Test 2 Study Guide
Chapter 16: Assessment of Fetal Well-Being
1) A standard ultrasound examination is performed during the second or third trimester and
includes an evaluation of which of the following? Select all that apply.
A) Confirm fetal heart activity.
B) Evaluate the cervix.
C) Determine fetal presentation.
D) Assess amniotic fluid volume.
E) Determine fetal number.
Answer: C, D, E
Explanation:
A) A limited ultrasound may be used to address a specific question or determine specific
information including confirming fetal heart activity.
B) A limited ultrasound may be used to address a specific question or determine specific
information including evaluating the cervix.
C) A standard ultrasound examination is performed during the second or third trimester and
includes an evaluation to determine fetal presentation.
D) A standard ultrasound e amination is performed during the second or third trimester and
includes an evaluation of amniotic fluid volume.
E) A standard ultrasound examination is performed during the second or third trimester and
includes an evaluation of fetal number.
Page Ref: 325
2) When assisting with a transabdominal ultrasound sampling, which of the following would the
nurse do?
A) Obtain preliminary urinary samples.
B) Have the woman empty her bladder before the test begins.
C) Assist the woman into a supine position on the examining table.
D) Instruct the woman to eat a fat-free meal 2 hours before the scheduled test time.
Answer: C
Explanation:
A) Preliminary blood work may be obtained, not urinary samples.
,B) The morning of the procedure, the woman is asked to drink fluids to fill her bladder because
displacement of an anteverted uterus by a full bladder may aid in positioning the uterus for
catheter insertion.
C) Clients are placed in a supine position on the table.
D) Dietary intake is not relevant to this procedure.
Page Ref: 328
3) The nurse is preparing a client in her second trimester for a three-dimensional ultrasound
examination. Which statement indicates that teaching has been effective?
A) "If the ultrasound is normal, it means my baby has no abnormalities."
B) "The nuchal translucency measurement will diagnose Down syndrome."
C) "I might be able to see who the baby looks like with the ultrasound."
D) "Measuring the length of my cervix will determine whether I will deliver early."
Answer: C
Explanation:
A) Not all fetal anomalies are detectable by ultrasound.
B) Nuchal translucency measurements are for detection, not diagnosis, of trisomies 13, 18, and
21.
C) Three-dimensional ultrasound uses algorithms to vary opacity, transparency, and depth to
project an image. This allows curved structures such as the fetal face to be viewed.
D) Transvaginal ultrasound can most accurately identify shortened cervical length indicating
cervical insufficiency or risk of preterm labor. However, a cervix of normal length does not
preclude preterm birth.
Page Ref: 326
4) A woman at 28 weeks' gestation is asked to keep a fetal activity record and to bring the results
with her to her next clinic visit. One week later, she calls the clinic and anxiously tells the nurse
that she has not felt the baby move for more than 30 minutes. Which of the following would be
the nurse's most appropriate initial comment?
A) "You need to come to the clinic right away for further evaluation."
B) "Have you been smoking?"
C) "When did you eat last?"
D) "Your baby might be asleep."
Answer: D
,Explanation:
A) The mother would need to come to the clinic only if there had been no fetal activity for
several hours.
B) Certain substances such as tobacco, drugs, alcohol, and caffeine have been shown to affect
fetal movements and can increase fetal movement.
C) After meals, an infant typically has increased movement.
D) Lack of fetal activity for 30 minutes typically is insignificant. Movement varies considerably,
but most women feel fetal movement at least 10 times in 3 hours.
Page Ref: 335
5) Which of the following tests provides information about the fetal number?
A) Amniocentesis
B) Standard second-trimester sonogram
C) Beta hCG
D) Maternal serum alpha-fetoprotein
Answer: B
Explanation:
A) Amniocentesis can make chromosomal and biochemical determinations and can validate
abnormalities detected by ultrasound.
B) A standard (comprehensive) second trimester sonogram provides information about the fetus,
placenta, and uterine conditions, including fetal number.
C) Serial quantitative beta hCG testing can be used to distinguish a normally developing fetus
from an ectopic pregnancy.
D) Maternal serum alpha-fetoprotein (MSAFP) is a component of the screening test, the
"quadruple check" that utilizes the multiple markers, including AFP, hCG, diameric inhibin-A,
and estriol, to screen pregnancies for NTD, trisomy 21 (Down syndrome), and trisomy 18.
Page Ref: 326
6) The client at 24 weeks' gestation is experiencing painless vaginal bleeding after intercourse.
The physician has ordered a transvaginal ultrasound examination. Which statements by the
client indicate an understanding of why this exam has been requested? Select all that apply.
A) "This ultrasound will show the baby's gender."
B) "This ultrasound might cause the miscarriage of my baby."
C) "This ultrasound carries a risk of creating a uterine infection."
, D) "This ultrasound can determine the location of my placenta."
E) "This ultrasound might detect whether the placenta is detaching prematurely."
Answer: D, E
Explanation:
A) Although gender can sometimes be detected with second-trimester ultrasound, that is never
the primary reason for the procedure.
B) Ultrasound is non-invasive, and does not increase the risk for either fetal loss or uterine
infection.
C) Ultrasound is non-invasive, and does not increase the risk for either fetal loss or uterine
infection.
D) Painless bleeding in the second and third trimesters can be a symptom of placenta previa.
Transvaginal ultrasound will determine the placental location.
E) Painless bleeding in the second and third trimesters can be a symptom of placenta previa.
Transvaginal ultrasound will determine the placental location.
Page Ref: 326—32
7) The nurse is returning phone calls from clients. Which client does the nurse anticipate would
not require a serum beta hCG?
A) A client with a risk of ectopic pregnancy
B) A client with spotting during pregnancy
C) A client with previous pelvic inflammatory disease
D) A client with a previous history of twins
Answer: D
Explanation:
A) Serial quantitative beta hCG testing can be used to distinguish a normally developing fetus
from an ectopic pregnancy.
B) Serologic evaluation in the first trimester is indicated for women with vaginal bleeding.
C) Serial quantitative beta hCG testing can be used to distinguish a normally developing fetus
from a risk of ectopic pregnancy (intrauterine device in place, previous pelvic inflammatory
disease, or reversal of a tubal sterilization).
D) A previous history of twins is not a risk factor for ectopic pregnancy. Beta hCG testing is not
indicated for this client.
Page Ref: 327
Chapter 16: Assessment of Fetal Well-Being
1) A standard ultrasound examination is performed during the second or third trimester and
includes an evaluation of which of the following? Select all that apply.
A) Confirm fetal heart activity.
B) Evaluate the cervix.
C) Determine fetal presentation.
D) Assess amniotic fluid volume.
E) Determine fetal number.
Answer: C, D, E
Explanation:
A) A limited ultrasound may be used to address a specific question or determine specific
information including confirming fetal heart activity.
B) A limited ultrasound may be used to address a specific question or determine specific
information including evaluating the cervix.
C) A standard ultrasound examination is performed during the second or third trimester and
includes an evaluation to determine fetal presentation.
D) A standard ultrasound e amination is performed during the second or third trimester and
includes an evaluation of amniotic fluid volume.
E) A standard ultrasound examination is performed during the second or third trimester and
includes an evaluation of fetal number.
Page Ref: 325
2) When assisting with a transabdominal ultrasound sampling, which of the following would the
nurse do?
A) Obtain preliminary urinary samples.
B) Have the woman empty her bladder before the test begins.
C) Assist the woman into a supine position on the examining table.
D) Instruct the woman to eat a fat-free meal 2 hours before the scheduled test time.
Answer: C
Explanation:
A) Preliminary blood work may be obtained, not urinary samples.
,B) The morning of the procedure, the woman is asked to drink fluids to fill her bladder because
displacement of an anteverted uterus by a full bladder may aid in positioning the uterus for
catheter insertion.
C) Clients are placed in a supine position on the table.
D) Dietary intake is not relevant to this procedure.
Page Ref: 328
3) The nurse is preparing a client in her second trimester for a three-dimensional ultrasound
examination. Which statement indicates that teaching has been effective?
A) "If the ultrasound is normal, it means my baby has no abnormalities."
B) "The nuchal translucency measurement will diagnose Down syndrome."
C) "I might be able to see who the baby looks like with the ultrasound."
D) "Measuring the length of my cervix will determine whether I will deliver early."
Answer: C
Explanation:
A) Not all fetal anomalies are detectable by ultrasound.
B) Nuchal translucency measurements are for detection, not diagnosis, of trisomies 13, 18, and
21.
C) Three-dimensional ultrasound uses algorithms to vary opacity, transparency, and depth to
project an image. This allows curved structures such as the fetal face to be viewed.
D) Transvaginal ultrasound can most accurately identify shortened cervical length indicating
cervical insufficiency or risk of preterm labor. However, a cervix of normal length does not
preclude preterm birth.
Page Ref: 326
4) A woman at 28 weeks' gestation is asked to keep a fetal activity record and to bring the results
with her to her next clinic visit. One week later, she calls the clinic and anxiously tells the nurse
that she has not felt the baby move for more than 30 minutes. Which of the following would be
the nurse's most appropriate initial comment?
A) "You need to come to the clinic right away for further evaluation."
B) "Have you been smoking?"
C) "When did you eat last?"
D) "Your baby might be asleep."
Answer: D
,Explanation:
A) The mother would need to come to the clinic only if there had been no fetal activity for
several hours.
B) Certain substances such as tobacco, drugs, alcohol, and caffeine have been shown to affect
fetal movements and can increase fetal movement.
C) After meals, an infant typically has increased movement.
D) Lack of fetal activity for 30 minutes typically is insignificant. Movement varies considerably,
but most women feel fetal movement at least 10 times in 3 hours.
Page Ref: 335
5) Which of the following tests provides information about the fetal number?
A) Amniocentesis
B) Standard second-trimester sonogram
C) Beta hCG
D) Maternal serum alpha-fetoprotein
Answer: B
Explanation:
A) Amniocentesis can make chromosomal and biochemical determinations and can validate
abnormalities detected by ultrasound.
B) A standard (comprehensive) second trimester sonogram provides information about the fetus,
placenta, and uterine conditions, including fetal number.
C) Serial quantitative beta hCG testing can be used to distinguish a normally developing fetus
from an ectopic pregnancy.
D) Maternal serum alpha-fetoprotein (MSAFP) is a component of the screening test, the
"quadruple check" that utilizes the multiple markers, including AFP, hCG, diameric inhibin-A,
and estriol, to screen pregnancies for NTD, trisomy 21 (Down syndrome), and trisomy 18.
Page Ref: 326
6) The client at 24 weeks' gestation is experiencing painless vaginal bleeding after intercourse.
The physician has ordered a transvaginal ultrasound examination. Which statements by the
client indicate an understanding of why this exam has been requested? Select all that apply.
A) "This ultrasound will show the baby's gender."
B) "This ultrasound might cause the miscarriage of my baby."
C) "This ultrasound carries a risk of creating a uterine infection."
, D) "This ultrasound can determine the location of my placenta."
E) "This ultrasound might detect whether the placenta is detaching prematurely."
Answer: D, E
Explanation:
A) Although gender can sometimes be detected with second-trimester ultrasound, that is never
the primary reason for the procedure.
B) Ultrasound is non-invasive, and does not increase the risk for either fetal loss or uterine
infection.
C) Ultrasound is non-invasive, and does not increase the risk for either fetal loss or uterine
infection.
D) Painless bleeding in the second and third trimesters can be a symptom of placenta previa.
Transvaginal ultrasound will determine the placental location.
E) Painless bleeding in the second and third trimesters can be a symptom of placenta previa.
Transvaginal ultrasound will determine the placental location.
Page Ref: 326—32
7) The nurse is returning phone calls from clients. Which client does the nurse anticipate would
not require a serum beta hCG?
A) A client with a risk of ectopic pregnancy
B) A client with spotting during pregnancy
C) A client with previous pelvic inflammatory disease
D) A client with a previous history of twins
Answer: D
Explanation:
A) Serial quantitative beta hCG testing can be used to distinguish a normally developing fetus
from an ectopic pregnancy.
B) Serologic evaluation in the first trimester is indicated for women with vaginal bleeding.
C) Serial quantitative beta hCG testing can be used to distinguish a normally developing fetus
from a risk of ectopic pregnancy (intrauterine device in place, previous pelvic inflammatory
disease, or reversal of a tubal sterilization).
D) A previous history of twins is not a risk factor for ectopic pregnancy. Beta hCG testing is not
indicated for this client.
Page Ref: 327
