Deck 6: Maternal Adaptations to Pregnancy

Question 1

A patient in her first trimester complains of nausea and vomiting. The patient asks, "Why is this happening?" What is the nurse's best response?

A) "It is due to an increase in gastric motility."
B) "It may be due to changes in hormones."
C) "It is related to an increase in glucose levels."
D) "It is caused by a decrease in gastric secretions."

Answer 1

"It may be due to changes in hormones."

Question 2

A pregnant woman has come to the emergency department with complaints of nasal congestion and epistaxis. Which is the correct interpretation of these symptoms by the health care provider?

A) Nasal stuffiness and nosebleeds are caused by a decrease in progesterone.
B) These conditions are abnormal. Refer the patient to an ear, nose, and throat specialist.
C) Estrogen relaxes the smooth muscles in the respiratory tract, so congestion and epistaxis are within normal limits.
D) Estrogen causes increased blood supply to the mucous membranes and can result in congestion and nosebleeds.

Answer 2

Estrogen causes increased blood supply to the mucous membranes and can result in congestion and nosebleeds.

Question 3

Physiologic anemia often occurs during pregnancy due to

A) inadequate intake of iron.
B) the fetus establishing iron stores.
C) dilution of hemoglobin concentration.
D) decreased production of erythrocytes.

Answer 3

dilution of hemoglobin concentration.

Question 4

A pregnant woman notices that she is beginning to develop dark skin patches on her face. She denies using any different type of facial products as a cleansing solution or makeup. What would the priority nursing intervention be in response to this situation?

A) Refer the patient to a dermatologist for further examination.
B) Ask the patient if she has been eating different types of foods.
C) Take a culture swab and send to the lab for culture and sensitivity (C&S).
D) Let the patient know that this is a common finding that occurs during pregnancy.

Question 5

An expected change during pregnancy is a darkly pigmented vertical midabdominal line. The nurse recognizes this alteration as

A) epulis.
B) linea nigra.
C) melasma.
D) striae gravidarum.

Question 6

What is the physiologic reason for vascular volume increasing by 40% to 60% during pregnancy?

A) Prevents maternal and fetal dehydration
B) Eliminates metabolic wastes of the mother
C) Provides adequate perfusion of the placenta
D) Compensates for decreased renal plasma flow

Question 7

While providing education to a primiparous patient regarding the normal changes of pregnancy, what is an important information for the nurse to share regarding Braxton Hicks contractions?

A) These contractions may indicate preterm labor.
B) These are contractions that never cause any discomfort.
C) Braxton Hicks contractions only start during the third trimester.
D) These occur throughout pregnancy, but you may not feel them until the third trimester.

Question 8

Which finding is a positive sign of pregnancy?

A) Amenorrhea
B) Breast changes
C) Fetal movement felt by the woman
D) Visualization of fetus by ultrasound

Question 9

What is the best explanation that the nurse can provide to a patient who is concerned that she has "pseudoanemia" of pregnancy?

A) Have her write down her concerns and tell her that you will ask the physician to respond once the lab results have been evaluated.
B) Tell her that this is a benign self-limiting condition that can be easily corrected by switching to a high-iron diet.
C) Inform her that because of the pregnancy, her blood volume has increased, leading to a substantial dilution effect on her serum blood levels, and that most women experience this condition.
D) Contact the physician and get a prescription for iron pills to correct this condition.

Question 10

During vital sign assessment of a pregnant patient in her third trimester, the patient complains of feeling faint, dizzy, and agitated. Which nursing intervention is most appropriate?

A) Have the patient stand up and retake her blood pressure.
B) Have the patient sit down and hold her arm in a dependent position.
C) Have the patient turn to her left side and recheck her blood pressure in 5 minutes.
D) Have the patient lie supine for 5 minutes and recheck her blood pressure on both arms.

Question 11

A patient reports to the clinic nurse that she has not had a period in over 12 weeks, she is tired, and her breasts are sore all of the time. The patient's urine test is positive for hCG. What is the correct nursing action related to this information?

A) Ask the patient if she has had any nausea or vomiting in the morning.
B) Schedule the patient to be seen by a health care provider within the next 4 weeks.
C) Send the patient to the maternity screening area of the clinic for a routine ultrasound.
D) Determine if there are any factors that might prohibit her from seeking medical care.

Question 12

Which physiologic finding is consistent with normal pregnancy?

A) Systemic vascular resistance increases as blood pressure decreases.
B) Cardiac output increases during pregnancy.
C) Blood pressure remains consistent independent of position changes.
D) Maternal vasoconstriction occurs in response to increased metabolism.

Question 13

The patient has just learned that she is pregnant and overhears the gynecologist saying that she has a positive Chadwick's sign. When the patient asks the nurse what this means, how would the nurse respond?

A) "Chadwick's sign signifies an increased risk of blood clots in pregnant women because of a congestion of blood."
B) "That sign means the cervix has softened as the result of tissue changes that naturally occur with pregnancy."
C) "This means that a mucus plug has formed in the cervical canal to help protect you from uterine infection."
D) "This sign occurs normally in pregnancy, when estrogen causes increased blood flow in the area of the cervix."

Question 14

A pregnant woman complains of frequent heartburn. The patient states that she has never had these symptoms before and wonders why this is happening now. The most appropriate response by the nurse is to

A) examine her dietary intake pattern and tell her to avoid certain foods.
B) tell her that this is a normal finding during early pregnancy and will resolve as she gets closer to term.
C) explain to the patient that physiologic changes caused by the pregnancy make her more likely to experience these types of symptoms.
D) refer her to her health care provider for additional testing because this is an abnormal finding.

Question 15

A patient who is 7 months pregnant states, "I'm worried that something will happen to my baby." Which is the nurse's best response?

A) "Your baby is doing fine."
B) "Tell me about your concerns."
C) "There is nothing to worry about."
D) "The doctor is taking good care of you and your baby."

Question 16

Which physiologic findings related to gallbladder function may lead to the development of gallstones during pregnancy?

A) Decrease in alkaline phosphatase levels compared with nonpregnant women
B) Increase in albumin and total protein as a result of hemodilution
C) Hypertonicity of gallbladder tissue
D) Prolonged emptying time

Question 17

Which of these findings would indicate a potential complication related to renal function during pregnancy?

A) Increase in glomerular filtration rate (GFR)
B) Increase in serum creatinine level
C) Decrease in blood urea nitrogen (BUN)
D) Mild proteinuria

Question 18

What is the term for the step in maternal role attainment that relates to the woman giving up certain aspects of her previous life?

A) Fantasy
B) Grief work
C) Role playing
D) Looking for a fit

Question 19

Which comment made by a patient in her first trimester indicates ambivalent feelings?

A) "My body is changing so quickly."
B) "I haven't felt well since this pregnancy began."
C) "I'm concerned about the amount of weight I've gained."
D) "I wanted to become pregnant, but I'm scared about being a mother."

Question 20

Which physiologic adaptation of pregnancy may lead to increased constipation during the pregnancy?

A) Increased emptying time in the intestines
B) Abdominal distention and bloating
C) Decreased absorption of water
D) Decreased motility in the intestines

Question 21

Which situation best describes a man trying on fathering behaviors?

A) Reading books on newborn care
B) Spending more time with his siblings
C) Coaching a little league baseball team
D) Exhibiting physical symptoms related to pregnancy

Question 22

An expectant patient in her third trimester reports that she developed a strong tie to her baby from the beginning and now is really in tune to her baby's temperament. The nurse interprets this as the development of which maternal task of pregnancy?

A) Learning to give of herself
B) Developing attachment with the baby
C) Securing acceptance of the baby by others
D) Seeking safe passage for herself and her baby

Question 23

Which comment made by a new mother exhibits understanding of her toddler's response to a new sibling?

A) "I can't believe he is sucking his thumb again."
B) "He is being difficult and I don't have time to deal with him."
C) "When we brought the baby home, we made Michael stop sleeping in the crib."
D) "My husband is going to stay with the baby so I can take Michael to the park tomorrow."

Question 24

An expectant couple asks the nurse about intercourse during pregnancy and whether it is safe for the baby. What information should the nurse provide?

A) Intercourse is safe until the third trimester.
B) Safer sex practices should be used once the membranes rupture.
C) Intercourse should be avoided if any spotting from the vagina occurs afterward.
D) Intercourse and orgasm are often contraindicated if a history of or signs of preterm labor are present.

Question 25

The nurse is teaching a pregnant patient about signs of possible pregnancy complications. Which should the nurse include in the teaching plan? (Select all that apply.)

A) Report watery vaginal discharge.
B) Report puffiness of the face or around the eyes.
C) Report any bloody show when you go into labor.
D) Report visual disturbances, such as spots before the eyes.
E) Report any dependent edema that occurs at the end of the day.

Question 26

A 36-year-old divorcee with a successful modeling career finds out that her 18-year-old daughter is expecting her first child. Which is a major factor in determining how this woman will respond to becoming a grandmother?

A) Her age
B) Her career
C) Being divorced
D) Age of the daughter

Question 27

The nurse is assessing a patient in her 37th week of pregnancy for the psychological responses commonly experienced as birth nears. Which psychological responses should the nurse expect to evaluate? (Select all that apply.)

A) The patient is excited to see her baby.
B) The patient has not started to prepare the nursery for the new baby.
C) The patient expresses concern about how to know if labor has started.
D) The patient and her spouse are concerned about getting to the birth center in time.
E) The patient and her spouse have not discussed how they will share household tasks.

Question 28

A pregnant patient comes into the medical clinic stating that her family and friends are telling her that she is always talking about the pregnancy and nothing else. She is concerned that something is wrong with her. What psychological behavior is she exhibiting?

A) Antepartum obsession
B) Ambivalence
C) Uncertainty
D) Introversion

Question 29

The capacity of the uterus in a term pregnancy is how many times its prepregnant capacity? Record your answer as a whole number. ______ times

Question 30

Which findings are presumptive signs of pregnancy? (Select all that apply.)

A) Quickening
B) Amenorrhea
C) Ballottement
D) Goodell's sign
E) Chadwick's sign

Question 31

Which comment made by a new mother to her own mother is most likely to encourage the grandmother's participation in the infant's care?

A) "Could you help me with the housework today?"
B) "The baby is spitting up a lot. What should I do?"
C) "I know you are busy, so I'll get John's mother to help me."
D) "The baby has a stomachache. I'll call the nurse to find out what to do."

Question 32

A patient relates a story of how her boyfriend is feeling her aches and pains associated with her pregnancy. She is concerned that her boyfriend is making fun of her concerns. How would you respond to this patient statement?

A) Tell her not to worry because it is natural for her boyfriend to make her feel better by identifying with her pregnancy.
B) Refer the patient to a psychologist for counseling to deal with this problem because it is clearly upsetting her.
C) Explain that her boyfriend may be experiencing couvade syndrome and that this is a normal finding seen with male partners.
D) Ask the patient specifically to define her concerns related to her relationship with her boyfriend and suggest methods to stop this type of behavior by her significant other.