The prenatal clinic nurse meets with a 30-year-old woman who is ...

[arivle123]

The prenatal clinic nurse meets with a 30-year-old woman who is experiencing her first pregnancy. The patient's quadruple-marker screen result is positive at 17 weeks of gestation.
 
  Which action by the nurse is most important?
  A.
  Call the social worker for a consultation.
  B.
  Document the findings in the woman's chart.
  C.
  Facilitate a referral to a genetics counselor.
  D.
  Prepare the woman for intrauterine death.

Question 2

A perinatal nurse is assessing a pregnant woman's medications and finds that one of them is categorized as Category D. What information should the nurse provide this patient?
 
  A.
  Studies have not found human fetal risk, although animal fetuses are harmed by it.
  B.
  There are no associated fetal risks with this drug and it is safe to take in pregnancy.
  C.
  There haven't been any studies of this drug in human fetuses; I wouldn't take it.
  D.
  We have to decide if the benefits of this drug outweigh the risk, as it can harm the fetus.

[nathang24]

Answer to Question 1

ANS: C
Feedback: All women should be offered screening with maternal serum markers. The triple-marker screen and the quadruple-marker screen test for the presence of alpha-fetoprotein, estradiol, human chorionic gonadotropin, and other markers. These tests screen for potential neural tube defects, Down syndrome, and trisomy 18. If the screen is positive, the woman should be referred to a genetics specialist for counseling and further testing, such as chorionic villus sampling or amniocentesis, should be performed (ACOG, 2007). There is no indication that the woman needs a social work consult or that she will experience intrauterine death. Documentation should be complete, but is not the most important action for the nurse to take.

Answer to Question 2

ANS: D
There are five categories of drugs based on fetal risk: Category A: no associated fetal risk, safe to take during pregnancy; Category B: no associated fetal risk in animals, fetal risk in humans not identified; Category C: evidence of adverse effects in animal fetuses, fetal risk in humans not identified; Category D: evidence of adverse effects and fetal risk in humans, benefits and risks must be considered before prescribing; and Category X: evidence of fetal risk and congenital anomalies in humans, risks outweigh the benefits, should not be prescribed during pregnancy.

[arivle123]

Thanks for the timely response, appreciate it

[kusterl]

Excellent