OB Chapt 11 Maternal Adaptation During Pregnancy
A pregnant woman is experiencing morning sickness. Which of the following responses indicates a need for further teaching? a) "I'll snack on unsalted cracker." b) "I'll avoid an empty stomach." c) "I'll take antacid between meals." d) "I'll eat frequent small servings of bland foods."
"I'll take antacid between meals." Correct Explanation: The patient should avoid use of medications unless prescribed by the provider. Avoiding an empty stomach, snacking on a cracker, or eating small servings of bland food are better options and may manage the morning sickness.
At 40 weeks gestation, a woman in for her prenatal visits states to the nurse "I am tired of being pregnant". What is the appropriate response by the nurse? a) "Most woman would have asked to be induced by this point, is that what you want?" b) "Are you getting enough rest? If you don't take time for rest, that is why you might be tired." c) "Do you need to speak with someone about your feelings?" d) "That is a very normal feeling, especially at this point in pregnancy."
"That is a very normal feeling, especially at this point in pregnancy." Correct Explanation: During the third trimester, the patient is preparing for parenthood and is often tired and ready for a break. The woman may feel large and unable to do any normal activities and be ready to have her baby in her arms rather than in her uterus. This is not an abnormal statement and the provider should not overreact. Deciding to induce is something that should be done in consultation with the physician, and only when it failing to do so would have a negative impact on the mother or baby.
A client in her second trimester of pregnancy arrives at the health care facility for a routine follow-up visit. The nurse is required to educate the client so that the client knows what to expect during her second trimester. Which of the following information should the nurse offer? a) "You will be more conscious of the changes taking place in your body now." b) "You will experience quickening, and you will actually feel the baby." c) "You may feel physical discomfort as the baby inside grows." d) "You may have mood swings that could overwhelm your partner."
"You will experience quickening, and you will actually feel the baby." Correct Explanation: The nurse should inform the client that quickening occurs in the second trimester. The client will be able to physically feel the fetal movements, which will help her bond with her developing fetus. Physical discomfort actually starts to increase in the third trimester as the fetus grows rapidly. The client feels conscious of the changes taking place in her body due to her pregnancy primarily in the first trimester, not the second. The client is likely to have mood swings in the first trimester of the pregnancy, which can be very overwhelming for the client as well as her partner.
During a prenatal visit, the nurse inspects the skin of the client's abdomen. Which of the following would the nurse identify as an abnormal finding? a) Linea nigra b) Bruising c) Striae d) Darkening of the umbilicus
Bruising Explanation: Bruising would not be a normal finding. Evidence of bruising might suggest domestic violence. Linea nigra, striae, and darkening of the umbilicus are normal findings.
Which of the following would the nurse identify as a normal physiologic change in the renal system due to pregnancy? a) Shortening of the ureters b) Reduction in kidney size c) Dilation of the renal pelvis d) Decrease in glomerular filtration rate
Dilation of the renal pelvis Correct Explanation: The renal pelvis becomes dilated during pregnancy, possibly due to the effect of progesterone on smooth muscle. The glomerular filtration rate increases during pregnancy. The kidneys enlarge during pregnancy. The ureters elongate, widen, and become more curved above the pelvic rim.
Which of the following is a positive sign of pregnancy? a) Fetal movement felt by examiner b) Uterine contractions c) Hegar's sign d) Positive pregnancy test
Fetal movement felt by examiner Correct Explanation: The positive signs of pregnancy are fetal image on sonogram, hearing a fetal heart rate, and examiner feeling fetal movement. A pregnancy test may come back as a false positive. Hegar's sign is a softening of the uterine isthmus. Uterine contractions may occur at any time.
A pregnant woman's husband does not voice concerns at prenatal visits. You would believe he is emotionally involved in the pregnancy by observing which of the following actions? a) He states he is concerned about the loss of his free time. b) He has refused to paint the baby's room blue. c) He states he definitely wants a girl. d) He walks around furniture as if his abdomen is enlarged.
He walks around furniture as if his abdomen is enlarged. Correct Explanation: Men who identify with their wife's pregnancy may act as if their abdomen is enlarging, the same as they may take on nausea of pregnancy.
The nurse teaches a pregnant woman about breastfeeding, stating that stimulation of the breast through sucking or touching stimulates the secretion of which hormone? a) Cortisol b) Follicle stimulating hormone c) Antidiuretic hormone d) Oxytocin
Oxytocin Correct Explanation: Oxytocin is responsible for milk ejection during breastfeeding. Its secretion is stimulated by stimulation of the breasts via sucking or touching. Secretion of follicle-stimulating hormone is inhibited during pregnancy. The secretion of antidiuretic hormone has no effect on breastfeeding. Cortisol secretion regulates carbohydrate and protein metabolism and is helpful in times of stress.
When a woman is pregnant she often craves specific things, like pickles or ice cream. There is one craving that is associated with iron deficiency anemia and should be reported to the Registered Nurse if it occurs. What is this craving called? a) Pica craving b) Carnivorous craving c) Lactose mania d) Chocolate mania
Pica craving Correct Explanation: Pica is the persistent ingestion of nonfood substances, such as clay, laundry starch, freezer frost, or dirt. Pica is associated with iron-deficiency anemia, but it is unknown whether iron-deficiency is the cause or the result. Some women find that the cravings cease when they begin taking iron supplements (Mills, 2007). If you suspect or discover that a pregnant woman is practicing pica, tell the registered nurse (RN) or the practitioner immediately.
A woman calls the clinic to schedule an appointment because "I think I might be pregnant." Upon further assessment gathering of information from the woman, which of the following would be a probable sign of pregnancy? a) Fatigue b) Nausea and vomiting c) Amenorrhea d) Positive home pregnancy test
Positive home pregnancy test Correct Explanation: A positive home pregnancy test is confirmed by hCG in the urine. This is considered a probable sign of pregnancy. Fatigue, amenorrhea, and vomiting can all have other causes.
The hormone responsible for the initiation of lactation is what? a) Estrogen b) Oxytocin c) Prolactin d) Progesterone
Prolactin Correct Explanation: Prolactin is the hormone responsible for the initiation of lactation, the production of breastmilk. Oxytocin is responsible for the let down of milk and contraction, estrogen and progesterone are responsible for uterine and pregnancy maintenance.
During pregnancy, there are many psychological changes. What is a critical component for a positive psychological experience with pregnancy by the woman? a) Having a planned pregnancy b) Her age at the time of pregnancy c) Social support d) Early prenatal care
Social support Correct Explanation: All of the above are correct and play a role pregnancy, but the most critical for a positive psychological experience is for the woman to have a social support system. Early care, maternal age, and planned pregnancy all affect fetal and maternal health, but are not necessarily linked to positive psychological experiences.
Morning sickness is associated with rising levels of human chorionic gonadotropin (hCG) and progesterone. a) False b) True
True Correct Explanation: Known as morning sickness, nausea and vomiting begins to be noticed at the same time levels of hCG and progesterone begin to rise so these may contribute to its cause. Another reason may be a systemic reaction to increased estrogen levels or decreased glucose levels, because glucose is being used in such great quantities by the growing fetus.
A client comes to the prenatal clinic for a follow-up examination. When assessing the breasts, which of the following would the nurse expect to find? Select all that apply. a) Hyperpigmentation of the nipple b) Prominent veins c) Increased sensitivity d) Warmth e) Pallor of the areolae
• Hyperpigmentation of the nipple • Prominent veins • Increased sensitivity Correct Explanation: Normal breast findings include prominent veins, nodular breasts, increased sensitivity to touch, and hyperpigmentation of the nipples and areolae. Warmth would suggest possible infection.
The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which of the following data collected by the nurse are presumptive signs of her pregnancy? Select all that apply. a) Fetal heartbeat b) Morning sickness c) Hydatidiform mole d) Ultrasound pictures e) Amenorrhea f) Breast changes
• Morning sickness • Amenorrhea • Breast changes Correct Explanation: Presumptive signs are possible signs of pregnancy that appear in the first trimester, often only noted subjectively by the mother (e.g., breast changes, amenorrhea, morning sickness). Probable signs are signs that appear in the first and early second trimesters, seen via objective criteria, but can also be indicators of other conditions (e.g., hydatidiform mole). Positive signs affirm that proof exists that there is a developing fetus in any trimester and are objective criteria seen by a trained observer or diagnostic study, (e.g., ultrasound.)
Many changes occur in the body of a pregnant woman. Some of these are changes in the integumentary system. What is one change in the integumentary system called? a) Chloasma b) Ballotment c) Chadwick's sign d) Linea rubria
Chloasma Correct Explanation: The so-called mask of pregnancy, chloasma can appear as brown blotchy areas on the forehead, cheeks, and nose of the pregnant woman. This condition may be permanent, or it may regress between pregnancies.
A nurse urges a pregnant patient at the first prenatal office visit to begin taking iron supplements immediately. What is the rationale for this intervention? a) To prevent megalohemoglobinemia b) To maintain proper blood glucose levels c) To reduce the risk for hypertension d) To avoid anemia
To avoid anemia Correct Explanation: The increase in the mother's circulatory red blood cell mass requires an additional 400 mg of iron per day or creates a total needed increase of about 800 mg. Iron deficiency can lead to anemia, which is a condition of lower-than-normal levels of red blood cells. Folic acid is taken to prevent megalohemoglobinemia (large, nonfunctioning red blood cells). Iron supplementation does not maintain proper blood glucose levels or reduce the risk for hypertension.
Which of the following tasks is the most important task of the first trimester of pregnancy? a) Accepting a coming child. b) Accepting the pregnancy. c) Sharing time with a significant other. d) Making plans for the baby.
Accepting the pregnancy. Correct Explanation: Before a fetus moves, adjusting to pregnancy is a primary task; later, adjusting to having a baby becomes the primary task.
During a routine visit to the clinic, a client tells the nurse that she thinks she may be pregnant. The physician orders a pregnancy test. The nurse should know the purpose of this test is to determine which change in the client's hormone level? a) Decrease in HCG b) Increase in luteinizing hormone (LH) c) Decrease in LH d) Increase in human chorionic gonadotropin (HCG)
Increase in human chorionic gonadotropin (HCG) Correct Explanation: HCG increases in a woman's blood and urine to fairly large concentrations until the 15th week of pregnancy. The other hormone values aren't indicative of pregnancy.
Amanda's menstrual period is two weeks late. She has been feeling tired and has had bouts of nausea in the morning. What classification of pregnancy symptoms is Amanda experiencing? a) Presumptive b) Positive c) Probable d) No classification
Presumptive Correct Explanation: The most common presumptive sign of pregnancy is a missed menstrual period, or amenorrhea. Other presumptive signs include nausea, fatigue, swollen, tender breasts, and frequent urination
Which of the following statements would the nurse include in the teaching plan for a pregnant woman related to changes in the uterus? a) Uterine growth occurs because of an increase in the number of cells in the uterus. b) The uterus reaches its maximum height in the abdomen at 39 weeks. c) The uterus moves into the abdomen by the second month of pregnancy. d) The uterus changes from a pear-shaped organ to an oval one.
The uterus changes from a pear-shaped organ to an oval one. Correct Explanation: The uterus starts as a pear-shaped organ and becomes oval as length increases over width. Uterine growth is primarily related to an increase in size of the myometrial cells. The uterus remains in the pelvic cavity for the first 3 months, after which it progressively ascends into the abdomen. The uterus reaches its highest level at the xiphoid process at approximately 36 weeks. Between 38 to 40 weeks, fundal height drops as the fetus begins to descend and engage into the pelvis.
During an examination, a client who's 32 weeks pregnant becomes dizzy, lightheaded, and pale while supine. What should the nurse do first? a) Turn the client on her left side. b) Take the client's blood pressure. c) Listen to fetal heart tones. d) Ask the client to breathe deeply.
Turn the client on her left side. Correct Explanation: As the enlarging uterus increases pressure on the inferior vena cava, it compromises venous return, which can cause dizziness, light-headedness, and pallor when the client is supine. The nurse can relieve these symptoms by turning the client on her left side, which relieves pressure on the vena cava and restores venous return. Although they're valuable assessments, fetal heart tone and maternal blood pressure measurements don't correct the problem. Because deep breathing has no effect on venous return, it can't relieve the client's symptoms.
To prepare his 4-year-old son for a new baby, which of the following statements would you suggest a father use? a) "A new baby will make our family bigger but not change our love for you." b) "Mother will need to spend a lot of time with the new baby." c) "It will be fun to have a sister or brother to give your old toys to." d) "The new baby will need your bed so we're buying you a new one."
"A new baby will make our family bigger but not change our love for you." Correct Explanation: It is important that siblings see a new family member as adding to the family (not displacing them) to prevent jealousy.
Amanda is about 16 weeks pregnant and is concerned because she feels her "abdomen" contracting. She calls the doctors office and speaks to the nurse. What is the most appropriate response to Amanda's concern? a) "You need to go to the emergency room right away." b) "What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy." c) "You need to come to the office to be examined." d) "You have nothing to be concerned about. I am sure you are not feeling contractions at this point in your pregnancy."
"What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy." Correct Explanation: Braxton Hicks contractions are the painless, intermittent, "practice" contractions of pregnancy.
A woman's prepregnant weight is within the normal range. During her second trimester, the nurse would determine that the woman is gaining the appropriate amount of weight when her weight increases by which amount per week? a) 1.5 lb b) 1 lb c) 2/3 lb d) 2 lb
1 lb Correct Explanation: The recommended weight gain pattern for a woman whose prepregnant weight is within the normal range would be 1 lb per week during the second and third trimesters. Underweight women should gain slightly more than 1 lb per week. Overweight women should gain about 2/3 lb per week.
A young woman comes in for her annual exam. She reports missing her last two periods but she is confident that she cannot be pregnant, because she took a home pregnancy test and the result was negative. If all of the following were present, which one would positively confirm a pregnancy? a) A fetal heartbeat b) A positive result on EIA c) Changes in the size and shape of the uterus d) Chadwick's sign
A fetal heartbeat Correct Explanation: The only positive sign of pregnancy is a sign or symptom that could only be attributable to the fetus, thus fetal heartbeat can have no other origin. Chadwick's sign is a color change in the cervix, vagina, and perineum. EIA only tests for HCG. A change in the size and shape of the uterus can occur due to other causes. (less)
Many factors influence how a woman adapts psychologically to pregnancy. What is the psychological adaptation the woman must come to terms with during the second trimester? a) Prepare for parenthood b) Prepare for labor and delivery c) Accept the baby d) Accept the pregnancy
Accept the baby Correct Explanation: Gradually, as the pregnancy progresses, she comes to have a sense of the child as his or her own separate entity. This acceptance may be enhanced when she first hears the fetal heartbeat, when she feels the baby move inside her, or when she sees the fetal image during a sonogram.
An overweight teenaged girl comes in for a routine physical exam. She reports that there have been no changes in her health since her last visit, so you are astounded to observe Chadwick's sign during her pelvic exam. A subsequent enzyme immunoassay (EIA) indicates that she is almost certainly pregnant but she denies it. Which task of pregnancy does she need help with? a) Preparing for parenthood b) Naming the baby c) Accepting the baby d) Accepting the pregnancy
Accepting the pregnancy Correct Explanation: Acceptance of pregnancy is mutli-factorial, and how the woman responds to the pregnancy is certainly influenced by her age and if the pregnancy was planned. As a teenage, she may not have been trying to get pregnant and may not want to accept the role and experience. The baby and parenthood decisions should all occur later
A friend tells you that she is going to use a home pregnancy test to determine whether she is pregnant. Which of the following precautions would you give her? a) Refrain from eating for 4 hours before testing. b) Use a diluted urine specimen. c) Wait until after two missed menstrual periods. d) Arrange for prenatal care if the test is positive.
Arrange for prenatal care if the test is positive. Correct Explanation: Home pregnancy testing can be accurate as soon as a period is missed; it should not take the place of prenatal care.
During a routine antepartal visit, a pregnant woman reports a white thick vaginal discharge. Which of the following would the nurse do next? a) Check the discharge for evidence of ruptured membranes. b) Tell the woman that this is entirely normal. c) Advise the woman about the need to culture the discharge. d) Ask the woman if she is having any itching or irritation.
Ask the woman if she is having any itching or irritation. Correct Explanation: Although vaginal secretions increase during pregnancy, the nurse would need to ascertain if this discharge is the normal leukorrhea of pregnancy or if it is a monilial vaginitis, which is common during pregnancy. The nurse needs additional information to conclude that the woman's complaint is normal. A culture may or may not be necessary. There is no evidence to suggest that her membranes have ruptured.
As a pregnant woman lies on the examining table, she grows very short of breath and dizzy. This phenomenon probably happens because a) Sympathetic nerve responses cause dyspnea when a woman lies supine b) Her cerebral arteries are growing congested with blood c) The uterus requires more blood in a supine position d) Blood is trapped in the vena cava in a supine position
Blood is trapped in the vena cava in a supine position Correct Explanation: Supine hypotension syndrome, or an interference with blood return to the heart, occurs when the weight of the fetus rests on the vena cava. Cerebral arteries should not be affected. Mean arterial pressure is high enough to maintain perfusion of the uterus in any orientation. The sympathetic nervous system will not be affected by the supine position.
During pregnancy a woman has many psychological adaptations that must be made. The nurse must remember that the baby's father is also experiencing the pregnancy and has adaptations that must be made. Some fathers actually have symptoms of the pregnancy along with the mothers. What is this called? a) Couvade syndrome b) Pseudo pregnancy c) Cretinism d) Pregnancy syndrome
Couvade syndrome Correct Explanation: Some fathers actually experience some of the physical symptoms of pregnancy, such as nausea and vomiting, along with their partner. This phenomenon is called couvade syndrome.
If a woman is 3 months pregnant, which of the following findings related to breast changes would you expect to assess? a) Darkened breast areolae b) Enlarged lymph nodes c) Deeply fissured nipples d) Slack, soft breast tissue
Darkened breast areolae Correct Explanation: As part of the pigment changes that occur with pregnancy, breast areolae become darker. The breast tissue should not be softer or slacker than before. There should not yet be any lymph enlargement, and the nipples should not have fissures.
Amanda makes an appointment with an obstetrician. During the exam, the obstetrician notes that the uterine isthmus is soft. What is the name of this sign, and how is it classified? a) Goodell's sign; probable b) Chadwick's sign; presumptive c) Goodell's sign; presumptive d) Hegar's sign; probable
Hegar's sign; probable Correct Explanation: Probable signs of pregnancy are those detected by a trained examiner. The examiner identifies Hegar's sign, softening of the uterine isthmus, and Goodell's sign, softening of the cervix, during the speculum and digital pelvic examinations.
A pregnant woman you care for tells you she often has allergic responses to drugs. She is concerned that she will be allergic to her fetus or her body will reject the pregnancy. You would base your reply to her on which of the following statements? a) The level of aldosterone during pregnancy reduces production of IgG antibodies. b) Immunologic activity is decreased during pregnancy. c) The kidneys release a hormone during pregnancy to prevent this from happening. d) The decreased corticosteroid activity during pregnancy ensures this will not happen.
Immunologic activity is decreased during pregnancy. Correct Explanation: It is unproven why women do not reject fetal (foreign) tissue, but a substance secreted by the placenta is thought to decrease the usual immunologic response and prevent this from happening.
Which change in respiratory function during pregnancy is considered normal? a) Decreased oxygen consumption b) Decreased inspiratory capacity c) Increased expiratory volume d) Increased tidal volume
Increased tidal volume Correct Explanation: A pregnant client breathes more deeply, which increases the tidal volume of gas moved in and out of the respiratory tract with each breath. The expiratory volume and residual volume decrease as the pregnancy progresses. The inspiratory capacity increases during pregnancy. The increased oxygen consumption in the pregnant client is 15% to 20% greater than in the nonpregnant state.
A woman in her third trimester shows the nurse a narrow, brown line that has formed on her abdomen, running from her belly button down to her pubic region. She expresses concern about this and asks the nurse whether it is normal. The nurse explains that this is a normal occurrence of pregnancy and that it results from the release of melanocyte-stimulating hormone from the pituitary, causing the appearance of extra pigmentation on the skin. This phenomenon is known as which of the following? a) Diastasis b) Linea nigra c) Melasma d) Striae gravidarum
Linea nigra Correct Explanation: Extra pigmentation generally appears on the abdominal wall, because of melanocyte-stimulating hormone from the pituitary. A narrow, brown line (linea nigra) may form, running from the umbilicus to the symphysis pubis and separating the abdomen into right and left halves. The other answers are other changes that occur in the integumentary system during pregnancy, including melasma (darkened or reddened areas on the face), diastasis (separation of the rectus muscles under the skin), and striae gravidarum (stretch marks; pink or reddish streaks on the sides of the abdominal wall and sometimes on the thighs).
A 22-year-old primagravida comes to the office for a prenatal visit. She is in her second trimester and has had prenatal care since she was 8 weeks pregnant. Her only complaint is a new brownish line straight down her abdomen. Vital signs are unremarkable. Urine has no protein, glucose, or leukocytes. Fetal heart rate is 140; the client's uterus is palpated to the umbilicus. What physical finding is responsible for her new "brown line?" a) Diastasis recti b) Linea nigra c) Corpus luteum d) Linea alba
Linea nigra Correct Explanation: The linea nigra is a hyperpigmented area of skin linear along the midline of the abdomen. It results from the hormonal changes of pregnancy and is considered an expected finding.
The nurse explains to a pregnant client, who is anemic, that she will need to take vitamins with iron during her pregnancy. What are food would you include on the patient's diet plan? a) Dairy b) Grains c) Legumes d) Meats
Meats Correct Explanation: Grains are a source of iron but not as good a source as the heme iron of meats. The other choices should be avoided when taking the iron and vitamin supplement as milk and legumes decrease the absorption of iron.
A 39-year-old woman is pregnant with her first child and appears to be thrilled about it. Now in her second trimester, she talks enthusiastically with the nurse about the latest maternity clothes she has bought and models them for the nurse. She also discusses the latest trends in health foods, which she has adopted since learning of her pregnancy. The nurse recognizes which primary emotional response to pregnancy in this patient? a) Narcissism b) Introversion c) Stress d) Emotional lability
Narcissism Explanation: Self-centeredness (narcissism) may be an early reaction to pregnancy. A woman who previously was barely conscious of her body, who dressed in the morning with little thought about what to wear, suddenly begins to concentrate on these aspects of her life. She dresses so her pregnancy will or will not show. There is no evidence in this scenario of stress, introversion, or emotional lability.
Early in pregnancy, frequent urination results mainly from which of the following? a) Increased concentration of urine b) Pressure on the bladder from the uterus c) Decreased glomerular selectivity d) Addition of fetal urine to maternal urine
Pressure on the bladder from the uterus Correct Explanation: Early in pregnancy, the expanding uterus presses on the bladder. During the second trimester there is some relief when the uterus lifts, but the pressure returns again as the fetus continues to grow. Urine concentration does not affect frequency. Fetal urine does not enter the mother's renal system, except through increases in circulatory volume. The glomeruli should not be affected by pregnancy.
The client at 18 weeks' gestation states, "I feel a fluttering sensation, kind of like gas." The nurse understands that the client is describing what occurrence? a) Quickening b) Lightening c) Placenta previa d) Linea nigra
Quickening Correct Explanation: The fluttering sensation that can be confused with gas is called "quickening." In the 2 weeks leading up to the 20-week mark, she may feel "flutters" that she may confuse with gas. Lightening is the descent of the presenting part of the fetus into the pelvis. Placenta previa is the implantation of the placenta so that it covers part or all of the cervical os. Linea nigra is a hyperpigmented line that appears on the maternal abdomen between the symphysis pubis and top of the fundus.
A woman in the third trimester of her first pregnancy expresses fear about the birth canal being wide enough for her to push the baby through it during labor. She is a petite person, and the baby seems so large. She asks the nurse how this will be possible. To help alleviate the patient's fears, the nurse should mention the role of the hormone that softens the cervix and collagen in the joints, which allows dilation and enlargement of the birth canal. This hormone is which of the following? a) Progesterone b) Human placental lactogen c) Estrogen d) Relaxin
Relaxin Correct Explanation: Relaxin, secreted by the corpus luteum of the ovary as well as the placenta, is responsible for helping to inhibit uterine activity and to soften the cervix and the collagen in joints. Softening of the cervix allows for dilatation at birth; softening of collagen allows for laxness in the lower spine and so helps enlarge the birth canal. The effect of estrogen is to cause breast and uterine enlargement. Progesterone has a major role in maintaining the endometrium, inhibiting uterine contractility, and aiding in the development of the breasts for lactation. Human placental lactogen (hPL), also known as human chorionic somatomammotropin, serves as an antagonist to insulin, making insulin less effective, thereby allowing more glucose to become available for fetal growth.
A patient who has just given a blood sample for pregnancy testing in the doctor's office asks the nurse what method of confirming pregnancy is the most accurate. The nurse explains the difference between presumptive symptoms, probable signs, and positive signs. Which of the following should the nurse mention as an example of a positive sign, which may be used to diagnose pregnancy? a) Laboratory test of a urine specimen for hCG b) Laboratory test of a blood serum specimen for hCG c) Absence of a period d) Visualization of the fetus by ultrasound
Visualization of the fetus by ultrasound Correct Explanation: There are only three documented or positive signs of pregnancy: 1) demonstration of a fetal heart separate from the mother's, 2) fetal movements felt by an examiner, and 3) visualization of the fetus by ultrasound. The absence of a period is an example of a presumptive symptom, which is a symptom that, when taken as a single entity, could easily indicate other conditions. Laboratory tests of either urine or blood serum for human chorionic gonadotropin (hCG) are examples of probable signs of pregnancy, which are objective and so can be verified by an examiner.
Psychological adjustment to pregnancy includes working through developmental tasks. Which of the following statements would make you believe a woman is doing this? a) "My mother and I are closer than ever before." b) "There are a lot of allergies in my husband's family." c) "I'm thinking about everything I eat these days." d) "I don't care what sex baby I have as long as it's healthy."
"My mother and I are closer than ever before." Explanation: A developmental task for a woman during pregnancy is to review and restructure her relationship with her mother.
The nurse is teaching a prenatal class about preparing for their expanding families. Which of the following is helpful advice from the nurse? "The hormones of pregnancy may cause anxiety or depression postpartum." "Don't worry your children will get along great with the baby." "Your old coping skills will get you through this time." "Your instinct will kick in and caring for this baby will be natural."
"The hormones of pregnancy may cause anxiety or depression postpartum." Correct Explanation: The "raging hormones"of pregnancy can keep the woman slightly out of touch with her usual methods of coping. Although she may normally interact and communicate in quite mature ways, during a pregnancy, she may become depressed, anxious, withdrawn, or angry as she accomplishes her own developmental tasks. Siblings often react to a pregnancy by regression in behavior and attitude because they fear that they will be replaced or unloved. In addition to anticipatory guidance concerning the alterations in family structure and functioning, prenatal preparation for first-time parents involves learning the basics of infant care and preparing for infant feeding, particularly for women who plan to breastfeed.
A nurse is caring for a pregnant client who has been diagnosed with lordosis. The nurse offers preventive measures for which of the following consequences of lordosis when caring for this client? a) Diastasis b) Chloasma c) Chronic backache d) Edema in lower extremities
Chronic backache Correct Explanation: The nurse should provide preventive measures for chronic backache as a consequence of lordosis when caring for this client. Chloasma is characterized by darkened areas on the face, particularly over the nose and cheeks. It is also known as the mark of pregnancy. Chloasma is not caused by lordosis. Diastasis occurs as the pregnancy progresses when the rectus muscle stretches to the point that it separates. It is not caused by lordosis. Edema in lower extremities occurs due to an impeded venous return caused by pressure of growing fetus on pelvic and femoral areas. It is not caused by lordosis.
A pregnant vegan reports that she eats lots of dark green leafy vegetables, legumes, citrus fruits, and berries. To ensure that her infant's nervous system will develop properly, what foods do you recommend that she add to her diet? a) Fortified cereals b) Nuts, seeds, and chocolate c) Carrots, sweet potatoes, and mangoes d) Milk and cheese
Fortified cereals Correct Explanation: Vegans need increased grains to meet the amino acid needs during pregnancy. She should be encouraged to consume grains with legumes to meet these needs. The inclusion of dairy, fruit, vegetables, and nuts are necessary for a healthy diet.
Positive signs of pregnancy are diagnostic, meaning nothing else can elicit that sign except pregnancy. What is the earliest positive sign of pregnancy? a) Finding of hCG in the blood b) Positive home pregnancy test c) Finding hCG in the urine d) Visualization of the gestational sac or fetus
Visualization of the gestational sac or fetus Explanation: The positive sign that can be elicited earliest in the pregnancy is visualization of the gestational sac or fetus. With transvaginal ultrasound, the gestational sac can be seen as early as 10 days after implantation.
