ATI RN
Atrium Health Womens Care Maternal Fetal Monitoring Questions
Question 1 of 5
Which clinical conditions are associated with increased levels of alpha-fetoprotein (AFP)? (Select all that apply.)
Correct Answer: C
Rationale: The correct answer is C) Twin gestation. Elevated levels of alpha-fetoprotein (AFP) are associated with twin gestations due to the presence of multiple fetuses producing the protein. AFP is a protein produced by the fetal liver and yolk sac, and its levels can be elevated in the maternal serum and amniotic fluid in conditions like twin gestation. A) Down syndrome is not associated with increased levels of AFP. In fact, in Down syndrome, AFP levels are usually decreased. B) Molar pregnancy is also not directly associated with increased AFP levels. In molar pregnancies, abnormal trophoblastic tissue develops, but this condition does not lead to elevated AFP levels. D) Incorrect gestational age assessment of a normal fetus resulting in an earlier estimation is not a condition that directly leads to increased AFP levels. Gestational age errors may impact various pregnancy assessments but do not influence AFP levels. Educationally, understanding the factors influencing AFP levels is crucial for healthcare professionals involved in maternal-fetal care. This knowledge helps in interpreting screening tests accurately and in providing appropriate counseling and care to pregnant individuals. Understanding the specific conditions associated with elevated AFP levels can aid in the differential diagnosis of maternal-fetal conditions and guide further diagnostic and management decisions.
Question 2 of 5
When assessing the psychological adjustment of an 8-week gravida, which of the following would the nurse expect to see signs of?
Correct Answer: A
Rationale: In the context of assessing the psychological adjustment of an 8-week gravida, the nurse would expect to see signs of ambivalence. Ambivalence refers to the conflicting feelings a woman may experience during pregnancy, such as mixed emotions about the pregnancy, concerns about the future, and uncertainties about motherhood. This is a common experience during the early stages of pregnancy as the woman adjusts to the changes happening in her life. Regarding the other options: - Depression (option B) may occur during pregnancy but is not typically a primary sign at 8 weeks unless there are pre-existing mental health issues. - Anxiety (option C) is common in pregnancy but may not be the primary expected sign at 8 weeks for all women. - Ecstasy (option D) is not a typical response to early pregnancy as it suggests extreme happiness which may not capture the range of emotions a woman may feel. Educationally, understanding the psychological aspects of pregnancy is crucial for nurses caring for pregnant women. By recognizing signs of ambivalence, nurses can provide appropriate support, education, and counseling to help women navigate their emotions and ensure a positive pregnancy experience. This knowledge enhances the nurse's ability to provide holistic care to pregnant women and promotes their overall well-being.
Question 3 of 5
The nurse working in an outpatient obstetric office assesses four primigravid clients. Which of the client findings should the nurse highlight for the physician? Select all that apply.
Correct Answer: A
Rationale: In this scenario, the correct answer is option A, which is "17 weeks’ gestation; denies feeling fetal movement." This finding should be highlighted to the physician because at 17 weeks of gestation, fetal movements should typically be felt by the mother. The absence of fetal movement at this stage could indicate a potential issue with fetal well-being, such as fetal distress or abnormal development, warranting further evaluation and monitoring. Option B, "24 weeks’ gestation; fundal height at the umbilicus," is not a concerning finding as fundal height corresponds to the gestational age and can vary among individuals. At 24 weeks, the fundal height at the umbilicus is within the expected range. Option C, "27 weeks’ gestation; salivates excessively," is not a typical indicator of a significant issue in pregnancy. While excessive salivation can be uncomfortable for the mother, it is not typically a cause for immediate concern unless it is accompanied by other symptoms. Option D, "34 weeks’ gestation; experiences uterine cramping," could indicate preterm labor, which is a serious concern in pregnancy. However, in this scenario, the absence of fetal movement at 17 weeks is a more urgent finding that requires immediate attention compared to uterine cramping at 34 weeks, which can be managed with appropriate interventions. Educationally, this question highlights the importance of assessing fetal movements as a crucial aspect of antenatal care. It underscores the significance of recognizing abnormal findings during pregnancy and the need for prompt communication with healthcare providers to ensure timely interventions and monitoring for maternal and fetal well-being.
Question 4 of 5
A woman states that she frequently awakens with 'painful leg cramps' during the night. Which of the following assessments should the nurse make?
Correct Answer: A
Rationale: In this scenario, the correct assessment the nurse should make is option A) Dietary evaluation. Leg cramps can be caused by various factors, including nutritional deficiencies such as low levels of potassium, calcium, or magnesium. By conducting a dietary evaluation, the nurse can assess the woman's intake of these essential nutrients and identify any deficiencies that may be contributing to the leg cramps. Option B) Goodell’s sign and option C) Hegar’s sign are not relevant in this context as they are specific to obstetric and gynecological assessments related to pregnancy. Goodell’s sign refers to the softening of the cervix, while Hegar’s sign is the softening of the lower segment of the uterus. These signs are not indicative of leg cramps. Option D) Posture evaluation is also not directly related to the woman's complaint of painful leg cramps. While posture can play a role in musculoskeletal issues, it is not the primary assessment needed in this situation. Educationally, this question highlights the importance of considering a holistic approach to assessment in nursing practice. It emphasizes the need to explore potential causes of symptoms beyond the obvious and to consider how factors such as nutrition can impact a patient's health. This type of critical thinking and assessment skills are essential for nurses to provide comprehensive care to their patients.
Question 5 of 5
The nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that are within normal limits during the latter half of the pregnancy.
Correct Answer: A
Rationale: The correct answer is option A: "During the third trimester I may experience frequent urination." This is an accurate anticipatory guidance because during the latter half of pregnancy, the growing uterus puts pressure on the bladder, leading to increased urinary frequency. This is a common and normal symptom in the third trimester due to the physical changes in the body. Option B, heartburn, is a common discomfort during pregnancy, particularly in the third trimester, but it is more related to the relaxation of the muscle that separates the esophagus from the stomach, allowing stomach acid to leak into the esophagus. While common, it is not specifically associated with the latter half of pregnancy as much as frequent urination. Option C, nagging backaches, are also common during pregnancy due to the increased strain on the back and pelvic area as the baby grows. However, this symptom can occur throughout pregnancy and is not necessarily more prevalent in the third trimester. Option D, persistent headache, while headaches can occur during pregnancy, persistent headaches may indicate a more serious issue like preeclampsia, which is not a normal symptom and requires immediate medical attention. In an educational context, providing anticipatory guidance to pregnant women is crucial for their understanding of the changes their bodies will go through and to help them differentiate between normal discomforts and potential warning signs that require medical attention. Understanding these normal physiological changes can help alleviate anxiety and promote better self-care during pregnancy.