PN108 PrepU Chapter 6

Amanda is about 16 weeks pregnant and is concerned because she feels her "abdomen" contracting. She calls the primary care provider's office and speaks to the nurse. What is the nurse's most appropriate response to Amanda's concern?

"What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy."

Which change related to the vital signs is expected in pregnant women?

Blood pressure decreases.

A client who has just given a blood sample for pregnancy testing in the health care provider'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. What should the nurse mention as an example of a positive sign, which may be used to diagnose pregnancy?

visualization of the fetus by ultrasound

Positive signs of pregnancy are diagnostic, meaning nothing else can elicit that sign except pregnancy. What is the earliest positive sign of pregnancy?

visualization of the fetus by ultrasound at 6+ weeks

A gravida 2 para 1 client in the 10th week of her pregnancy says to the nurse, "I've never urinated as often as I have for the past three weeks." Which response would be most appropriate for the nurse to make?

"By the time you are 12 weeks pregnant, this frequent urination should really decrease, but it is likely to return toward the end of your pregnancy."

The nurse is teaching the pregnant woman about nutrition for herself and her baby. Which statement by the woman indicates that the teaching was effective?

"I will need to take iron supplementation throughout my pregnancy even if I am not anemic."

The nurse is teaching a prenatal class about preparing for their expanding families. What is helpful advice from the nurse?

"The hormones of pregnancy may cause anxiety or depression postpartum."

A client at 36 weeks' gestation comes in for her weekly primary care provider visit. She tells the nurse, "I am having contractions, but they are irregular and go away when I rest. Do you think I am going into labor?" The best response by the nurse would be:

"These are called Braxton-Hicks contractions and are preparing your body for labor but are not 'true' labor contractions."

A student nurse asks the instructor about maternal pulse and blood pressure changes during the prenatal period. Which response from the nurse about cardiovascular changes during the first and second trimesters is accurate?

"Women experience increased pulse rate and decreased blood pressure."

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 information should the nurse offer?

"You will experience quickening, and you will actually feel the baby."

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?

1 lb (.45 kg)

The nurse is teaching a pregnant woman with a prepregnancy body mass index of 26 about recommended weight gain. The nurse determines that the teaching was successful when the woman states that she should gain approximately how much during pregnancy?

15 to 25 pounds (7 to 11 kilograms)

A nurse should teach a client who is pregnant for the first time that she should be able to feel the baby move at about how many weeks gestation?

18 to 20

The nurse is teaching a pregnant woman about recommended weight gain. The woman has a prepregnancy body mass index (BMI) of 21. The nurse determines that the teaching was successful when the woman states that she should gain no more than which amount during pregnancy?

25 to 35 pounds (11 to 18 kilograms)

Before becoming pregnant, a woman's heart rate averaged 72 beats per minute. The woman is now 15 weeks pregnant. The nurse would expect this woman's heart rate to be approximately:

85 beats per minute.

At her 16-week checkup, a client's blood pressure is slightly decreased from her prepregnancy level. The nurse evaluates this change based on which statements concerning blood pressure during pregnancy?

A decrease in the second trimester may occur because of placental growth.

A woman tells the nurse that she is going to use a home pregnancy test to determine whether she is pregnant. Which precautions should the nurse give her?

Arrange for prenatal care if the test is positive.

A nurse assesses a primigravida client and observes darkening of the skin on the client's face. How should the nurse document this pigmentation?

Chloasma

Increased pigmentation on the face of some pregnant women is called:

Chloasma

The nurse is caring for a young couple who are expecting their first baby. They are experiencing the phenomenon known as Couvade syndrome. What can the nurse explain to this family to help them understand this syndrome?

Couvade syndrome is when the partner begins to experience the same physical symptoms as the pregnant woman experiences.

Which of the following is NOT a probable sign of pregnancy?

Fetal movement felt by examiner

During a vaginal exam, the nurse notes that the lower uterine segment is softened. The nurse documents this finding as:

Hagar's sign.

A 16-year-old girl arrives at the office for her first prenatal visit. After missing her period, she took two home pregnancy tests, both of which were positive, and came in a week ago for a blood test. The blood test also was positive. Today she appears pale and apprehensive, and asks, "Is there any other kind of test I can take, just to make sure?" Which of the following would be the most accurate nursing diagnosis of this patient?

Ineffective denial of pregnancy due to apprehension and fear

During pregnancy a woman's breasts change from their prepregnant state. What is one of these changes?

Montgomery's tubercles become more prominent.

The nursing instructor is teaching students about normal changes of pregnancy. The instructor talks about diastasis recti. What is the instructor presenting?

Separation of the muscles of the abdominal wall

The cardiovascular system of a pregnant woman copes with the increasing demands of organ systems that are working harder as well as an increased blood volume. The heart itself is pushed upward and to the left. What can this repositioning of the heart cause?

Systolic murmurs

The nurse midwife is performing a pelvic examination on a client who came to her following a positive home pregnancy test. The nurse checks the woman's cervix for the probable sign of pregnancy known as Goodell's sign. Which description illustrates this alteration?

The cervix softens.

Which statement would the nurse include in the teaching plan for a pregnant woman related to changes in the uterus?

The uterus changes from a pear-shaped organ to an oval one.

A woman's physician has suggested that she eat iodized salt during pregnancy. On which of the following would you base your explanation for this suggestion?

Thyroid activity, which depends on iodine intake, increases during pregnancy.

T/F: Morning sickness is associated with rising levels of human chorionic gonadotropin (hCG) and progesterone.

True

The nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. The mother will most likely experience which of the following at that time?

Urinary frequency

Place the following events in the sequence the pregnant woman would experience them, from first to last. All options must be used.

amennorhea uterine enlargement quickening Braxton Hicks contractions labor

A woman is at 20 weeks' gestation. The nurse would expect to find the fundus at which area?

at the level of the umbilicus

The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply.

breast changes amenorrhea morning sickness

During a prenatal visit, the nurse inspects the skin of the client's abdomen. Which would the nurse identify as an abnormal finding?

bruising

Some women are lactose intolerant. Lactose intolerance occurs more frequently in individuals of African, Hispanic, Native American, Ashkenazic Jewish, and Asian descent. What is the major concern for a lactose intolerant woman who is pregnant?

calcium deficiency

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?

chloasma

A nurse is caring for a pregnant client who has been diagnosed with lordosis. The nurse offers preventive measures for which consequence of lordosis when caring for this client?

chronic backache

Which assessment finding in the pregnant woman at 12 weeks of gestation should the nurse find most concerning? The inability to:

detect fetal heart sounds with a Doppler.

Which effect would the nurse identify as a normal physiologic change in the renal system due to pregnancy?

dilation of the renal pelvis

Pregnancy tests (both urine and blood) measure levels of which hormone to validate the existence of pregnancy?

human chorionic gonadotropin (hCG)

During a routine visit to the clinic, a client tells the nurse that she thinks she may be pregnant. The physician prescribes a pregnancy test. The nurse should know the purpose of this test is to determine which change in the client's hormone level?

increase in human chorionic gonadotropin (hCG)

Which change in the musculoskeletal system would the nurse mention when teaching a group of pregnant women about the physiologic changes of pregnancy?

increased lordosis

A nurse conducting a presentation for a group of nurses working at the family health clinic describes the changes in various body systems related to pregnancy. The nurse determines that additional teaching is needed when the group identifies which component as contributing to the pregnant woman's hypercoagulable state?

increased number of red blood cells

Which change in respiratory function during pregnancy is considered normal?

increased tidal volume

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. What is the name of this phenomenon?

linea nigra

The obstetrical nurse knows that a woman's hormone levels change dramatically during pregnancy. Which hormonal actions accurately represent these changes? Select all that apply.

maintaining the endometrium so that the embryo can implant causing changes in the mother's metabolism so that nutrients are available for both relaxing the ligaments that connect the pelvic bones, allowing them to spread slightly preparing the breasts for lactation, keeping the milk from coming in until birth occurs

A nurse strongly encourages a pregnant client to avoid eating swordfish and tilefish because these fish contain which component?

mercury, which could harm the developing fetus if eaten in large amounts

The nurse teaches a pregnant woman about breastfeeding, stating that stimulation of the breast through sucking or touching stimulates the secretion of which hormone?

oxytocin

A woman comes to the prenatal clinic suspecting that she is pregnant, and assessment reveals probable signs of pregnancy. Which findings would the nurse most likely assess? Select all that apply.

positive pregnancy test ballottement softening of the cervix

In a client's seventh month of pregnancy, she reports feeling "dizzy, like I'm going to pass out, when I lie down flat on my back." The nurse explains that this is due to:

pressure of the gravid uterus on the vena cava.

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?

presumptive

A client comes to the prenatal clinic for a follow-up examination. When assessing the breasts, which findings would the nurse expect? Select all that apply.

prominent veins hyperpigmentation of the nipple increased sensitivity

Which change in the breasts should a nurse recognize as a normal change associated with pregnancy?

tingling sensations and tenderness

A nurse urges a pregnant client at the first prenatal office visit to begin taking iron supplements immediately. What is the rationale for this intervention?

to avoid anemia

The nurse is providing care for a pregnant woman who is 28 weeks' gestation. Before pregnancy she had a normal body mass index (BMI) and weighed 130 pounds (60 kilograms). When weighing her at this visit, she weighs 140 pounds (64 kilograms). How should the nurse interpret this assessment?

underweight and at risk for giving birth to a low-birth-weight baby

A primiparous client is being seen in the clinic for her first prenatal visit. It is determined that she is 11 weeks pregnant. The nurse develops a teaching plan to educate the client about what she will most likely experience during this period. Which possible effect would the nurse include?

urinary frequency

Which assessment finding in a woman is a positive sign of pregnancy?

visualization of the fetus by ultrasound at 6+ weeks