Module 4 Unit C Practice Questions Flashcards
A normal anatomy ultrasound identifies 3 umbilical cord vessels. The normal cord contains:
Two arteries that carry deoxygenated blood and one vein that carries oxygenated blood
[I know this one seems tricky because it seems contrary to the way we think of how these vessels operate within adults. The easiest way to remember this is that it is the opposite.
The two umbilical arteries carry deoxygenated fetal blood toward the placenta for replenishment, and the one umbilical vein carries newly oxygenated and nutrient-rich blood back to the fetus]
Where would the clinician expect to find a patient’s fundus during a prenatal visit at 14 4/7 weeks’ gestation?
Slightly below halfway between the symphysis and umbilicus
[At 14 weeks the fundal height is typically: Symphysis + 2 finger breadths to almost halfway between symphysis and umbilicus
At the umbilicus is consistent with 20 weeks.
At the symphysis is consistent with 12 weeks.]
When the clinician measures fundal height at 26 weeks’ gestation, what cm range is expected?
24-28 cm
[When using a measuring tape from >20 weeks, it is normal to measure within 2 cm above or below the gestational age in centimeters. Therefore, at 26 weeks it would be normal to measure between 24-28 CM.]
The clinician is auscultating the fetal heart rate at a 21-week visit. What is the expected FHR range?
110-180 bpm
The average baseline fetal heart rate in a healthy fetus at 20 weeks is approximately 155 beats per minute with a range of 110-180 bpm
Which of these is an important reason for ultrasonographic assessment of the fetal face during a 20-week ultrasound?
To assess for presence or absence of clefting
What is the physiologic reason for second trimester fetuses tending to have different baseline heart rates compared with fetuses at term?
Earlier in gestation, the sympathetic nervous system predominates, causing a higher heart rate
[Very early-gestation fetuses have a predominantly sympathetic nervous system and thus their heart rates tend to be higher compared with heart rates in later gestation.]
Given that first trimester genetic tests do NOT evaluate for neural tube defects, what part of second trimester genetic tests DO evaluate for neural tube defects?
alpha-fetoprotein
[AFP is a protein made by the fetus that can be measured in the amniotic fluid and maternal serum. A fetus with a neural tube defect (an opening in the skull or spine) will leak a higher than usual amount of AFP. Recall that first trimester tests do NOT screen or test for neural tube defects?]
A patient is interested in avoiding any electronic monitoring methods for her baby. What is the earliest gestational age at which the clinician might be able to hear fetal heart tones with a fetoscope?
15 weeks
[It is possible to hear the fetal heartbeat with a fetoscope beginning at 15 or 20 weeks.]
When can an amniocentesis be performed?
15w+
[An amniocentesis could be performed from 15 weeks and on.]
What is the average gestational age range for quickening?
16-20 weeks
[Average gestational age for quickening is 16-20 weeks but some pregnant people might feel fetal movement as early as 14 weeks (e.g. those who have felt fetal movement or carried a baby to term before) and others might not feel movement until 22 weeks.]
A patient at 24 weeks calls the office to say that she felt fetal movement for the first time at 19 weeks but she has not felt any movement for the last 5 days. What should the clinician recommend?
Come to the office today for an assessment.
[Most pregnant people in the second trimester feel some movement daily or several times each day but not in a discernible pattern like in the third trimester. In general, once the mother begins feeling movement, we expect that she will continue to feel it. If the patient has not felt movement in 5 days we would want to evaluate further.]
A patient is at a prenatal visit at 22 weeks’ gestation. How should the clinician assess the fundal height?
Tape measure from symphysis to fundus
[After 20 weeks we begin measuring the fundal height using a measuring tape. Bimanual exam would be appropriate when under 12 weeks. Palpation in relationship to the symphysis and umbilicus is beneficial between 12-20 weeks.]
The midwife/WHNP is reviewing the report of a 20-week anatomy ultrasound. The reports states that the sonographer was unable to visualize the ventricular outflow tracts of the fetal heart. How should the midwife/WHNP proceed?
Ensure the patient has a follow up ultrasound within 1-2 weeks.
[The inability to visualize the ventricular outflow tracts of the fetal heart does not mean that it is missing. This can happen depending on the position the fetus is lying during the ultrasound. The next appropriate step is to perform a follow-up US in a week or 2. If there is an abnormal finding on the ultrasound, then consultation would be appropriate.]
True or false? The quad screen is a blood test with 4 analytes that screens for neural tube defects, Down Syndrome, and trisomy 18.
True
[Quad screen: Tests for 4 analytes (AFP, HCG, estriol, and inhibin A) and screens for:
- Trisomy 18
-Trisomy 21
-Neural tube defects]
What is the average fetal heart rate for a fetus at 20 weeks’ gestation?
155
