Deck 6: Anatomy and Physiology of Pregnancy

Question 1

A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. The nurse suspects that:

A) This is a normal respiratory change in pregnancy caused by elevated levels of estrogen.
B) This is an abnormal cardiovascular change, 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 using cocaine intranasally.

Answer 1

This is a normal respiratory change in pregnancy caused by elevated levels of estrogen.

Question 2

A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity using the GTPAL system?

A) 2-0-0-1-1
B) 2-1-0-1-0
C) 3-1-0-1-0
D) 3-0-1-1-0

Answer 2

3-1-0-1-0

Question 3

The musculoskeletal system adapts to the changes that occur during pregnancy. A woman can expect to experience what change?

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.

Answer 3

She will have increased lordosis.

Question 4

When the nurse is providing education to the pregnant patient regarding changes in the cervix, vagina, and the position of the fetus, it is important to be aware that:

A) Because of a number of changes in the cervix, abnormal Papanicolaou (Pap) tests are much 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's 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 5

The mucous plug that forms in the endocervical canal is called:

A) The operculum.
B) Leucorrhea.
C) The funic souffle.
D) Ballottement.

Question 6

A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have:

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

Question 7

Human chorionic gonadotropin (hCG) is an important biochemical marker for pregnancy and therefore the basis for many tests. A maternity nurse should be aware that:

A) hCG can be detected as early as 2½ weeks after conception.
B) The hCG level increases gradually and uniformly throughout pregnancy.
C) Much lower than normal increases in the level of hCG may indicate a postdate pregnancy.
D) A higher than normal level of hCG may indicate an ectopic pregnancy or Down syndrome.

Question 8

Which time-based description of a stage of development in pregnancy is accurate?

A) Viability-22 to 37 weeks since the last menstrual period (LMP) (assuming a fetal weight greater than 500 g)
B) Term-pregnancy from the beginning of week 38 of gestation to the end of week 42
C) Preterm-pregnancy from 20 to 28 weeks
D) Postdate-pregnancy that extends beyond 38 weeks

Question 9

The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is:

A) A positive pregnancy test.
B) Fetal movement palpated by the nurse-midwife.
C) Braxton Hicks contractions.
D) Quickening.

Question 10

To reassure and educate pregnant patients about changes in their cardiovascular system, maternity nurses should be aware that:

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

Question 11

Some pregnant patients may complain of changes in their voice and impaired hearing. The nurse can tell these patients that these are common reactions to:

A) A decreased estrogen level.
B) Displacement of the diaphragm, resulting in thoracic breathing.
C) Congestion and swelling, which occur because the upper respiratory tract has become more vascular.
D) Increased blood volume.

Question 12

Over-the-counter (OTC) pregnancy tests usually rely on which technology to test for human chorionic gonadotropin (hCG)?

A) Radioimmunoassay
B) Radioreceptor assay
C) Latex agglutination test
D) Enzyme-linked immunosorbent assay (ELISA)

Question 13

Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester?

A) Less audible heart sounds (S1, S2)
B) Increased pulse rate
C) Increased blood pressure
D) Decreased red blood cell (RBC) production

Question 14

To reassure and educate pregnant patients about changes in the uterus, nurses should be aware that:

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

Question 15

The nurse caring for the pregnant patient must understand that the hormone essential for maintaining pregnancy is:

A) Estrogen.
B) Human chorionic gonadotropin (hCG).
C) Oxytocin.
D) Progesterone.

Question 16

To reassure and educate their pregnant patients about changes in their blood pressure, maternity nurses should be aware that:

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 patient's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit.
C) The systolic blood pressure increases slightly as pregnancy advances; the 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 term pregnancy.

Question 17

Appendicitis may be difficult to diagnose in pregnancy because the appendix is:

A) Displaced upward and laterally, high and to the right.
B) Displaced upward and laterally, high and to the left.
C) Deep at McBurney point.
D) Displaced downward and laterally, low and to the right.

Question 18

The nurse providing care to the pregnant woman should know that all are normal gastrointestinal changes in pregnancy except:

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

Question 19

A woman is at 14 weeks of gestation. The nurse would expect to palpate the fundus at which level?

A) Not palpable above the symphysis at this time
B) Slightly above the symphysis pubis
C) At the level of the umbilicus
D) Slightly above the umbilicus

Question 20

A woman's obstetric history indicates that she is pregnant for the fourth time and all of her children from previous pregnancies are living. One child was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system?

A) 3-1-1-1-3
B) 4-1-2-0-4
C) 3-0-3-0-3
D) 4-2-1-0-3

Question 21

The diagnosis of pregnancy is based on which positive signs of pregnancy? Choose 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 22

A woman is in for a routine prenatal checkup. You are assessing her urine for proteinuria. You know that which findings are considered normal? Choose all that apply.

A) Dipstick assessment of trace to +1
B) <300 mg/24 hours
C) Dipstick assessment of +2
D) >300 mg/24 hours

Question 23

To reassure and educate pregnant patients about the functioning of their kidneys in eliminating waste products, maternity nurses should be aware that:

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

Question 24

Which statement about a condition of pregnancy is accurate?

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.