Chapter 10: Assessment of High-Risk
Pregnancy Perry: Maternal Child
Nursing Care, 6th Edition Exam 3
1. A woman arrives at the clinic seeking confirmation that she is pregnant. The following
information is obtained: She is 24 years old with a body mass index (BMI) of 17.5. She admits to
having used cocaine "several times" during the past year and drinks alcohol occasionally. Her
blood pressure (BP) is 108/70 mm Hg, her pulse rate is 72 beats/min, and her respiratory rate is
16 breaths/min. The family history is positive for diabetes mellitus and cancer. Her sister
recently gave birth to an infant with a neural tube defect (NTD). Which characteristics place the
woman in a high risk category?
a. Blood pressure, age, and BMI
b. Drug/alcohol use, age, and family history
c. Family history, blood pressure, and BMI
d. Family history, BMI, and drug/alcohol abuseAns- ANS: D
Her family history of NTD, low BMI, and substance abuse all are high risk factors of pregnancy.
The woman's BP is normal, and her age does not put her at risk. Her BMI is low and may
indicate poor nutritional status, which would be a high risk. The woman's drug/alcohol use and
family history put her in a high risk category, but her age does not. The woman's family history
puts her in a high risk category. Her BMI is low and may indicate poor nutritional status, which
would be high risk. Her BP is normal.
, 2. A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had
irregular menstrual periods all her life. She has a history of smoking approximately one pack of
cigarettes a day, but she tells you that she is trying to cut down. Her laboratory data are within
normal limits. What diagnostic technique could be used with this pregnant woman at this time?
a. Ultrasound examination
b. Maternal serum alpha-fetoprotein (MSAFP) screening
c. Amniocentesis
d. Nonstress test (NST)Ans- ANS: A
An ultrasound examination could be done to confirm the pregnancy and determine the
gestational age of the fetus. It is too early in the pregnancy to perform MSAFP screening,
amniocentesis, or NST. MSAFP screening is performed at 16 to 18 weeks of gestation, followed
by amniocentesis if MSAFP levels are abnormal or if fetal/maternal anomalies are detected. NST
is performed to assess fetal well-being in the third trimester.
3. The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has
smoked throughout the pregnancy, and fundal height measurements now are suggestive of
growth restriction in the fetus. In addition to ultrasound to measure fetal size, what other tool
would be useful in confirming the diagnosis?
a. Doppler blood flow analysis
b. Contraction stress test (CST)
c. Amniocentesis
Pregnancy Perry: Maternal Child
Nursing Care, 6th Edition Exam 3
1. A woman arrives at the clinic seeking confirmation that she is pregnant. The following
information is obtained: She is 24 years old with a body mass index (BMI) of 17.5. She admits to
having used cocaine "several times" during the past year and drinks alcohol occasionally. Her
blood pressure (BP) is 108/70 mm Hg, her pulse rate is 72 beats/min, and her respiratory rate is
16 breaths/min. The family history is positive for diabetes mellitus and cancer. Her sister
recently gave birth to an infant with a neural tube defect (NTD). Which characteristics place the
woman in a high risk category?
a. Blood pressure, age, and BMI
b. Drug/alcohol use, age, and family history
c. Family history, blood pressure, and BMI
d. Family history, BMI, and drug/alcohol abuseAns- ANS: D
Her family history of NTD, low BMI, and substance abuse all are high risk factors of pregnancy.
The woman's BP is normal, and her age does not put her at risk. Her BMI is low and may
indicate poor nutritional status, which would be a high risk. The woman's drug/alcohol use and
family history put her in a high risk category, but her age does not. The woman's family history
puts her in a high risk category. Her BMI is low and may indicate poor nutritional status, which
would be high risk. Her BP is normal.
, 2. A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had
irregular menstrual periods all her life. She has a history of smoking approximately one pack of
cigarettes a day, but she tells you that she is trying to cut down. Her laboratory data are within
normal limits. What diagnostic technique could be used with this pregnant woman at this time?
a. Ultrasound examination
b. Maternal serum alpha-fetoprotein (MSAFP) screening
c. Amniocentesis
d. Nonstress test (NST)Ans- ANS: A
An ultrasound examination could be done to confirm the pregnancy and determine the
gestational age of the fetus. It is too early in the pregnancy to perform MSAFP screening,
amniocentesis, or NST. MSAFP screening is performed at 16 to 18 weeks of gestation, followed
by amniocentesis if MSAFP levels are abnormal or if fetal/maternal anomalies are detected. NST
is performed to assess fetal well-being in the third trimester.
3. The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has
smoked throughout the pregnancy, and fundal height measurements now are suggestive of
growth restriction in the fetus. In addition to ultrasound to measure fetal size, what other tool
would be useful in confirming the diagnosis?
a. Doppler blood flow analysis
b. Contraction stress test (CST)
c. Amniocentesis
