ATI RN
Pregnancy Assessment Questions Questions
Question 1 of 5
A client with diabetes mellitus is at 37 weeks gestation. She has had weekly NSTs for the last 3 weeks, and the results have been reactive. This week, the NST was nonreactive after 40 minutes. The nurse anticipates which of the following will be performed for the client based on these results?
Correct Answer: B
Rationale: The correct answer is B: Scheduled for a biophysical profile. At 37 weeks gestation, a nonreactive NST after 40 minutes indicates a need for further evaluation with a biophysical profile to assess fetal well-being comprehensively. This test includes NST along with ultrasound evaluation of amniotic fluid volume, fetal tone, fetal breathing movements, and gross body movements. Biophysical profile provides a more detailed assessment of fetal status compared to NST alone. Choice A is incorrect because an immediate ultrasound is not the next step after a nonreactive NST. Choice C is incorrect because hospital admission for labor induction is premature based on one nonreactive NST result. Choice D is incorrect because waiting for 2 days for a follow-up NST is not recommended due to the urgency of assessing fetal well-being promptly.
Question 2 of 5
The nurse is admitting a client, who reports, 'My water broke yesterday, and I haven't felt my baby move any today.' She is 38 weeks with a history of gestational diabetes. Which assessment data is of most concern to the nurse on admission?
Correct Answer: C
Rationale: The correct answer is C because minimal variability and variable decelerations on fetal heart monitoring indicate fetal distress, which is a critical concern. Minimal variability suggests the baby's nervous system is compromised, and decelerations can indicate umbilical cord compression or placental insufficiency, possibly leading to fetal hypoxia. This situation requires immediate intervention to prevent potential harm to the baby. Choice A is incorrect as the vital signs are slightly elevated but not as concerning as fetal distress. Choice B is incorrect as pain score is subjective and not as critical as fetal well-being. Choice D is incorrect as cervical dilation/effacement/station is important for labor progress but not as concerning as fetal distress in this scenario.
Question 3 of 5
The nurse reports a nonreactive NST to the physician. The physician orders vibroacoustic stimulation. Which does the nurse understand the appropriate application for the vibroacoustic stimulation to be? Select all that apply.
Correct Answer: C
Rationale: The correct answer is C: Apply the artificial larynx stimulus by the fetal head. Vibroacoustic stimulation involves using sound waves to stimulate the fetus and provoke a response, particularly in cases of nonreactive nonstress test (NST). By applying the artificial larynx stimulus near the fetal head, the nurse ensures direct and effective stimulation of the fetus. This method has been found to be safe and effective in improving fetal heart rate reactivity. Incorrect Choices: A: Clap loudly by the fetal head - This is not an appropriate method for vibroacoustic stimulation as it may not provide the controlled and targeted stimulation needed. B: Apply a sterile drape to abdomen prior to stimulation - This is not necessary for vibroacoustic stimulation and does not contribute to its effectiveness. D: Limit the use of the artificial larynx stimulus to three times - There is no specific limit to the number of times vibroacoustic stimulation can be applied, as it depends on the
Question 4 of 5
Which laboratory is important to know when a client is having an amniocentesis?
Correct Answer: C
Rationale: Step-by-step rationale: 1. Rh factor is crucial to know to prevent Rh incompatibility issues during pregnancy. 2. Amniocentesis can pose a risk for Rh sensitization in Rh-negative mothers. 3. Knowing the Rh status helps determine if Rhogam (anti-D) is needed after amniocentesis. 4. Blood type (A) and CBC (B) are important but not directly relevant to amniocentesis. 5. PT and PTT (D) are coagulation tests, typically not required for routine amniocentesis.
Question 5 of 5
The nurse has admitted a client who is 30 weeks gestation with suspected intrauterine growth restriction. The physician has ordered a Doppler blood flow study. What does the nurse suspect if the results show an S/D ratio above the 95th percentile for the gestational age, a ratio above 3, or end-diastolic blood flow that is absent or reversed?
Correct Answer: B
Rationale: The correct answer is B: Placental insufficiency. An elevated S/D ratio (>95th percentile for gestational age or >3) and absent/reversed end-diastolic blood flow on Doppler study indicate impaired placental blood flow, leading to decreased oxygen and nutrient delivery to the fetus. This can result in intrauterine growth restriction (IUGR) and compromise fetal well-being. Decreased blood pressure (A) is not directly related to these Doppler findings. Increased amniotic fluid (C) is more commonly associated with conditions like fetal anomalies or maternal diabetes. Decreased fetal movement (D) may be a sign of fetal distress but is not specifically indicated by Doppler findings in IUGR.