ATI RN
Assessment of High Risk Pregnancy NCLEX Questions Questions
Question 1 of 5
The results of a contraction stress test (CST) are positive. Which intervention is necessary based on this test result?
Correct Answer: B
Rationale: The correct answer is B because a positive contraction stress test (CST) indicates potential fetal distress, requiring immediate medical attention. Contacting the health care provider is necessary to discuss birth options for the patient, such as potential induction or cesarean section to prevent harm to the fetus. A is incorrect because waiting another week could pose risks to the fetus if distress is already present. C is incorrect as sending the patient out for a meal and repeating the test is not a valid or necessary intervention. D is incorrect as a fetal kick count assessment does not address the immediate concerns raised by a positive CST result.
Question 2 of 5
Which complication could occur as a result of percutaneous umbilical blood sampling (PUBS)?
Correct Answer: B
Rationale: The correct answer is B: Fetal bradycardia. During PUBS, a needle is inserted into the umbilical cord to obtain fetal blood for testing. This procedure carries a risk of causing fetal bradycardia, which is a decrease in the fetal heart rate. This can be a serious complication as it may indicate fetal distress. It is important to monitor the fetal heart rate during and after the procedure to detect and address any signs of bradycardia promptly. Other choices are incorrect because: A: Postdates pregnancy - PUBS is not known to cause postdates pregnancy. C: Placenta previa - PUBS is not associated with the development of placenta previa. D: Uterine rupture - PUBS does not typically lead to uterine rupture. In summary, fetal bradycardia is the potential complication of PUBS due to the invasive nature of the procedure and the risk of affecting fetal well-being.
Question 3 of 5
The nurse is reviewing the procedure for alpha-fetoprotein (AFP) screening with a patient at 16 weeks' gestation. The nurse determines that the patient understands the teaching when she states that will be collected for the initial screening process?
Correct Answer: B
Rationale: The correct answer is B: Blood. Alpha-fetoprotein (AFP) screening is a test that measures the level of AFP in the mother's blood to screen for certain fetal abnormalities. AFP is a protein produced by the fetus and can be detected in the mother's blood. Blood is the most appropriate sample for this screening as it directly reflects the fetal AFP levels. Urine (A), saliva (C), and amniotic fluid (D) do not contain AFP in levels that can be accurately measured for this screening, making them incorrect choices. Blood is the standard and most reliable sample for AFP screening due to its direct correlation with fetal AFP levels.
Question 4 of 5
A nurse is teaching the staff about managed care. Which information should the nurse include in the teaching session?
Correct Answer: D
Rationale: Managed care describes health care systems in which the provider or the health care system receives a predetermined capitated (fixed amount) payment for each patient enrolled in the program. Therefore, the focus of care shifts from individual illness care to prevention, early intervention, and outpatient care.
Question 5 of 5
When should the nurse begin discharge planning?
Correct Answer: C
Rationale: In the context of high-risk pregnancy, discharge planning is a crucial aspect of care that should begin as early as possible. Option C, "Upon admission to the hospital," is the correct choice for several reasons. Initiating discharge planning upon admission allows the healthcare team to assess the patient's needs, risks, and potential complications from the start. This early planning facilitates the development of a comprehensive care plan tailored to the specific high-risk pregnancy situation, ensuring that all necessary resources, education, and support are in place well in advance of discharge. Options A and B ("When the patient is ready" and "Close to the time of discharge") are incorrect because they overlook the proactive nature of discharge planning in high-risk pregnancy. Waiting until the patient feels ready or until the last minute can lead to rushed decisions, inadequate preparation, and increased risk of post-discharge complications. Option D ("After an order is written/prescribed") is also incorrect as it implies a reactive approach to discharge planning, which is not ideal in high-risk pregnancy where early identification and management of risks are key to improving outcomes for both the mother and the baby. In an educational context, understanding the importance of early discharge planning in high-risk pregnancy emphasizes the need for nurses to be proactive in assessing, planning, and coordinating care to ensure a smooth transition from hospital to home and ultimately improve patient outcomes. By starting discharge planning upon admission, nurses can address potential challenges, provide thorough education, and arrange necessary follow-up care, all of which are essential in managing high-risk pregnancies effectively.