Deck 8: Physical and Psychologic Changes of Pregnancy

Question 1

A patient in the prenatal clinic believes she is pregnant because she has not menstruated for 3 months, and her breasts are getting bigger. What response by the nurse is best?
1) "Lack of menses and breast enlargement are presumptive signs of pregnancy."
2) "The changes you are describing are definitely indicators that you are pregnant."
3) "Lack of menses can be caused by many things. We need to do a pregnancy test."
4) "Breast and menstrual changes are positive signs of pregnancy. Congratulations."

Answer 1

3

Question 2

The manager notes that a neonatal intensive care unit (NICU) nurse is practicing culturally competent care. What did the manager observe to make this decision? Select all that apply.
1) Respects the rituals of the ethnic group of a new mother
2) Explains the processes that are followed in an American hospital
3) Speaks a few phrases in the language of a non-English speaking client
4) Discusses the odd practices that a client from Europe wants to have done
5) Contacts an interpreter to facilitate communication with a Spanish-speaking client

Answer 2

1, 3, 5

Question 3

The nurse is reviewing the assessment findings of a patient who is at 35 weeks' gestation. Which data suggest the need for further investigation?
1) Glycosuria
2) Funic souffle
3) Pseudoanemia
4) Melasma gravidarum

Answer 3

1

Question 4

An adolescent patient reports that her period is late but that her home pregnancy test is negative. Which response is most appropriate?
1) "This means you are not pregnant."
2) "We do not trust home tests. Come to the clinic for a blood test."
3) "Most people do not use the tests correctly. Did you read the instructions?"
4) "You might be pregnant, but it might be too early for your home test to be accurate."

Question 5

A client in labor is a Lebanese immigrant, and she explains that in the Islamic faith, the baby's name is selected after the baby is born. Which nursing response is appropriate?
1) "Are you afraid your baby will not live?"
2) "We have a very low rate of complications at this facility."
3) "In the United States, you can feel free to choose your baby's name prior to the delivery."
4) "Thank you for explaining that to me. By sharing your cultural beliefs with me, you are helping me to provide you with the best possible care."

Question 6

The nurse is preparing an educational program on the different types of pregnancy tests. What should the nurse include about the β-subunit radioimmunoassay (RIA) test? Select all that apply.
1) It causes a color change.
2) It takes 2 to 3 hours to perform.
3) It is able to detect trophoblastic disease.
4) It is able to detect an ectopic pregnancy.
5) It is the same as an over-the-counter test.

Question 7

The nurse is presenting an in-service to nursing staff regarding the provision of culturally competent client care. Which statement should the nurse include in the presentation?
1) "Developed countries are becoming increasingly more ethnically diverse."
2) "The rituals and customs of a group reflect the values of the dominant culture."
3) "Identification of cultural values is a task that is unrelated to providing culturally sensitive care."
4) "Many immigrants to a new country will adopt the beliefs and practices of the dominant culture."

Question 8

During an interview the nurse asks the partner of a woman in the second trimester of pregnancy what changes they have noticed during the pregnancy. Which answer would indicate a typical response to pregnancy?
1) "She daydreams about what kind of parent she is going to be."
2) "I have not noticed anything. I just found out she is pregnant."
3) "She has been having dreams at night about misplacing the baby."
4) "She has been more tense and anxious than usual, and she is not sleeping well."

Question 9

While auscultating fetal heart tones, a client who is at 37 weeks' gestation and is in the supine position is experiencing dizziness, lightheadedness, and clammy skin. Which nursing action is the most appropriate?
1) Administer supplemental oxygen.
2) Help the patient turn onto her right side.
3) Place a wedge beneath the patient's right hip.
4) Prepare for administration of packed red blood cells (PRBCs).

Question 10

The mother of a client who is 14 weeks pregnant is uncertain about how to be a good grandmother to this baby due to working full time and being so busy. How should the nurse respond in this situation?
1) "How do you envision your role as grandmother?"
2) "Don't worry. You'll be a wonderful grandmother. It will all work out fine."
3) "As long as there is another grandmother available, you do not have to worry."
4) "Grandmothers are supposed to be available. You should retire from your job."

Question 11

A client at 30 weeks' gestation is tearful at the time of her follow-up visit. She tells the prenatal clinic nurse that she is excited to finally become a mother and that she has been thinking about what kind of parent she will be. However, she is upset because her mother has told her that she does not want to be a grandmother because she does not feel old enough. Meanwhile, the client's husband has said that the pregnancy does not feel real to him yet, and that he will become excited when the baby is actually here. What is the most likely explanation for what is happening within this family?
1) Family members are adjusting to the role change at their own pace.
2) Her mother is rejecting the role of grandparent and will not help out.
3) Her husband will not attach with this child and will not be a good father.
4) The client is not progressing through the developmental tasks of pregnancy.

Question 12

The nurse is reviewing with a pregnant client the skin changes that she might experience during gestation. What should the nurse include in this discussion? Select all that apply.
1) Linea nigra
2) Spider nevi
3) Psoriatic lesions
4) Striae gravidarum
5) Melasma gravidarum

Question 13

A 20-year-old client who is at 10 weeks' gestation confides that the pregnancy was unplanned and is unsure about continuing it or sharing news about it with her partner. How should the nurse respond to this client?
1) "You should go to a pregnancy support group to be a good mother."
2) "It's common to feel ambiguous about pregnancy in the first trimester."
3) "These thoughts are because your mother died when you were 4 years old."
4) "It's really unusual for a pregnant woman to feel this way early in the pregnancy."

Question 14

A patient who is experiencing her first pregnancy has just completed the initial prenatal examination with a certified nurse-midwife. Which statement indicates that the patient has a correct understanding of her condition?
1) "The increased size of my uterus means that I am finally pregnant."
2) "Because we heard the baby's heartbeat, I am undoubtedly pregnant."
3) "Since I haven't felt the baby move yet, we don't know if I'm pregnant."
4) "My last period was 2 months ago, which means I'm 2 months along."

Question 15

The nurse has completed a presentation for newly pregnant women about the changes of pregnancy. Which participant's statement reflects accurate comprehension of the information?
1) "Uterine souffle is a positive change of pregnancy."
2) "A positive Goodell sign is a probable change of pregnancy."
3) "Changes in the pelvic organs are presumptive signs of pregnancy."
4) "Three positive pregnancy tests in a 1-week period is considered to be a positive change of pregnancy."

Question 16

A 28-year-old client who is pregnant with her first child reports increased dental caries (cavities) since becoming pregnant. How should the nurse explain the likely cause for this change?
1) "Each woman experiences changes that affect her teeth while she's pregnant."
2) "When a woman is pregnant, her teeth lose calcium and she is more susceptible to getting cavities."
3) "During pregnancy, tooth enamel softens and the woman is more susceptible to getting cavities."
4) "It may be necessary to pay extra attention to dental care while you're pregnant, especially if you're vomiting frequently."

Question 17

A patient with a normal prepregnancy weight asks why she has been told to gain 25 to 35 pounds during her pregnancy, but her underweight friend was told to gain 28 to 40 pounds. What should the nurse explain as being the recommended weight gain during pregnancy?
1) More than 25 to 35 pounds for an overweight patient
2) More than 25 to 35 pounds for an underweight woman
3) 25 to 35 pounds, regardless of a patient's prepregnancy weight
4) The same for a normal-weight woman as for an overweight woman

Question 18

The nurse suspects that a pregnant client is experiencing effects to the gastrointestinal system because of elevated progesterone levels. What did the nurse assess to make this clinical determination? Select all that apply.
1) Nausea
2) Bloating
3) Diarrhea
4) Vomiting
5) Constipation

Question 19

The partner of a pregnant client at 16 weeks' gestation accompanies her to the clinic. The partner tells you that the baby just does not seem real to him, and he is having a hard time relating to his partner's fatigue and food aversions. Which statement would be best for the nurse to make?
1) "Many men feel this way. Feeling the baby move will help make it real."
2) "My husband had no problem with this. What was your childhood like?"
3) "You might need professional psychologic counseling. Ask your physician."
4) "If you would concentrate harder, you would be aware of the reality of this pregnancy."

Question 20

The nurse notes that a client who is 10 weeks pregnant is experiencing changes to the upper respiratory system. What should the nurse explain as being the reason for these changes? Select all that apply.
1) Estrogen-induced edema
2) Hypersecretion of mucus
3) Decreased white blood cell production
4) Vascular congestion of the nasal mucosa
5) Amniotic fluid reducing total fluid volume