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Worksheets2205 exam 1. pt.10
Total questions: 41
Worksheet time: 21mins
Quad screen: pattern most consistent with Down syndrome risk is:
High AFP
Low AFP + high hCG/inhibin A
High AFP + low hCG
Normal AFP confirms diagnosis
MSAFP [maternal serum alpha-fetoprotein] is mainly used to screen for:
Open neural tube defects / open abdominal wall defects
Gestational diabetes
Placenta previa
Group B strep
MSAFP is typically collected during which gestational range?
6–10 weeks
10–13 weeks
24–28 weeks
14–22 weeks
After an abnormal AFP screen, what is the best next concept?
Screen result confirms diagnosis—no follow up needed
Abnormal screen requires follow-up testing (often ultrasound ± amniocentesis)
Repeat AFP daily until normal
Treat with magnesium sulfate immediately
Amniocentesis is best described as:
Placental biopsy at 10–13 weeks
Aspiration of amniotic fluid for testing (typically after 15 weeks)
Cervical biopsy after 20 weeks
IV test measuring fetal oxygenation directly
After amniocentesis, which action is priority?
Perform digital vaginal exam
Keep client NPO 24 hours
Monitor FHR and uterine activity; give Rh immune globulin if Rh-negative
Start oxytocin infusion
CVS [chorionic villus sampling] is typically performed:
10–13 weeks
16–18 weeks
After 28 weeks
After 15 weeks only
A key limitation of CVS compared with amniocentesis is:
CVS cannot evaluate genetics
CVS does not screen neural tube defects the same way AFP does
CVS has zero miscarriage risk
CVS is done after fetal viability only
Nuchal translucency screening is performed around:
6–8 weeks
16–18 weeks
28–30 weeks
11–13 weeks
A nurse interprets nuchal translucency. Which result is most concerning?
1.6 mm
2.0 mm
2.4 mm
2.8 mm
A nurse is planning teaching for prenatal testing indications. Which history best supports antenatal surveillance?
Previous fetal demise/stillbirth
Mild nausea only
Normal BP and normal fetal movement
Seasonal allergies
A nurse is reviewing contraindications to procedures that stimulate contractions. Which condition is the clearest “do not do this”?
Placenta previa with bleeding
Normal pregnancy at 39 weeks
Mild anemia
Controlled gestational diabetes
A nurse is teaching fetal kick counts. Which instruction is best?
Count for 5 minutes once weekly
Immediately perform CST if fewer kicks
Lie down, focus, and report decreased movement per provider plan
Kick counts replace all fetal testing
A client asks why ultrasound may be ordered after abnormal screening. Best response?
“It’s used to confirm and further evaluate abnormal screening findings.”
“It treats fetal anomalies.”
“It replaces all lab work forever.”
“It is only done at delivery.”
A nurse is teaching warning signs. Which finding requires urgent evaluation?
Mild nausea early pregnancy
Slight ankle edema at end of day
Persistent severe headache or visual changes
Increased appetite
A nurse is reviewing pregnancy loss definitions: abortion (pregnancy loss) is generally:
Loss after 28 weeks
Loss before 20 weeks (typical teaching threshold)
Loss after delivery
Loss only after fetal heartbeat
IUFD [intrauterine fetal demise] most closely refers to:
Loss before implantation
Loss before 6 weeks only
Fetal death at/after viability threshold (course-defined criteria)
Bleeding with a viable fetus and closed cervix
A client has vaginal bleeding/cramping; cervix is closed; ultrasound shows viable pregnancy. Which type is most consistent?
Threatened abortion
Inevitable abortion
Incomplete abortion
Complete abortion
Cervix is dilated with bleeding/cramping, but no products have passed. Most consistent type?
Threatened
Missed
Complete
Inevitable
Ultrasound shows uterus empty; products completely expelled. Which type is most consistent?
Complete abortion
Threatened abortion
Inevitable abortion
Missed abortion
Retained products remain in uterus (not fully expelled). Which type is most consistent?
Complete
Missed
Inevitable
Incomplete
No bleeding/cramping; pregnancy symptoms regress; nonviable embryo/fetus on ultrasound. Most consistent?
Missed abortion
Threatened abortion
Complete abortion
Inevitable abortion
Most common cause of spontaneous abortion is:
Maternal hypotension
Chromosomal abnormalities
High calcium intake
Daily exercise
After pregnancy termination, which finding requires immediate provider notification?
Mild cramping controlled with OTC meds
Light spotting for 1–2 days
Sudden severe abdominal pain + heavy bleeding
Mild fatigue
After medication termination, which symptom most suggests infection?
Mild nausea only
Foul-smelling discharge with fever
Mild spotting only
Breast tenderness only
A nurse caring for a client with pregnancy loss should prioritize:
Therapeutic communication and privacy
Avoid discussing grief
Rushing paperwork to “move on”
Limiting support persons
A client asks to see/hold the fetus after an IUFD. Best nursing response?
“That’s not allowed here.”
“You must decide right now.”
“No visitors are permitted.”
“We can support memory-making if you want.”
A client with suspected IUFD reports decreased fetal movement. What is the priority diagnostic confirmation?
NST immediately only
Doppler only once then discharge
Ultrasound to confirm fetal cardiac activity status
Pelvic exam to check dilation
A nurse teaching post-loss care includes which priority teaching?
Avoid follow-up visits
Follow-up, mental health screening, and contraception discussion as appropriate
Encourage isolation for 6 weeks
Never discuss lactation changes
A nurse is triaging a pregnant client with painless bright-red bleeding. Priority action?
Digital vaginal exam
Obtain IV access, monitor, and confirm placental location by ultrasound before any vaginal exam
Induce labor immediately
Send home if fetal movement is present
A pregnant client has painful bleeding and a rigid tender uterus. Best priority interpretation?
Placenta previa
Cervical insufficiency
Placental abruption
Normal labor changes
A nurse is caring for suspected placenta previa. Which action is contraindicated?
Continuous fetal monitoring
IV access and type/cross as ordered
Ultrasound for placental location
Digital vaginal exam
A client with known placenta previa is stable at 33 weeks with minimal bleeding. Best plan?
Expectant management: pelvic rest + monitoring + prepare for emergent delivery if bleeding worsens
Frequent cervical checks
Artificial rupture of membranes
Encourage intercourse to “ripen cervix”
A placenta previa client develops heavy bleeding with nonreassuring fetal status. Priority intervention?
Prepare for cesarean birth
Wait for NST in 2 hours
Encourage ambulation
Offer oral fluids only
Which finding best matches placental abruption?
Painless bleeding with soft uterus
Painful bleeding with uterine tenderness/rigidity
Bleeding only after delivery
No pain and no uterine tone change
Biggest risk factor emphasized for abruption is:
Hypertension
Late menarche
Daily aerobic exercise
High HDL
Which substance use is strongly associated with abruption risk?
Cocaine use
Dairy intake
Prenatal vitamins
Acetaminophen use
Abruption can cause maternal DIC [disseminated intravascular coagulation]. Which lab trend supports DIC concern?
Rising fibrinogen
Decreasing PT/aPTT
Low fibrinogen / abnormal coagulation profile
Elevated HDL
A nurse suspects severe abruption. What is the priority first intervention?
Establish large-bore IV access + begin stabilization (fluids/blood as ordered)
Perform vaginal exam
Delay interventions until ultrasound complete
Encourage pushing
A patient with abruption shows fetal distress and worsening maternal vitals. Priority action?
Prepare for urgent delivery (often emergent C-section depending on status)
Schedule quad screen
Reassure and recheck in 4 hours
Start CST
Vasa previa is most dangerous when:
Membranes rupture → fetal vessels tear → rapid fetal blood loss
Client lies on left side
Client eats high protein
Client takes prenatal vitamins
