Family Nurse Practitioner Exam

In a 28-week pregnant multigravida with a fundal height of 29 cm, the best recommendation is to:

1. Advise the mother that her pregnancy is progressing well

2. Order an ultrasound of the uterus

3. Refer her to an obstetrician for an amniocentesis

4. Recommend bed rest with bathroom privileges

The correct answer is: Advise the mother that her pregnancy is progressing well

The recommendation to advise the mother that her pregnancy is progressing well is based on the fact that fundal height measurements are typically used to assess fetal growth and development during pregnancy. At 28 weeks of gestation, a fundal height of 29 cm falls within an acceptable range, suggesting that the fetus is likely growing adequately. Fundal height measurements are generally expected to correlate closely with gestational age, and minor discrepancies—such as being one centimeter above the week of gestation—can be normal variations in pregnancy assessment. It's important to recognize that while the fundal height might be slightly ahead of the expected measurement, this does not necessarily indicate a problem, especially in the absence of other concerning clinical signs or symptoms. This reassurance is beneficial for the mother, as it can help reduce anxiety regarding the progress of her pregnancy. The other options would imply a level of concern that is not warranted given the context. An ultrasound or referral for amniocentesis would usually be considered if there were significant discrepancies in growth or other risk factors detected during the pregnancy. Similarly, recommending bed rest typically is reserved for more complicated pregnancies where there are risks of preterm labor or other medical issues present. Therefore, advising the mother that her pregnancy is progressing well is the