Question 1

The nurse is performing an assessment of a patient who is 38 weeks pregnant with her first child. The nurse notes a thin, brown, pigmented area on the abdomen starting at the top of the uterus and extending downward to the top of the pubis. The most appropriate response is:

Accepted Answer

The thin, brown, pigmented line described is known as the linea nigra, a common and normal finding during pregnancy. It does not require intervention by an advanced practice provider, nor does it typically cause itching, rashes, or pain. While it may fade after delivery, it does not always disappear immediately.

Question 2

A pregnant patient calls the triage nurse complaining of generalized itching, especially on the palms of her hands and soles of her feet. She is 34 weeks pregnant and has had an uneventful pregnancy to this point. Her last appointment was 2 weeks ago. The triage nurse should:

Accepted Answer

Generalized itching, especially on the palms of the hands and soles of the feet, can be a symptom of cholestasis of pregnancy, a liver condition that requires further evaluation. Asking about possible exposures can help rule out other causes of itching. Therefore, both advising the patient to come in for further evaluation and asking about possible exposures are appropriate steps.

Question 3

The nurse is examining a pregnant patient who is 36 weeks pregnant with twins. When the patient stands to leave the examination room, the nurse notes that she is having difficulty standing up straight. Which of the following is likely to be the cause?

Accepted Answer

Pregnancy-related lordosis is common in the later stages of pregnancy, especially with twin gestation, due to the increased weight and size of the uterus, causing a shift in the center of gravity and resulting in difficulty standing up straight.

Question 4

A woman presents to the clinic because she missed her last menstrual period and thinks she may be pregnant. She reports fatigue, breast tenderness, urinary frequency, nausea, and vomiting in the morning. The health-care provider will interpret these findings as which of the following changes of pregnancy?

Accepted Answer

Presumptive signs of pregnancy are those reported by the patient, such as missed periods, nausea, vomiting, breast tenderness, and urinary frequency. These signs suggest pregnancy but are not definitive because they can be caused by conditions other than pregnancy.

Question 5

Which of the following changes in respiratory functioning during pregnancy are considered normal?

Accepted Answer

Increased tidal volume is a normal physiological change during pregnancy. This adjustment helps to meet the higher oxygen demands of the mother and the fetus.

Question 6

The nurse visits a pregnant woman at 34 weeks gestation. The woman is very concerned because she notices pain in her groin, especially when walking. This complaint may be explained as:

Accepted Answer

Pain in the groin area during pregnancy, especially at 34 weeks, is often due to the stretching of the round ligaments as the uterus expands, which is a common and normal occurrence.

Question 7

When performing a physical assessment of a pregnant patient at 28 weeks gestation, the student nurse notes a yellow discharge coming from one of the nipples. The student nurse correctly identifies this as:

Accepted Answer

The yellow discharge noted from the nipple at 28 weeks gestation is most likely colostrum, which is the first form of milk produced by the mammary glands. It can begin to be produced during the second trimester of pregnancy, indicating the body's preparation for breastfeeding.

Question 8

During a focused health history, the pregnant patient expresses concern about her breast size. She worries that her breasts are "too large" and will not fit in her current bras. The best response to this concern is:

Accepted Answer

Both options B and D acknowledge the patient's concerns in a professional manner. Option B provides reassurance that breast enlargement during pregnancy is normal, while option D offers practical support to address the discomfort.

Question 9

A normal adaptation of pregnancy is increased blood supply to the pelvic region resulting in a blue discoloration of the cervix. This change is known as:

Accepted Answer

Chadwick's sign is the correct answer because it refers to the bluish discoloration of the cervix, vagina, and labia resulting from increased blood flow, which is a normal physiological change during pregnancy.

Question 10

The nurse is assessing a pregnant patient who is at 38 weeks gestation and thinks she is in labor. The patient states that she has had irregular contractions every few hours. The contractions are not painful. The nurse tells the patient:

Accepted Answer

All the statements are correct. Braxton-Hicks contractions are common and normal at 38 weeks gestation, indicating the body's preparation for labor but not the start of actual labor. Observing the pattern and intensity of contractions is important for determining the onset of labor.

Question 11

A pregnant woman is concerned about sleeping positions. She is only comfortable lying flat on her back. The nurse advises the woman:

Accepted Answer

In the third trimester, lying flat on the back can compress the inferior vena cava, reducing blood flow to the heart and potentially affecting fetal blood supply. Side-lying positions, especially on the left side, are recommended to optimize blood flow.

Question 12

You are assessing a 23-year-old patient who is 6 weeks pregnant and diagnosed with hyperemesis gravidarum. Untreated hyperemesis gravidarum can often result in which of the following conditions?

Accepted Answer

Untreated hyperemesis gravidarum, which is characterized by severe nausea and vomiting in pregnancy, can lead to dehydration due to the excessive loss of fluids. This condition can become serious if not properly managed.

Question 13

You are providing patient education to a pregnant woman. Prenatal vitamins are important during pregnancy because:

Accepted Answer

Pregnant women are at increased risk for iron deficiency anemia due to the increased blood volume and demands of the growing fetus. Iron supplements are often recommended to meet these increased needs.

Question 14

The patient is 30 weeks pregnant and you are going to assess the fundal height of the uterus. How should you position the patient?

Accepted Answer

The patient should be positioned semi-sitting with knees slightly bent to assess the fundal height of the uterus. This position allows the uterus to fall forward and makes it easier to palpate the fundus.

Question 15

You are assessing a woman who is 30 weeks pregnant. You are palpating her abdomen for fundal height. Where should her uterus be located?

Accepted Answer

At 30 weeks of pregnancy, the uterus is typically located between the umbilicus and the xiphoid process. This is a general guideline for assessing fundal height, which helps estimate the gestational age of the fetus.

Question 16

A patient who is pregnant calls the office with concerns that she has not felt fetal movement. She is at 17 weeks gestation and is a G1P0. She says, "My friend is as pregnant as I am and she feels movement." The nurse explains to the patient:

Accepted Answer

Feeling fetal movements, also known as "quickening," typically occurs between 18 to 25 weeks for first-time mothers. At 17 weeks, it is not unusual for a first-time mother not to have felt fetal movement yet.

Question 17

The nurse is assessing a woman on the second day after a normal, spontaneous vaginal birth without complications. The woman tells the nurse that she feels very sad and she begins to cry. She states that she is happy about the baby but she does not know why she is so sad. The best response the nurse can give is:

Accepted Answer

The best response is understanding and informative, acknowledging the woman's feelings as common and temporary, known as "baby blues," and advising her to seek help if they persist, without immediately jumping to conclusions or prescribing medication.

Question 18

A pregnant woman is 20 weeks pregnant and is having a routine assessment. You are assessing the fetal heart rate and place the Doppler below the umbilicus in the left lower quadrant. The patient asks you why you are listening to the heart rate at that particular place. How should the nurse respond?

Accepted Answer

The position of the baby in the uterus affects where the best sound of the heartbeat can be detected. At different stages of pregnancy and depending on the baby's position, the optimal spot to hear the fetal heartbeat can vary.

Question 19

You are going to assess the fetal heart rate. What should be done first just prior to auscultating the heart rate?

Accepted Answer

Performing Leopold maneuvers before fetal auscultation helps in identifying the fetal position, which facilitates locating the best site for auscultation of the fetal heart rate.

Question 20

A pregnant woman is 14 weeks pregnant and asks how fast her uterus will enlarge throughout her pregnancy. Which of the following is the nurse's best response?

Accepted Answer

The uterus grows approximately 1 cm per week of pregnancy, which is a general guideline used to assess the progress of the pregnancy and the growth of the uterus up until around 36 weeks.

Quiz 21: Assessing the Pregnant Woman