Deck 8: Physiological and Psychosocial Changes During Pregnancy

Question 1

A pregnant woman calls the clinic to complain of sharp,right-sided lower abdominal pain.Which question by the nurse would elicit the most relevant information?

A) "Do you have a fever, constipation, or any diarrhea?"
B) "Have you fallen down or experienced any kind of injury in the last few days?"
C) "Have you tried placing either a heating pad or an ice pack on your abdomen?"
D) "Is the pain worse between your navel and hip bone or closer to the hip?"

Answer 1

"Do you have a fever, constipation, or any diarrhea?"

Question 2

A woman in the third trimester of her first pregnancy complains of excessive fatigue.Her hemoglobin is 11.2 g/dL.What action by the nurse is best?

A) Arrange hospital admission for blood transfusions.
B) Assess the woman's diet for adequate iron and protein.
C) Inform the woman that this is a normal finding in pregnancy.
D) Tell the woman to get more sleep at night and to take naps.

Answer 2

Assess the woman's diet for adequate iron and protein.

Question 3

A woman in her third trimester of pregnancy complains of a painful burning sensation in her hands and lower arms.Which action by the nurse is best?

A) Advise the woman to elevate her hands at night.
B) Document the finding and alert the provider.
C) Encourage the woman to see a neurologist.
D) Request a prescription for pregabalin (Lyrica).

Answer 3

Advise the woman to elevate her hands at night.

Question 4

A student asks the nurse why so many pregnant women get cholecystitis.Which response by the nurse is best?

A) "Inefficient emptying leads to stasis of bile and inflammation, or cholecystitis."
B) "Pregnant women crave high-fat foods that cause gallbladder irritation."
C) "Some pregnant women have a genetic predisposition to gallbladder problems."
D) "Vascular changes to the liver capsule cause bile to back up into the gallbladder."

Question 5

The nurse has learned that which hormone is primarily responsible for maintaining a pregnancy?

A) Estrogen
B) Human chorionic gonadotropin
C) Oxytocin
D) Progesterone

Question 6

A father accompanies his partner to her OB clinic visit.The woman is near term.The father confides to the nurse that the patient is cranky,irritable,and yells at him for no reason.Which action by the nurse is best?

A) Explain why the woman needs emotional support.
B) Instruct the mother to get more rest during the day.
C) Reassure the father that this behavior is normal in pregnancy.
D) Teach the father assertive communication skills.

Question 7

A nurse is teaching a woman who is in her first trimester of pregnancy about physical changes she can expect.Which information should the nurse provide?

A) Diminishing sexual interest occurs.
B) Harmful agents are able to invade the uterus.
C) Leukorrhea is an abnormal condition.
D) Pregnant women are more susceptible to yeast infections.

Question 8

A patient who is 28 weeks pregnant calls the obstetrical clinic and complains of irregular,painless contractions that last for 10 to 15 seconds.What response by the nurse is best?

A) "If they last more than 60 seconds or become regular, come in."
B) "Oh, you are just having what are called Braxton Hicks contractions."
C) "Pregnant women often experience this type of contraction."
D) "You should come in to the clinic as soon as possible today."

Question 9

The nurse caring for perinatal patients understands the term decidua to mean which of the following?

A) Collateral uterine circulation
B) Endometrial lining of the uterus
C) Endometrial tissue covering the embryo
D) Placental remnants left in the uterus

Question 10

A woman in her second trimester of pregnancy is in the clinic for a checkup.She complains of feeling short of breath at times.Her lungs are clear and her oxygen saturation is 98%.Her vital signs are all normal.What action by the nurse is best?

A) Alert the provider to the symptoms.
B) Encourage slow, deep breathing.
C) Document the findings.
D) Facilitate a chest x-ray.

Question 11

According to Rubin (1975),completion of what task is paramount for a pregnant woman to master in order to have successful integration of the maternal role?

A) Incorporating the pregnancy into her total identity
B) Learning to adapt to all the physiological changes
C) Recognizing a "before pregnant" and "after pregnant" self
D) Reorienting all relationships to put the pregnancy first

Question 12

A woman who gave birth 2 months ago calls the perinatal clinic crying because her hair is falling out in large amounts.What action by the nurse is most appropriate?

A) Advise the woman to make an appointment with a dermatologist.
B) Explain that this symptom will end once she stops breastfeeding.
C) Reassure the woman that her hair will grow back within a year.
D) Tell the woman it's really extra hair that grew in pregnancy.

Question 13

A pregnant woman is complaining of frequent heartburn.What statement by the patient indicates to the nurse that teaching has been effective?

A) "Drinking less alcohol should prevent this."
B) "Eating larger, less frequent meals will help."
C) "I should take antacids before each meal."
D) "I will not lie down for 1 hour after eating."

Question 14

What information should the nurse plan to teach a pregnant woman regarding safety in the third trimester?

A) Don't drive after dark.
B) Exercise to maintain good posture.
C) Use handrails when using the stairs.
D) Wear supportive shoes.

Question 15

A nurse is assessing a patient in the women's clinic for Chadwick's sign.How does the nurse perform this assessment?

A) Auscultates the woman's abdomen for fetal heart tones
B) Inspects the vulva and vagina for a bluish tint
C) Palpates the woman's abdomen for a fluid wave
D) Percusses the woman's abdomen for uterine margins

Question 16

A pregnant woman in the perinatal clinic complains of occasional fainting.Which action by the nurse is best?

A) Educate her that this is a frequent occurrence in pregnancy.
B) Encourage her to carry small snacks with her at all times.
C) Instruct her to lie down when the warning signs occur.
D) Tell her to lie down on her left side if she has warning signs.

Question 17

The perinatal nurse reads the diagnosis of ptyalism in a patient's chart.What teaching does the nurse plan for this patient?

A) Chew food thoroughly before swallowing.
B) Drink plenty of decaffeinated beverages.
C) Eat something before getting up in the morning.
D) Lozenges and chewing gum can help.

Question 18

An instructor is explaining to students in the OB rotation that Goodell's sign is which of the following?

A) Bluish cervical discoloration
B) Cervical softening
C) False labor contractions
D) Slowed fetal heart tones

Question 19

A pregnant woman in the perinatal clinic complains of a diffuse,reddish discoloration of her palms.What action by the nurse is most appropriate?

A) Ask if she has been exposed to measles.
B) Assess her for Reynaud's phenomenon.
C) Explain that this is a normal finding.
D) Take the woman's vital signs.

Question 20

A woman in the emergency department is in her third trimester and is bleeding heavily from a laceration on her thigh from a car crash.She is pale and diaphoretic.Her blood pressure is 138/82 mm Hg.What can the nurse conclude from this information?

A) Blood loss from the laceration has not been that great.
B) She is in shock from the trauma of the injury and blood loss.
C) Her increased blood volume is maintaining the blood pressure.
D) Her vital signs and physical assessment do not match.

Question 21

The nursing instructor explains to a class of students that the pituitary gland has many functions related to pregnancy.Which of the following functions are performed by hormones secreted by this gland?

A) Cause the corpus luteum to produce progesterone
B) Influence ovarian follicular development
C) Maintain the pregnancy
D) Prompt ovulation
E) Stimulate the uterine lining

Question 22

In providing anticipatory guidance to a couple expecting their first child,which tasks and activities does the nurse discuss with the parents?

A) Honing communication and listening skills
B) Learning to cope with a lack of sexual activity
C) Negotiating household roles and daily tasks
D) Reorganizing the house for a new member
E) Reviewing patterns of money management

Question 23

To provide anticipatory psychosocial guidance to a woman entering her third trimester,what topic should the nurse plan to include?

A) Extreme fatigue may make the woman very vulnerable at the end.
B) She may feel overwhelmed with the physical discomforts of pregnancy.
C) Initial feelings of uncertainty will go away at childbirth.
D) She may worry about impending childbirth but see it as a relief.

Question 24

The nurse is explaining to a student that a pregnant woman needs to complete a process called "binding in." Which is the best explanation of this phenomenon?

A) Becoming excited about the impending childbirth
B) Incorporating the pregnancy into the woman's reality
C) Learning to not focus on one's own discomforts
D) Renegotiating roles within the woman's family

Question 25

A woman is in the first trimester of her first pregnancy and confides to the nurse that she is not really sure if she is happy because so many things in her life will change.She is not sure she is willing to alter her current lifestyle.What action by the nurse is most appropriate?

A) Ask the woman if she would like to see a counselor.
B) Reassure the woman that ambivalence is normal now.
C) Refer the woman to an expectant-mother support group.
D) Tell the woman she needs to think of her unborn child.

Question 26

A woman in the first trimester of her first pregnancy is upset and worried about physical changes,the labor and birth process,and being able to care for a newborn.Which action by the nurse is best?

A) Ask the woman about her exposure to newborns.
B) Assess the woman for access to a knowledgeable support person.
C) Provide information about childbirth preparation classes.
D) Reassure the woman that these fears are natural.

Question 27

A woman has given birth to a child with a cleft lip.What action by the patient would best indicate that goals for the diagnosis of dysfunctional grieving have been at least partially met?

A) Birth announcements include photo and wording to explain cleft lip.
B) Father accepts information about a cleft lip/cleft palate support group.
C) Mother watches demonstration of holding baby appropriately for feeding.
D) Parents express concern about their abilities to care for the baby.

Question 28

A pregnant woman has the nursing diagnosis of risk for ineffective role performance.What statement by the patient indicates that she is meeting a maternal task associated with the second trimester?

A) "All of this morning sickness and fatigue are distressing."
B) "I don't understand why I feel drawn to pregnant women."
C) "I really will miss my girls' nights out at the local bars."
D) "This baby seems so real to me since I feel him move."

Question 29

A nurse is providing anticipatory guidance regarding psychosocial adaptations to pregnancy to a group of women.Which topics are consistent with their associated trimesters?

A) First trimester: ambivalence about the pregnancy
B) First trimester: separation from the fetus
C) Second trimester: active dreams and fantasy life
D) Second trimester: becoming more introspective
E) Third trimester: realignment of roles and tasks

Question 30

A nurse is providing anticipatory guidance to a pregnant woman regarding normal changes in the nose and nasal passages.What information should the nurse provide?

A) Blow your nose gently.
B) Dry mucous membranes cause bleeding.
C) Increase your fluid intake.
D) Stuffiness is common.
E) Use decongestant spray.

Question 31

The nurse is explaining to a student that several physiological factors cause a pregnant woman to be prone to venous thrombosis and embolic phenomena.What factors are included?

A) Dehydration
B) Increased blood factors
C) Sedentary lifestyle
D) Venous stasis
E) Volume overload

Question 32

A patient is complaining of constipation.What teaching should the nurse plan to provide?

A) Avoid vigorous exercise.
B) Drink 8 to 10 glasses of water each day.
C) Don't strain to move your bowels.
D) Eat small, frequent meals.
E) Increase your fiber intake.

Question 33

A woman is in her fourth month of pregnancy and is in the clinic for a scheduled visit.She confides to the nurse that her husband seems detached and is no longer interested in hearing about the pregnancy.Which action by the nurse is best?

A) Explain that paternal reactions vary widely.
B) Offer a referral to a marriage counselor.
C) Reassure the woman that this behavior changes after the birth.
D) Tell her that men are usually jealous of the baby.

Question 34

A nurse manager on the high-risk OB unit wants to improve the experience of women admitted for lengthy stays.What action by the manager is best?

A) Designate a specific chaplain to visit women every day.
B) Develop a program to help women attain developmental tasks.
C) Initiate primary nursing to provide consistency in caregiving.
D) Provide open visitation and special events for siblings.

Question 35

A woman is in her second trimester of pregnancy.Which behaviors by the woman's family or friends would best indicate to the nurse that they are accepting the unborn child?

A) An older sibling is talking about "my baby brother or sister."
B) Close friends throw a baby shower for the expectant mother.
C) Immediate family members express delight over the pregnancy.
D) The parents state that no matter what the gender, they will love the baby.

Question 36

A nurse works with pregnant adolescents during pregnancy and for the first 2 years afterward.Which teen demonstrates the most successful resolution of the conflict between normal growth and development tasks and tasks associated with being a new mother?

A) Attends alternative school with an on-site day care
B) Lives at home with parents who care for the infant
C) Needs strong encouragement to keep appointments
D) Plans activities around the baby one day at a time

Question 37

A nurse is working with a woman in her second trimester and her partner.The partner comes to clinic appointments but spends his time texting on his cell phone in the waiting room.The woman states that this behavior makes her sad.Which action by the nurse is best?

A) Ask the father to turn off his cell phone in the clinic.
B) Assess the woman for ongoing relationship problems.
C) Invite the father into the exam room to listen to the baby's heartbeat.
D) Refer the couple to counseling for depression.

Question 38

A pregnant woman had several urinary tract infections (UTIs)in her last pregnancy and wants to avoid them during this pregnancy.What advice by the nurse is best?

A) Drink 8 to 10 glasses of water daily.
B) Drink a glass of apple juice daily.
C) Empty the bladder before intercourse.
D) Void every 1 to 2 hours while awake.
E) Void every 2 to 3 hours while awake.

Question 39

A nurse is providing anticipatory guidance to a pregnant woman who has another child.Which information should the nurse plan to include?

A) School-age: can fully grasp the reality of the pregnancy
B) School-age: too young to attend sibling classes
C) Teen: may feel resentment and embarrassment
D) Toddler: may be excited to play with the new baby
E) Toddler: may regress in behavior