Question 1

The partner of a client at 16 weeks' gestation accompanies her to the clinic. The partner tells the nurse that the baby just doesn't 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?

Accepted Answer

The best response is empathetic and informative, acknowledging the partner's feelings as common and suggesting that feeling the baby move can help make the pregnancy feel more real. This approach is supportive and offers a positive outlook for the future.

Question 2

It is 1 week before a pregnant client's due date. The nurse notes on the chart that the client's pulse rate was 74-80 before pregnancy. Today, the client's pulse rate at rest is 90. What action should the nurse should take?

Accepted Answer

C

Question 3

The client at 30 weeks' gestation with her first child is upset. She tells the prenatal clinic nurse that she is excited to become a mother, and has been thinking about what kind of parent she will be. But her mother has told her that she doesn't want to be a grandmother because she doesn't feel old enough, while her husband has said that the pregnancy doesn't feel real to him yet, and he will become excited when the baby is actually here. What is the most likely explanation for what is happening within this family?

Accepted Answer

The most likely explanation is that each family member is adjusting to the significant life change of welcoming a new baby at their own pace. This is a normal process as individuals come to terms with new roles and responsibilities in their own time.

Question 4

The nurse is assessing a client in the third trimester of pregnancy. What physiologic changes in the client are expected?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

During pregnancy, physiological changes include an increase in chest circumference to accommodate the growing fetus and increased blood volume, leading to thoracic breathing as the diaphragm is displaced upwards. Epistaxis (nosebleeds) may occur due to increased blood volume and hormonal changes affecting the mucous membranes. A narrowed subcostal angle and a productive cough are not typical physiological changes in pregnancy.

Question 5

The pregnant client at 14 weeks' gestation is in the clinic for a regular prenatal visit. Her mother also is present. The grandmother-to-be states that she is quite uncertain about how she can be a good grandmother to this baby because she works full time. Her own grandmother was retired, and was always available when needed by a grandchild. What is the nurse's best response to this concern?

Accepted Answer

Asking the grandmother-to-be about her thoughts on her role encourages her to express her feelings and expectations, facilitating a more personalized and supportive conversation. This approach respects her individuality and acknowledges that there are many ways to be a good grandmother, regardless of one's work status.

Question 6

The nurse has completed a community presentation about the changes of pregnancy, and knows that the lesson was successful when a community member states that which of the following is one probable or objective change of pregnancy?

Accepted Answer

Enlargement of the uterus is considered a probable or objective change of pregnancy, as it can be observed and measured by a healthcare provider.

Question 7

A client who is experiencing her first pregnancy has just completed the initial prenatal examination with a certified nurse-midwife. Which statement indicates that the client needs additional information?

Accepted Answer

The statement "My last period was 2 months ago, which means I'm 2 months along" indicates a need for additional information because pregnancy duration is calculated from the first day of the last menstrual period, but this does not directly correlate to the time of conception or fetal development. Gestational age is typically 2 weeks more than the actual fetal age due to this calculation method.

Question 8

What is the increased vascularization causing the softening of the cervix known as?

Accepted Answer

Goodell sign is the indication of increased vascularization causing the softening of the cervix, typically observed in early pregnancy.

Question 9

The nurse is listening to the fetal heart tones of a client at 37 weeks' gestation while the client is in a supine position. The client states, "I'm getting lightheaded and dizzy." What is the nurse's best action?

Accepted Answer

The client is likely experiencing supine hypotensive syndrome, which occurs when the weight of the uterus compresses the inferior vena cava, reducing blood flow. Turning the client onto her left side relieves the pressure and restores circulation.

Question 10

During her first months of pregnancy, a client tells the nurse, "It seems like I have to go to the bathroom every 5 minutes." The nurse explains to the client that this is because of which of the following?

Accepted Answer

The growing uterus puts pressure on the bladder during pregnancy, leading to increased frequency of urination. This is a common and normal physiological change as the uterus expands and exerts pressure on the bladder, reducing its capacity for urine storage.

Question 11

The nurse has received a phone call from a multigravida who is 21 weeks pregnant and has not felt fetal movement yet. What is the best action for the nurse to take?

Accepted Answer

At 21 weeks, most pregnant women should have started to feel fetal movements. The absence of perceived fetal movements by this stage, especially in a multigravida (a woman who has been pregnant before), warrants further evaluation to assess fetal well-being. Scheduling an appointment with her physician for the same day is the best action to ensure prompt assessment and management.

Question 12

The client is at 6 weeks' gestation, and is spotting. The client had an ectopic pregnancy 1 year ago, so the nurse anticipates that the physician will order which intervention?

Accepted Answer

The answer of The client is at 6 weeks' gestation,...

Question 13

A client with a normal prepregnancy weight asks why she has been told to gain 25-35 pounds during her pregnancy while her underweight friend was told to gain more weight. What should the nurse tell the client the recommended weight gain is during pregnancy?

Accepted Answer

Underweight women are generally advised to gain more weight during pregnancy, up to 40 pounds, to support fetal development and maternal health.

Question 14

A woman calls the clinic and tells a nurse that she thinks she might be pregnant. She wants to use a home pregnancy test before going to the clinic, and asks the nurse how to use it correctly. What information should the nurse give?

Accepted Answer

The client should follow up with a healthcare provider after taking the home pregnancy test to confirm the results and discuss further care.

Question 15

The client in the prenatal clinic tells the nurse that she is sure she is pregnant because she has not had a menstrual cycle for 3 months, and her breasts are getting bigger. What response by the nurse is best?

Accepted Answer

The answer of The client in the prenatal clinic tells...

Question 16

A client at 16 weeks' gestation has a hematocrit of 35%. Her prepregnancy hematocrit was 40%. Which statement by the nurse best explains this change?

Accepted Answer

During pregnancy, a woman's blood volume increases to support the growing fetus, which can dilute red blood cells and lower hematocrit levels. This is a normal physiological change and does not necessarily indicate a problem.

Question 17

The adolescent client reports to the clinic nurse that her period is late, but her home pregnancy test is negative. What should the nurse explain that these findings most likely indicate?

Accepted Answer

Home pregnancy tests are most accurate when taken after a missed period, but they can sometimes yield false negatives if taken too early. This is because the level of the pregnancy hormone hCG might not be high enough to detect.

Question 18

A prenatal educator is asking a partner about normal psychologic adjustment of an expectant mother during the second trimester of pregnancy. Which answer by the partner would indicate a typical expectant mother's response to pregnancy?

Accepted Answer

During the second trimester, many expectant mothers start to mentally prepare for their role as a parent, which includes daydreaming about what kind of parent they will be. This is a normal part of psychologic adjustment to pregnancy.

Question 19

A client who is in the second trimester of pregnancy tells the nurse that she has developed a darkening of the line in the midline of her abdomen from the symphysis pubis to the umbilicus. What other expected changes during pregnancy might she also notice?

Accepted Answer

The darkening of the line in the midline of the abdomen is known as linea nigra, which is a common change during pregnancy. Another expected change is the development of reddish streaks on the abdomen, known as striae gravidarum or stretch marks, due to the stretching of the skin.

Question 20

The nurse understands that a client's pregnancy is progressing normally when what physiologic changes are documented on the prenatal record of a woman at 36 weeks' gestation?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

A) The joints of the pelvis relax due to the hormone relaxin, causing a waddling gait as a normal adaptation to accommodate the growing fetus and prepare for childbirth.C) The increased blood volume during pregnancy is necessary to support the uteroplacental circulation, with the uterus vasculature containing a significant portion of the total maternal blood volume.D) Progesterone causes relaxation of smooth muscle, leading to delayed gastric emptying and common complaints of constipation and bloating during pregnancy.E) Supine hypotension syndrome occurs when the pregnant uterus compresses the inferior vena cava when the woman lies on her back, reducing blood return to the heart and causing hypotension.

Quiz 11: Physical and Psychologic Changes of Pregnancy