Question 1

A pregnant patient tells the nurse that she is not happy to learn about the pregnancy. At which point in the pregnancy does the nurse realize that the patient will change her mind about the pregnancy?

Accepted Answer

Quickening or feeling the baby move inside the body is a dramatic event and causes the pregnant woman's feelings about the pregnancy to change. Quickening occurs during the second trimester of the pregnancy, which is after the third but before the seventh month. Lightening occurs near the end of the pregnancy.

Question 2

The nurse determines that a pregnant patient is working through developmental tasks. Which statement did the patient make to the nurse?

Accepted Answer

For the first time in her life, a woman during pregnancy can begin to empathize with the way her mother used to worry. This can make her own mother become more important to her and a new, more equal relationship develops. Thinking about diet, allergies, and the baby's sex are not developmental tasks for the pregnant patient.

Question 3

A newly wed young adult patient tells the nurse that she hopes to become pregnant soon. What should the nurse recommend to this patient to support the 2020 National Health Goals for pregnancy? (Select all that apply.)

Accepted Answer

Nurses can help the nation achieve the 2020 National Health Goals for pregnancy by being certain women receive counseling in nutrition and low uses of alcohol and tobacco before pregnancy so they can enter intended pregnancies in the best health possible. Increasing exercise and reducing work hours are not interventions that would support the 2020 National Health Goals for pregnancy.

Question 4

The nurse is planning to instruct a patient who is 6 weeks pregnant about increasing the intake of milk each day. Which statement should the nurse make as the most effective health teaching measure?

Accepted Answer

There is a tendency to organize health instructions during pregnancy around the baby; however, this approach may be inappropriate early in pregnancy, before the fetus stirs, and before a woman is convinced not only she is pregnant but also there is a baby inside her. At early stages, a woman may be much more interested in doing things for herself because it is her body, her tiredness, and her well-being that will be directly affected.
The nurse should instruct the patient to drink more milk to improve fingernail strength. The statements that address fetal development are inappropriate for the nurse to use for health teaching at this time.

Question 5

The spouse of a pregnant patient is quiet during prenatal visits but is demonstrating emotional involvement in the pregnancy. What action did the spouse perform?

Accepted Answer

Many men experience physical symptoms and may begin to gain weight along with their partner. As a woman's abdomen begins to grow, the partner may perceive himself as growing larger too, as if he were the one who was experiencing changing boundaries the same as his partner. This indicates emotional involvement in the pregnancy. Stating a specific sex for the baby, losing free time, and refusing to paint the baby's room blue are not indications that the spouse is emotionally involved in the pregnancy.

Question 6

A father is preparing a 4-year-old son for the arrival of a new baby. Which statement should the nurse suggest the father use to explain this to the child?

Accepted Answer

Preschool-age children may need to be assured periodically during pregnancy a new baby will be an addition to the family and will not replace them in their parents' affection. Explaining that the mother will have less time for the child, equating the new baby as "fun," and taking away a bed for the baby will not help the child accept the new baby into the family.

Question 7

A patient makes an appointment at the prenatal clinic because she thinks she might be pregnant. Which assessment is a probable sign of pregnancy?

Accepted Answer

A probable sign of pregnancy is one that is objective and can be measured by an observer. A positive pregnancy test is a probable sign of pregnancy. Amenorrhea, enlargement and darkening of areola, and nausea and vomiting are presumptive signs because they could indicate another health condition.

Question 8

After an examination, an advanced practice nurse confirms that a patient is pregnant. What did the nurse assess in this patient? (Select all that apply.)

Accepted Answer

There are only three documented or positive signs of pregnancy-demonstration of a fetal heart separate from the mother's, fetal movements felt by an examiner, and visualization of the fetus by ultrasound. Painful breast tissue is a presumptive sign of pregnancy. A positive pregnancy test is a probably sign of pregnancy.

Question 9

The nurse is assessing a patient who is 3 months pregnant. Which breast changes would the nurse expect to assess in this patient?

Accepted Answer

As the pregnancy progresses, the areola of the nipples darkens, and its diameter increases. Enlarged lymph nodes; slack, soft breast tissue; and deeply fissured nipples are not expected breast changes in a pregnant patient.

Question 10

After a routine examination, a patient tells the nurse that she plans to use a home pregnancy test to determine if she is pregnant. What should the nurse respond to this patient's plan?

Accepted Answer

After a positive pregnancy test, the first step should be to arrange for prenatal care. This is the response that the nurse should make to the patient. The urine is not usually diluted for a home pregnancy test. The patient should not wait for 2 months before determining if she is pregnant. Eating does not impact the results of the home pregnancy test.

Question 11

A patient who is 2 months pregnant is concerned about frequent urination. What should the nurse instruct the patient about this occurrence?

Accepted Answer

A pregnant woman may notice an increase in urinary frequency during the first 3 months of pregnancy, until the uterus rises out of the pelvis and relieves pressure on the bladder. An increase in urination early in pregnancy is not caused by concentrated urine or a decrease in the glomerular cells of the kidney. The fetus is not adding urine to the patient's bladder.

Question 12

A patient who is 16 weeks pregnant has a lower blood pressure than that of prepregnancy levels. What should the nurse realize as being the cause for this lower blood pressure?

Accepted Answer

In some women, blood pressure actually decreases slightly during the second trimester because the expanding placenta causes peripheral resistance to circulation to lower. The lower blood pressure is not because prepregnancy blood pressure measurements were inaccurate. Blood pressure does not normally decrease throughout the entire pregnancy. There is no enough information to determine if the patient is dehydrated; however, this is not the reason for the blood pressure to be lower in the second trimester of pregnancy.

Question 13

A pregnant patient who has frequent allergic responses to drugs is concerned about an allergic reaction to the fetus. What information will the nurse use when responding to this patient's concern?

Accepted Answer

Immunologic competency during pregnancy decreases probably to prevent a woman's body from rejecting the fetus as if it were a transplanted organ. Aldosterone does not impact the production of IgG antibodies. The kidneys do not influence an allergic response. Adrenal gland activity increases during pregnancy.

Question 14

During a routine prenatal examination, a pregnant patient's urine is found to have a trace amount of glucose. What does this finding indicate to the nurse?

Accepted Answer

Because reabsorption of glucose by the tubule cells occurs at a fixed rate, this causes some accidental spilling of glucose into the urine during pregnancy. Lactose, which is being produced by the mammary glands but is not used during pregnancy, will also be spilled into the urine. If more than a trace amount of glucose is found in the pregnant patient's urine, this could indicate gestational diabetes. The increase of glucose in the urine is not because of eating excessive calories. The glomerular filtration rate increases in pregnancy.

Question 15

During an assessment, a patient who is 5 months pregnant tells the nurse that she has to change her diet because she is just becoming too fat. Which nursing diagnosis should the nurse use to guide interventions for the patient at this time?

Accepted Answer

The diagnosis of disturbed body image is the most appropriate because the patient is equating the weight gain of pregnancy as being fat. The patient may or may not have a knowledge deficit. There is no evidence to support the diagnosis of imbalanced nutrition. There is also no evidence to support that the patient is experiencing powerlessness.

Question 16

The nurse is concerned that a pregnant patient is not adjusting emotionally to being pregnant. Which statement indicates that the patient may need additional counseling?

Accepted Answer

The statement that the patient needs to get back to work after delivery could indicate that the patient feels the pregnancy is robbing her of financial stability or ruin chances of a promotion. Desiring to lose weight after pregnancy does not indicate that the patient is not adjusting emotionally to being pregnant. The statements about parental support do not indicate that the patient is not adjusting emotionally to being pregnant.

Question 17

The nurse instructs a pregnant patient on the need to increase foods containing folic acid. Which patient statement indicates that teaching has been effective?

Accepted Answer

The patient should be instructed to eat foods that are high in folic acid such as spinach, asparagus, and legumes. Adding spinach every day to the evening salad indicates that teaching about folic acid nutrition has been effective. Oranges, milk, cabbage, and cauliflower are not food items that will specifically influence the folic acid level.

Question 18

A patient who is 6 months pregnant is complaining of a lumbar backache. What actions should the nurse suggest to help this patient? (Select all that apply.)

Accepted Answer

Interventions to reduce lower lumbar backache associated with pregnancy include pelvic rocking exercises, walking with the head high, and resting and elevating the feet. The patient should be instructed to limit the use of high heels. Twisting the spine is not recommended to help with a lumbar backache.

Question 19

A pregnant patient is observed talking with another patient holding an infant in the clinic waiting room. What does this observation indicate to the nurse?

Accepted Answer

A step in preparing for parenthood is role-playing or fantasizing about what it will be like to be a parent. This is done by a pregnant woman spending time with other pregnant women or mothers of young children to learn how to be a mother. The pregnant patient's behavior does not indicate narcissism. Spending time with a mother of a small child is not reworking developmental tasks. This behavior does not demonstrate ambivalence about being pregnant.

Quiz 10: Nursing Care Related to Psychological and Physiologic Changes of Pregnancy