A&P of Pregnancy Quiz Rationales

During a health-teaching session, a pregnant client asks the nurse how soon the fertilized ovum becomes implanted in the endometrium. Which answer should the nurse supply?

A: 7days after fertilization Rationale: Implantation occurs at the end of the first week after fertilization, when the blastocyst attaches to the endometrium.

While assessing a multigravid client at 10 weeks' gestation, the nurse notes a purplish color to the vagina and cervix. The nurse documents this as what finding?

A: Chadwick's sign Rationale: A purplish blue discoloration of the vagina and cervix is termed Chadwick's sign; it is caused by increased vascularity of the vagina during pregnancy and is considered a probable sign of pregnancy.

A nurse is performing a physical examination of a primigravid client who's 8 weeks pregnant. At this time, the nurse expects to assess:

A: Hegar's sign Rationale: When performing a vaginal or rectovaginal examination, the nurse may assess Hegar's sign (softening of the uterine isthmus) between the 6th and 8th weeks of pregnancy. The fetal outline may be palpated after 24 weeks

A client is scheduled to have IVF as an infertility treatment. Which client statement about IVF indicates that the client understands this procedure?

A: IVF involves bypassing the blocked or absent fallopian tubes Rationale: IVF is a technique that involves bypassing the blocked or absent fallopian tubes. PCP removes the ova by laparscope- or ultrasound-guided transvaginal retrieval and mixes them with prepared sperm from the woman's partner or a donor. Up to 4embryos are returned to the uterus to increase the likelihood of success. Supplemental progesterone is given to enhance the implantation process.

A nurse is providing care for a pregnant 16-year-old. The client says that she is concerned she may gain too much weight and wants to start dieting. The nurse should respond by saying:

A: Nutrition is important because depriving your baby of nutrients can cause developmental and growth problems Rationale: Depriving the developing fetus of nutrients can cause serious problems and the nurse should discuss this issue with the client. The client isn't eating for two; this belief is a misconception. Exploring feelings helps the client understand her concerns, but the nurse also needs to make the client aware of the risks at this time. The vitamins are supplements and don't contain everything a mother or developing fetus needs; they work in conjunction with a balanced diet.

A client comes to the office for her first prenatal visit. She reports that January 3 was the first day of her last period. According to Naegele's rule, what date should the nurse record asthe estimated date of delivery (EDD)?

A: October 10 Rationale: The nurse can calculate EDD using Naegele's rule (add 7days to the first day of the last period, then subtract 3 months, and finally add 1yr). Thus Jan 3+7= Jan 10, Jan 10-3mo=Oct 10 (previous year), Oct 10+1yr= Oct 10 (current year)

A pregnant client is experiencing a thin, odorless, vaginal discharge. What should the nurse instruct the client to do to prevent vaginal infection?

A: Try wearing a panty liner and discarding it after every urination Rationale: this kind of discharge is normal during pregnancy. Keeping the area clean and dry by wearing a panty liner will prevent infection.

The nurse is developing a community health education program about sexually transmitted infections. Which information about women who acquire gonorrhea should be included?

A: Women w/ gonorrhea are usually asymptomatic Rationale: Many women who acquire gonorrhea are asymptomatic or experience mild symptoms that are easily ignored

A client, 11wks pregnant, is admitted to the facility w/ hyperemesis gravidarum. The client tells the nurse she has never known anyone who had such severe morning sickness. The nurse understands that hyperemesis gravidarum results from:

A: an unknown cause Rationale: The cause of hyperemesis gravidarum isn't known. However, etiologic theories implicate hormonal alterations and allergic or psychosomatic conditions. No evidence suggests that hyperemesis gravidarum results from a neurologic disorder, inadequate nutrition, or hemolysis of fetal RBCs.

When measuring the fundal height of a primigravid client at 20 weeks' gestation, the nurse will locate the fundal height at which point?

A: at about the level of the client's umbilicus Rationale: Measurement of the client's fundal height is a gross estimate of fetal gestational age. At 20 weeks' gestation, the fundal height should be at about the level of the client's umbilicus. The fundus typically is over the symphysis pubis at 12 weeks

A nurse is caring for a client in the first 4wks of pregnancy. The nurse should expect to collect which assessment findings?

A: breast sensitivity Rationale: Breast sensitivity is the only sign assessed w/in the first 4wks of pregnancy. Amenorrhea is expected during this time.

A male client has been diagnosed as having a low sperm count during infertility studies. After giving instructions about causes of low sperm counts, the nurse determines that the client needs further instructions when the client says low sperm counts may be caused by which health problem?

A: decreased body temp Rationale: Increased, not decreased, body temperature resulting from occupations or infections can contribute to low sperm counts caused by decreased sperm production.

A client is planning to be treated for infertility with the zygote intrafallopian transfer (ZIFT) method. Which information should the nurse include when teaching the client about this type of treatment method?

A: fertilization takes place outside of the body Rationale: The ZIFT method requires that fertilization take place outside the body. After fertilization has occurred, the fertilized eggs are transferred by laparoscopy to the open end of the fallopian tube.

Which finding are considered positive signs of pregnancy?

A: fetal heartbeat and fetal movement on palpation Rationale: Fetal heartbeat and fetal movement on palpation are considered positive signs of pregnancy because they can't be caused by any other condition

After instructing a female client about the radioimmunoassay pregnancy test, the nurse determines that the client understands the instructions when the client states that which hormone is evaluated by this test?

A: hCG Rationale: The hormone analyzed in most pregnancy tests is hCG. In the pregnant woman, trace amounts of hCG appear in the serum as early as 24 to 48 hours after implantation owing to the trophoblast production of this hormone.

A client who tells the nurse that she would like to use the basal body temperature method for family planning receives instructions about the method. Which client statement indicates to the nurse that the teaching has been successful?

A: its important to take my temp at about the same time every morning before arising Rationale: The client using the basal body temperature method should take her temperature for 5 minutes at the same time every morning on awakening, before arising or starting any activity. Doing so prevents other factors, such as eating or moving, from possibly influencing body temperature. The temperature reading should be recorded on a graph.

A client is in the eighth month of pregnancy. To enhance cardiac output and renal function, the nurse should advise the client to use which body position?

A: left lateral Rationale: The left lateral position shifts the enlarged uterus away from the vena cava and aorta, enhancing cardiac output, kidney perfusion, and kidney function.

After trying for a year to conceive, a couple consults an infertility specialist. When obtaining a hx from the husband, the nurse asks about childhood infectious disease. Which childhood infectious disease most significantly affects male fertility?

A: mumps Rationale: mumps is the childhood infectious disease that most significantly affects male fertility

A female client with infertility related to anovulatory cycles is prescribed menotropins. The nurse should assess the client for which possible adverse effect of this medication?

A: ovarian enlargement Rationale: Ovarian enlargement, hyperstimulation syndrome, febrile reaction, and multiple pregnancies are considered adverse effects of menotropins. If ovarian enlargement occurs, the drug should be discontinued to prevent damage to the ovary

A 30-year-old multigravid client has missed three periods and now visits the prenatal clinic because she assumes she is pregnant. She is experiencing enlargement of her abdomen, a positive pregnancy test, and changes in the pigmentation on her face and abdomen. These assessment findings reflect this woman is experiencing a cluster of which signs of pregnancy?

A: probable Rationale: The plan of care should reflect that this woman is experiencing probable signs of pregnancy. She may be pregnant, but the signs and symptoms may have another etiology. An enlarging abdomen and a positive pregnancy test may also be caused by tumors, hydatidiform mole, or other disease processes as well as pregnancy.

A 15-year-old primigravid client at approximately 16 weeks' gestation tells the nurse that she has been experiencing an occasional sharp pain from the fundus to her pubic bone on the left side. The nurse determines that the client is most likely experiencing which complication?

A: round ligament pain Rationale: Based on the description, the client is most likely experiencing round ligament pain. The round ligaments, two fibrous muscular cords passing from the body of the uterus near the attachments of the fallopian tubes through the broad ligaments into the inguinal canal and inserting into the fascia of the vulva, act as stays to steady the uterus. If a pregnant woman moves quickly, she may pull one of these ligaments and feel a quick, sharp pain.

A newly pregnant client tells the nurse that she hasn't been taking her prenatal vitamins b/c they make her nauseated. In addition to telling the client how important taking the vitamins are, the nurse should also advise her to:

A: take the vitamin on a full stomach Rationale: Prenatal vitamin commonly cause nausea and taking them in a full stomach may curb this adverse effect

Which statement by the nurse would be most appropriate when responding to a primigravid client who asks, "What should I do about this brown discoloration across my nose and cheeks?"

A: this usually disappears after birth Rationale: Discoloration on the face that commonly appears during pregnancy, called chloasma (mask of pregnancy), usually fades postpartum and is of no clinical significance.

A couple is visiting the clinic b/c they have been unable to conceive after 3yrs of frequent coitus. The nurse determines that the couple needs further instruction when they identify which factor as a cause of male infertility?

A; seminal fluid w/ an alkaline pH Rationale: the couple needs further instruction when they identify that one cause of male infertility is decreased sperm count due to seminal fluid that has an alkaline pH. A slightly alkaline ph is necessary to protect the sperm from the acidic secretions of the vaginal and is normal finding. An alkaline pH is not associated w/ decreased sperm count.