Deck 9: Physical and Physiologic Changes of Pregnancy

Question 1

The 20-year-old client at 10 weeks' gestation is preparing for her first prenatal visit.She confides: "This pregnancy was unplanned.I'm not sure if I want to be pregnant or not.I haven't even told my boyfriend I'm pregnant.And I haven't decided if I'm going to continue the pregnancy." Which of the following statements should the nurse make next?

A)"It's really unusual for a pregnant woman to feel this way early in the pregnancy."
B)"These thoughts are because your mother died when you were 4 years old."
C)"You should go to a pregnancy support group to be a good mother."
D)"It's common to feel ambivalent about pregnancy in the first trimester."

Answer 1

"It's common to feel ambivalent about pregnancy in the first trimester."

Question 2

The nurse is caring for a pregnant client who speaks little English.Which of the following actions should the nurse take to make certain that the client understands the plan of care?

A)Write all of the instructions down and send them home with the client.
B)Obtain a medical interpreter of the language the client speaks.
C)Ask a housekeeper who speaks this language to interpret.
D)Use gestures and facial expressions to get the plan across.

Answer 2

Obtain a medical interpreter of the language the client speaks.

Question 3

The nurse has received a phone call from a multigravida,who is 21 weeks pregnant and has not felt fetal movement yet.The best action for the nurse to take would be to:

A)Reassure the client that this is a normal finding in multigravidas.
B)Suggest that she should feel for movement with her fingertips.
C)Schedule an appointment for her with her physician for that same day.
D)Tell her gently that her fetus is probably dead.

Answer 3

Schedule an appointment for her with her physician for that same day.

Question 4

A client complains that during her first months of pregnancy,"It seems like I have to go to the bathroom every five minutes." The nurse relates to the client that this is because:

A)The client probably has a urinary tract infection.
B)Bladder capacity increases throughout pregnancy.
C)The growing uterus puts pressure on the bladder.
D)Some women are very sensitive to body function changes.

Question 5

A pregnant client at 16 weeks' gestation has a hematocrit of 35%.Her prepregnancy hematocrit was 40%.Which of the following statements by the nurse best explains this change?

A)"Because of your pregnancy,you're not making enough red blood cells."
B)Because your blood volume has increased,your hematocrit count is lower."
C)This change could indicate a serious problem that might harm your baby."
D)"You're not eating enough iron-rich foods like meat."

Question 6

A prenatal educator is asking a partner about normal psychological adjustment of an expectant mother during the second trimester of pregnancy.Which of the following answers by the partner would indicate a typical expectant mother's response to pregnancy?

A)"She is very body-conscious,and hates every little change."
B)"She daydreams about what kind of parent she is going to be."
C)"I haven't noticed anything.I just found out she was pregnant."
D)"She has been having dreams at night about misplacing the baby."

Question 7

The partner of a client at 16 weeks' gestation accompanies her to the clinic.The partner tells you that the baby just doesn't seem real to him,and he's having a hard time relating to his partner's fatigue and food aversions.Which of the following statements would be best for the nurse to make?

A)"If you would concentrate harder,you'd be aware of the reality of this pregnancy."
B)"My husband had no problem with this.What was your childhood like?"
C)"You might need professional psychological counseling.Ask your physician."
D)"Many men feel this way.Feeling the baby move will help make it real."

Question 8

A woman telephones the clinic to say that it has been 6 weeks since her last menstrual period,but a home pregnancy test run today was negative.She asks,"Do you think I could be pregnant?" After determining that the test was performed correctly,the nurse's best reply would be:

A)"Probably not.These tests rarely give a false-negative result."
B)"You might be.If you haven't started your period in one week,you should repeat the test following the instructions carefully,and call the clinic again."
C)"You probably are.There are a lot of false-negative results with these tests."
D)"You might have an ectopic pregnancy.You should be seen by a doctor in the next few days."

Question 9

It is one week before a pregnant client's due date.The nurse notes on the chart that the client's pulse rate was 74-80 before pregnancy.Today,the client's pulse rate at rest is 90.The nurse should take which of the following actions?

A)Chart the findings.
B)Notify the physician of tachycardia.
C)Prepare the client for an electrocardiogram (EKG).
D)Prepare the client for transport to the hospital.

Question 10

A client calls a prenatal clinic,stating,"I have nausea in the morning,I am late with my menstrual cycle,and I am feeling really fatigued." The nurse explains to the client that these symptoms are:

A)Subjective or presumptive signs of pregnancy,but not diagnostic.
B)Objective or probable signs of pregnancy,but not diagnostic.
C)Diagnostic or positive signs of pregnancy.
D)Signs of an ectopic pregnancy.

Question 11

A client with a normal prepregnancy weight asks why she has been told to gain 25-35 pounds during her pregnancy but her underweight friend was told to gain more weight.The nurse should tell the client that recommended weight gain during pregnancy should be:

A)25-35 pounds,regardless of a client's prepregnant weight.
B)More than 25-35 pounds for an overweight woman.
C)Up to 40 pounds for an underweight woman.
D)The same for a normal weight woman as for an overweight woman.

Question 12

A client who is in her 14th week of pregnancy is in the clinic for a prenatal visit.Her mother also is present.The grandmother-to-be states that she is quite uncertain about how she can be a good grandmother to this baby because she works full-time,and her own grandmother was retired and was always available when needed by a grandchild.The best response to this concern would be:

A)"Don't worry.You'll be a wonderful grandmother.It will all work out fine."
B)"Grandmothers are supposed to be available.You should retire from your job."
C)"As long as there is another grandmother available,you don't have to worry."
D)"What are your thoughts on what your role as grandmother will include?"

Question 13

At a second-trimester prenatal visit,a married couple are discussing their new roles as parents with the nurse.The father comments that he really wants to be a good father to their new baby.The nurse should explain that in developing the fatherhood role,the most important thing is to:

A)Participate actively in as many aspects of childbearing and childrearing as possible.
B)Identify a father he admires and try to develop a fathering role similar to that.
C)Decide with his partner on a fathering role that is mutually agreeable to both of them.
D)Begin by examining the basic pattern of fathering that his father used with him.

Question 14

A client who is in the second trimester of pregnancy tells the nurse that she has developed a darkening of the line in the midline of her abdomen from the symphysis pubis to the umbilicus.Which of the following are other expected changes during pregnancy that she also might notice?

A)Lightening of the nipples and areolas
B)Reddish streaks called striae on her abdomen
C)A decrease in hair thickness
D)Small purplish dots on her face and arms

Question 15

The nurse understands that a client's pregnancy is progressing normally when which of the following physiologic changes are documented on the prenatal record of a woman at 36 weeks' gestation? Select all that apply

A)The joints of the pelvis have relaxed,causing a waddling gait.
B)The cervix is firm and purplish-blue in color.
C)The uterus vasculature contains one-sixth of the total maternal blood volume.
D)Gastric emptying time is prolonged,and the client complains of constipation and bloating.
E)Supine hypotension,creating dizziness,occurs when the client lies on her back.