Deck 13: Anatomy and Physiology of Pregnancy

Question 1

The nurse is providing education to a client regarding the normal changes of the breasts during pregnancy.Which statement regarding these changes is correct?

A) The visibility of blood vessels that form an intertwining blue network indicates a possible infection of the tubercles.
B) The mammary glands do not develop until 2 weeks before labor.
C) Lactation is inhibited until the progesterone level declines after birth.
D) Colostrum is the yellowish oily substance used to lubricate the nipples for breastfeeding.

Answer 1

Lactation is inhibited until the progesterone level declines after birth.

Question 2

Some pregnant clients may report changes in their voice and impaired hearing.What should the nurse explain to the client concerning these findings?

A) Voice changes are caused by decreased estrogen levels.
B) Displacement of the diaphragm results in thoracic breathing.
C) These changes are the results of congestion and swelling of the upper respiratory tract.
D) Increased blood volume causes changes in the voice.

Answer 2

These changes are the results of congestion and swelling of the upper respiratory tract.

Question 3

A 31-year-old woman believes that she may be pregnant.She took an over-the-counter (OTC)pregnancy test 1 week ago after missing her period;the test was positive.During her assessment interview,the nurse asks about the woman's last menstrual period and whether she is taking any medications.The client states that she takes medicine for epilepsy.She has been under considerable stress lately at work and has not been sleeping well.Her physical examination does not indicate that she is pregnant.She has an ultrasound scan,which confirms that she is not pregnant.What is the most likely cause of the false-positive pregnancy test result?

A) The pregnancy test was taken too early.
B) Anticonvulsant medications may cause the false-positive test result.
C) The woman has a fibroid tumor.
D) She has been under considerable stress and has a hormone imbalance.

Answer 3

Anticonvulsant medications may cause the false-positive test result.

Question 4

The nurse is providing health education to a pregnant client regarding the cardiovascular system.Which information is correct and important to share?

A) A pregnant woman experiencing disturbed cardiac rhythm requires close medical and obstetric observation no matter how healthy she may appear otherwise.
B) Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks of gestation to term.
C) Palpitations are twice as likely to occur in twin gestations.
D) All of the above changes will likely occur.

Question 5

A woman is in her seventh month of pregnancy.She reports episodes of nasal congestion and occasional epistaxis.Which statement best describes why this may be happening to this client?

A) This respiratory change is normal in pregnancy and caused by an elevated level of estrogen.
B) This cardiovascular change is abnormal,and the nosebleeds are an ominous sign.
C) The woman is a victim of domestic violence and is being hit in the face by her partner.
D) The woman has been likely intranasally using cocaine for several months.

Question 6

Why might it be more difficult to diagnose appendicitis during pregnancy?

A) The appendix is displaced upward and laterally,high and to the right.
B) The appendix is displaced upward and laterally,high and to the left.
C) The appendix is deep at the McBurney's point.
D) The appendix is displaced downward and laterally,low and to the right.

Question 7

What is the correct term used to describe the mucous plug that forms in the endocervical canal?

A) Operculum
B) Leukorrhea
C) Funic souffle
D) Ballottement

Question 8

Which gastrointestinal alteration of pregnancy is a normal finding?

A) Insufficient salivation (ptyalism)is caused by increases in estrogen.
B) Acid indigestion (pyrosis)begins early but declines throughout pregnancy.
C) Hyperthyroidism often develops (temporarily)because hormone production increases.
D) Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial.

Question 9

hCG is an important biochemical marker for pregnancy and therefore the basis for many tests.Which statement regarding hCG is true?

A) hCG can be detected as early as weeks after conception.
B) hCG levels gradually and uniformly increase throughout pregnancy.
C) Significantly lower-than-normal increases in the levels of hCG may indicate a postdate pregnancy.
D) Higher-than-normal levels of hCG may indicate an ectopic pregnancy or Down syndrome.

Question 10

Of which physiologic alteration of the uterus during pregnancy is it important for the nurse to alert the patient?

A) Lightening occurs near the end of the second trimester as the uterus rises into a different position.
B) Woman's increased urinary frequency in the first trimester is the result of exaggerated uterine anti-reflexion caused by softening.
C) Braxton Hicks contractions become more painful in the third trimester,particularly if the woman tries to exercise.
D) Uterine souffle is the movement of the fetus.

Question 11

Pregnancy hormones prepare the vagina for stretching during labor and birth.Which change related to the pelvic viscera should the nurse share with the client?

A) Because of several changes in the cervix,abnormal Papanicolaou (Pap)tests are easier to evaluate.
B) Quickening is a technique of palpating the fetus to engage it in passive movement.
C) The deepening color of the vaginal mucosa and cervix (Chadwick sign)usually appears in the second trimester or later as the vagina prepares to stretch during labor.
D) Increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal,especially in the second trimester.

Question 12

Which statement regarding the probable signs of pregnancy is most accurate?

A) Determined by ultrasound
B) Observed by the health care provider
C) Reported by the client
D) Confirmed by diagnostic tests

Question 13

A pregnant client tells her nurse that she is worried about the blotchy,brownish coloring over her cheeks,nose,and forehead.The nurse can reassure her that this is a normal condition related to hormonal changes.What is the correct term for this integumentary finding?

A) Melasma
B) Linea nigra
C) Striae gravidarum
D) Palmar erythema

Question 14

The musculoskeletal system adapts to the changes that occur throughout the pregnancy.Which musculoskeletal alteration should the client expect?

A) Her center of gravity will shift backward.
B) She will have increased lordosis.
C) She will have increased abdominal muscle tone.
D) She will notice decreased mobility of her pelvic joints.

Question 15

Which clinical finding in a primiparous client at 32 weeks of gestation might be an indication of anemia?

A) Ptyalism
B) Pyrosis
C) Pica
D) Decreased peristalsis

Question 16

Which renal system adaptation is an anticipated anatomic change of pregnancy?

A) Increased urinary output makes pregnant women less susceptible to urinary infections.
B) Increased bladder sensitivity and then compression of the bladder by the enlarging uterus result in the urge to urinate even when the bladder is almost empty.
C) Renal (kidney)function is more efficient when the woman assumes a supine position.
D) Using diuretic agents during pregnancy can help keep kidney function regular.

Question 17

A client is seen at the clinic at 14 weeks of gestation for a follow-up appointment.At which level does the nurse expect to palpate the fundus?

A) Nonpalpable above the symphysis at 14 weeks of gestation
B) Slightly above the symphysis pubis
C) At the level of the umbilicus
D) Slightly above the umbilicus

Question 18

Which presumptive sign or symptom of pregnancy would a client experience who is approximately 10 weeks of gestation?

A) Amenorrhea
B) Positive pregnancy test
C) Chadwick sign
D) Hegar sign

Question 19

Which hormone is essential for maintaining pregnancy?

A) Estrogen
B) hCG
C) Oxytocin
D) Progesterone

Question 20

A first-time mother at 18 weeks of gestation is in for her regularly scheduled prenatal visit.The client tells the nurse that she is afraid that she is going into premature labor because she is beginning to have regular contractions.The nurse explains that these are Braxton Hicks contractions.What other information is important for the nurse to share?

A) Braxton Hicks contractions should be painless.
B) They may increase in frequency with walking.
C) These contractions might cause cervical dilation.
D) Braxton Hicks contractions will impede oxygen flow to the fetus.

Question 21

Which statement best describes the rationale for the physiologic anemia that occurs during pregnancy?

A) Physiologic anemia involves an inadequate intake of iron.
B) Dilution of hemoglobin concentration occurs in pregnancy with physiologic anemia.
C) Fetus establishes the iron stores.
D) Decreased production of erythrocytes occur.

Question 22

Which finding in the urinalysis of a pregnant woman is considered a variation of normal?

A) Proteinuria
B) Glycosuria
C) Bacteria in the urine
D) Ketones in the urine

Question 23

Pregnancy is a hypercoagulable state in which women are at a fivefold to sixfold increased risk for thromboembolic disease.The tendency for blood to clot is greater,attributable to an increase in various clotting factors.Which of these come into play during pregnancy? (Select all that apply. )

A) Factor VII
B) Factor VIII
C) Factor IX
D) Factor XIII
E) Fibrinogen

Question 24

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

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

Question 25

The diagnosis of pregnancy is based on which positive signs of pregnancy? (Select all that apply. )

A) Identification of fetal heartbeat
B) Palpation of fetal outline
C) Visualization of the fetus
D) Verification of fetal movement
E) Positive hCG test

Question 26

Cardiac output increases up to 50% by the 32nd week of pregnancy.What is the rationale for this change?

A) To compensate for the decreased renal plasma flow
B) To provide adequate perfusion of the placenta
C) To eliminate metabolic wastes of the mother
D) To prevent maternal and fetal dehydration

Question 27

To reassure and educate their pregnant clients regarding changes in their blood pressure,nurses should be cognizant of what?

A) A blood pressure cuff that is too small produces a reading that is too low;a cuff that is too large produces a reading that is too high.
B) Shifting the client's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit.
C) Systolic blood pressure slightly increases as the pregnancy advances;diastolic pressure remains constant.
D) Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of a term pregnancy.

Question 28

Numerous changes in the integumentary system occur during pregnancy.Which change persists after birth?

A) Epulis
B) Chloasma
C) Telangiectasia
D) Striae gravidarum

Question 29

During pregnancy,many changes occur as a direct result of the presence of the fetus.Which of these adaptations meet this criterion? (Select all that apply. )

A) Leukorrhea
B) Development of the operculum
C) Quickening
D) Ballottement
E) Lightening