The nurse in a health care clinic is instructing a pregnant client how to perform "kick counts." Which statement by the client indicates a need for further instruction?

"I need to lie flat on my back to perform the procedure."

“If I count fewer than 10 kicks in a 2-hour period, I would count the kicks again over the next 2 hours."

"I need to place my hands on the largest part of my abdomen and concentrate on the fetal movements to count the kicks."

“I will record the number of movements or kicks."

Answer and Explanation

The Correct Answer is A

A. "I need to lie flat on my back to perform the procedure." Lying flat on the back can cause supine hypotension syndrome due to compression of the inferior vena cava. The client should lie on her left side or sit in a comfortable position to improve placental circulation.

B. “If I count fewer than 10 kicks in a 2-hour period, I would count the kicks again over the next 2 hours." If fewer than 10 movements are felt in 2 hours, the client should rest, eat, and try counting again. If movements remain low, she should contact her provider.

C. "I need to place my hands on the largest part of my abdomen and concentrate on the fetal movements to count the kicks." Placing hands on the abdomen helps the client feel subtle fetal movements.

D. “I will record the number of movements or kicks." Keeping a record of fetal movements helps monitor fetal well-being.

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Correct Answer is D

Explanation

A. A client who has a history of preterm labor. A history of preterm labor is not an indication for MSAFP screening. MSAFP is primarily used to detect neural tube defects (e.g., spina bifida) and chromosomal abnormalities (e.g., Down syndrome).

B. A client who has been exposed to AIDS. HIV/AIDS exposure does not impact MSAFP levels and is not an indication for the test. The focus in these clients is viral load monitoring and antiretroviral therapy.

C. A client who has mitral valve prolapse. Mitral valve prolapse does not affect fetal development in a way that would require MSAFP screening.

D. All of the clients. It is a standard screening test offered to all pregnant clients during the second trimester. The test is recommended for detecting fetal neural tube defects and certain chromosomal abnormalities, typically offered between 15-20 weeks of gestation.

A. "I should schedule the test when the baby is usually active." B. "I will have to lie on my back during the test." C. "My baby's heart rate will be monitored during the test." D. "It will take 20 to 30 minutes to complete the test."

Correct Answer is B

Explanation

A. "I should schedule the test when the baby is usually active." The test relies on fetal movements to assess heart rate responses, so scheduling it when the baby is active improves accuracy.

B. "I will have to lie on my back during the test." Lying on the back (supine) can cause supine hypotensive syndrome by compressing the inferior vena cava. The client should lie in a semi-Fowler’s or left lateral position.

C. "My baby's heart rate will be monitored during the test." The NST assesses fetal heart rate patterns in response to movement, so monitoring the fetal heart rate is essential.

D. "It will take 20 to 30 minutes to complete the test." An NST typically lasts 20-30 minutes unless additional monitoring is needed due to a nonreactive result.

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The nurse in a health care clinic is instructing a pregnant client how to perform "kick counts." Which statement by the client indicates a need for further instruction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a clinic is reviewing the medical records of a group of clients who are pregnant. The nurse should anticipate the provider will order a maternal serum alpha-fetoprotein (MSAFP) screening for which of the following clients?

Correct Answer is D

Explanation

A nurse is providing teaching to a client who is at 30 weeks of gestation and is to have a nonstress test (NST). Which of the following statements by the client indicates a need for further teaching?

Correct Answer is B

Explanation

The nurse in a health care clinic is instructing a pregnant client how to perform "kick counts." Which statement by the client indicates a need for further instruction?

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A nurse is teaching a client who is at 15 weeks of gestation and is to undergo an amniocentesis. The nurse should explain that the purpose of this test is to identify which of the following conditions? (Select all that apply.)