Health Promotion and Maintenance
73. A client with type 1 insulin-dependent diabetes presents to a prenatal clinic at 17 weeks' gestation for α-fetoprotein testing. She asks a nurse why this test is being performed. Which explanation by the nurse would be most accurate?
. "This test is to determine the sex of your baby."
. "This test is to determine glycemic control."
. "This test is screening for neural tube defects."
. "This test is to determine fetal lung maturity."
Test-Taking Tip
The most important fact in this question is that the client with insulin-dependent diabetes has a higher risk for having a fetus with neural tube defects, and the AFP test screens for this possibility.
Content Area: Maternity, Antepartum; Integrated Process: Nursing Process, Implementation; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Diagnostic Tests
Health Promotion and Maintenance
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Answer 1 is incorrect because analysis of amniotic fluid from amniocentesis allows determination of fetal gender. Answer 2 is incorrect because glycemic control is determined by hemoglobin A1c, a maternal blood test. Answer 3 is correct because the α-fetoprotein (AFP) is a maternal blood test that screens for possible neural tube defects (the most common anomaly) in fetuses of a client with diabetes. It can also indicate the presence of Down syndrome. Answer 4 is incorrect because the presence of phosphatidylglycerol and the L/S ratio determine fetal lung maturity. It is obtained from amniotic fluid.