could be a false reading.

Discuss options for intrauterine surgical correction of congenital defects.

Inform her that a repeat AFP test should be conducted.

Explain that a sonogram should be scheduled for definitive results.

Answer and Explanation

The Correct Answer is D

Choice A rationale

While it’s true that AFP results can sometimes be false readings, it’s not the most appropriate advice for the nurse to give in this situation. Simply reassuring the client without suggesting further investigation could potentially overlook a serious condition.

Choice B rationale

Discussing options for intrauterine surgical correction of congenital defects at this stage is premature. The elevated AFP level alone does not confirm the presence of congenital defects, and suggesting surgical intervention may cause unnecessary anxiety.

Choice C rationale

Informing the client that a repeat AFP test should be conducted is a reasonable suggestion. However, it’s not the most appropriate next step in this case. A repeat test would provide more information, but it wouldn’t give definitive results about the cause of the elevated AFP level.

Choice D rationale

Explaining that a sonogram should be scheduled for definitive results is the most appropriate advice. An ultrasound can provide a more detailed view of the fetus and help identify any potential issues that might have led to the elevated AFP level. This would be the most informative next step and would guide further actions based on the findings.

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Correct Answer is A

Explanation

Choice A rationale

Bright red bleeding in the third trimester of a pregnancy with an Rh-negative mother is an obstetric emergency and warrants the highest priority. The immediate assessment of the fetal heart rate (FHR) and the mother's contraction pattern is crucial. The nurse must determine if the bleeding is caused by conditions such as placental abruption or placenta previa, both of which are life-threatening for the mother and the fetus.

Choice B rationale

While a sterile vaginal examination may eventually be necessary to diagnose the cause of bleeding, it is not the immediate priority. Assessment of fetal well-being and maternal status takes precedence. Additionally, performing a vaginal examination increases the risk of further hemorrhage and potential infection.

Choice C rationale

Leopold maneuvers are used to determine fetal presentation and position, but they are not the priority intervention in this scenario. The nurse's main concern is stabilizing the mother and assessing for signs of fetal distress.

Choice D rationale

Assessing the woman's Rh and Coombs status for RhoGam administration is important. Still, it is not the most immediate priority in this life-threatening situation. The priority is to assess fetal well-being and stabilize the mother. If placental abruption is suspected, RhoGam administration may not be indicated.

A. Iron-deficiency anemia. B. Gestational diabetes. C. High cholesterol. D. Excessive weight gain.

Correct Answer is A

Explanation

Choice A rationale

Iron-deficiency anemia is a common nutritional issue among pregnant teenagers. During pregnancy, the body needs more iron to support the growth and development of the fetus. Teenagers, who are still growing themselves, may already have lower iron stores. Therefore, it is crucial to include information about the importance of iron and how to get enough from the diet in a nutrition education program for pregnant teenagers.

Choice B rationale

While gestational diabetes is a concern during pregnancy, it is not the most crucial topic for a nutrition education program specifically for pregnant teenagers. Gestational diabetes is a condition that can develop during pregnancy in women who don’t already have diabetes. It’s not as common in teenagers as it is in older women.

Choice C rationale

High cholesterol is generally not a primary concern during pregnancy. In fact, it’s normal for cholesterol levels to rise during pregnancy. However, long-term high cholesterol can increase the risk of heart disease.

Choice D rationale

Excessive weight gain can be a concern during pregnancy, but it is not the most crucial topic for a nutrition education program for pregnant teenagers. It’s normal and healthy to gain weight during pregnancy, but the amount should be carefully monitored. Excessive weight gain can lead to complications such as gestational diabetes or high blood pressure.

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An 18-week pregnant client was informed this morning that she has an elevated alpha-fetoprotein (AFP) level. After the healthcare provider leaves the room, the client asks about the next steps.What should the nurse advise?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

What is the most crucial topic for the nurse to include in a nutrition education program for pregnant teenagers?

Correct Answer is A

Explanation

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An 18-week pregnant client was informed this morning that she has an elevated alpha-fetoprotein (AFP) level. After the healthcare provider leaves the room, the client asks about the next steps.
What should the nurse advise?