Question 1

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

Accepted Answer

The softening of the lower uterine segment is called Hegar's sign.Lightening occurs in the last 2 weeks of pregnancy,when the fetus descends.Braxton Hicks contractions become more defined in the final trimester but are not painful.Walking or exercise usually causes them to stop.The uterine souffle is the sound made by blood in the uterine arteries; it can be heard with a fetal stethoscope.

Question 2

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

Accepted Answer

Progesterone is essential for maintaining pregnancy; it does so by relaxing smooth muscles.This reduces uterine activity and prevents miscarriage.Estrogen plays a vital role in pregnancy,but it is not the primary hormone for maintaining pregnancy.hCG levels increase at implantation but decline after 60 to 70 days.Oxytocin stimulates uterine contractions.

Question 3

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

Accepted Answer

The appendix is displaced high and to the right,beyond McBurney point.

Question 4

A patient at 24 weeks of gestation contacts the nurse at her obstetric provider's office to complain that she has cravings for dirt and gravel.The nurse is aware that this condition is known as ________ and may indicate anemia.

Accepted Answer

Pica (a desire to eat nonfood substances)is an indication of iron deficiency and should be evaluated.Ptyalism (excessive salivation),pyrosis (heartburn),and decreased peristalsis are normal findings of gastrointestinal change during pregnancy.Food cravings during pregnancy are normal.

Question 5

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 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?

Accepted Answer

The correct calculation of this woman's gravidity and parity is 4-1-2-0-4.The numbers reflect the woman's gravidity and parity information.Using the GPTAL system,her information is calculated as:
G: The first number reflects the total number of times the woman has been pregnant; she is pregnant for the fourth time.
T: This number indicates the number of pregnancies carried to term,not the number of deliveries at term; only one of her pregnancies has resulted in a fetus at term.
P: This is the number of pregnancies that resulted in a preterm birth; the woman has had two pregnancies in which she delivered preterm.
A: This number signifies whether the woman has had any abortions or miscarriages before the period of viability; she has not.
L: This number signifies the number of children born that currently are living; the woman has four children.

Question 6

A woman who has completed one pregnancy with a fetus (or fetuses)reaching the stage of fetal viability is called a:

Accepted Answer

A primipara is a woman who has completed one pregnancy with a viable fetus.To remember terms,keep in mind: gravida is a pregnant woman; para comes from parity,meaning a viable fetus; primi means first; multi means many; and null means none.A primigravida is a woman pregnant for the first time.A multipara is a woman who has completed two or more pregnancies with a viable fetus.A nulligravida is a woman who has never been pregnant.

Question 7

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:

Accepted Answer

Positive signs of pregnancy are attributed to the presence of a fetus,such as hearing the fetal heartbeat or palpating fetal movement.A positive pregnancy test and Braxton Hicks contractions are probable signs of pregnancy.Quickening is a presumptive sign of pregnancy.

Question 8

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

Accepted Answer

The operculum protects against bacterial invasion.Leukorrhea is the mucus that forms the endocervical plug (the operculum).The funic souffle is the sound of blood flowing through the umbilical vessels.Ballottement is a technique for palpating the fetus.

Question 9

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

Accepted Answer

An increase in the normal lumbosacral curve (lordosis)develops,and a compensatory curvature in the cervicodorsal region develops to help the woman maintain her balance.The center of gravity shifts forward.She will have decreased muscle tone.She will notice increased mobility of her pelvic joints.

Question 10

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

Accepted Answer

Amenorrhea is a presumptive sign of pregnancy.Presumptive signs of pregnancy are felt by the woman.A positive pregnancy test,the presence of Chadwick's sign,and the presence of Hegar's sign all are probable signs of pregnancy.

Question 11

During a client's physical examination the nurse notes that the lower uterine segment is soft on palpation.The nurse would document this finding as:

Accepted Answer

At approximately 6 weeks of gestation,softening and compressibility of the lower uterine segment occur; this is called Hegar's sign.McDonald's sign indicates a fast food restaurant.Chadwick's sign is the blue-violet coloring of the cervix caused by increased vascularity; this occurs around the fourth week of gestation.Softening of the cervical tip is called Goodell's sign,which may be observed around the sixth week of pregnancy.

Question 12

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

Accepted Answer

Term is 38 to 42 weeks of gestation.Viability is the ability of the fetus to live outside the uterus before coming to term,or 22 to 24 weeks since LMP.Preterm is 20 to 37 weeks of gestation.Postdate or postterm is a pregnancy that extends beyond 42 weeks or what is considered the limit of full term.

Question 13

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

Accepted Answer

In normal pregnancies,the uterus grows at a predictable rate.It may be palpated above the symphysis pubis sometime between the twelfth and fourteenth weeks of pregnancy.As the uterus grows,it may be palpated above the symphysis pubis sometime between the twelfth and fourteenth weeks of pregnancy.The uterus rises gradually to the level of the umbilicus at 22 to 24 weeks of gestation.

Question 14

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

Accepted Answer

Higher levels also could be a sign of multiple gestation.hCG can be detected 7 to 8 days after conception.The hCG level fluctuates during pregnancy: peaking,declining,stabilizing,and increasing again.Abnormally slow increases may indicate impending miscarriage.

Question 15

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

Accepted Answer

Striae gravidarum,or stretch marks,reflect separation within the underlying connective tissue of the skin.They usually fade after birth,although they never disappear completely.An epulis is a red,raised nodule on the gums that bleeds easily.Chloasma,or mask of pregnancy,is a blotchy,brown hyperpigmentation of the skin over the cheeks,nose,and forehead,especially in dark-complexioned pregnant women.Chloasma usually fades after the birth.Telangiectasia,or vascular spiders,are tiny,star-shaped or branchlike,slightly raised,pulsating end-arterioles usually found on the neck,thorax,face,and arms.They occur as a result of elevated levels of circulating estrogen.These usually disappear after birth.

Question 16

To reassure and educate pregnant clients about changes in the cervix,vagina,and position of the fetus,nurses should be aware that:

Accepted Answer

Increased sensitivity and an increased interest in sex sometimes go together.This frequently occurs during the second trimester.Cervical changes make evaluation of abnormal Pap tests more difficult.Quickening is the first recognition of fetal movements by the mother.Ballottement is a technique used to palpate the fetus.Chadwick's sign appears from the sixth to eighth weeks.

Question 17

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

Accepted Answer

Anticonvulsants may cause false-positive pregnancy test results.OTC pregnancy tests use enzyme-linked immunosorbent assay technology,which can yield positive results 4 days after implantation.Implantation occurs 6 to 10 days after conception.If the woman were pregnant,she would be into her third week at this point (having missed her period 1 week ago).Fibroid tumors do not produce hormones and have no bearing on hCG pregnancy tests.Although stress may interrupt normal hormone cycles (menstrual cycles),it does not affect human chorionic gonadotropin levels or produce positive pregnancy test results.

Question 18

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

Accepted Answer

Between 14 and 20 weeks of gestation,the pulse increases about 10 to 15 beats/min,which persists to term.Splitting of S? and S? is more audible.In the first trimester,blood pressure usually remains the same as at the prepregnancy level,but it gradually decreases up to about 20 weeks of gestation.During the second trimester,both the systolic and the diastolic pressures decrease by about 5 to 10 mm Hg.Production of RBCs accelerates during pregnancy.

Question 19

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

Accepted Answer

Elevated levels of estrogen cause capillaries to become engorged in the respiratory tract.This may result in edema in the nose,larynx,trachea,and bronchi.This congestion may cause nasal stuffiness and epistaxis.Cardiovascular changes in pregnancy may cause edema in lower extremities.Determining that the woman is a victim of domestic violence and was hit in the face cannot be made on the basis of the sparse facts provided.If the woman had been hit in the face,she most likely would have additional physical findings.Determination of the use of cocaine by the woman cannot be made on the basis of the sparse facts provided.

Question 20

To reassure and educate pregnant clients about changes in their breasts,nurses should be aware that:

Accepted Answer

Lactation is inhibited until after birth.The visible blue network of blood vessels is a normal outgrowth of a richer blood supply.The mammary glands are functionally complete by midpregnancy.Colostrum is a creamy,white-to-yellow premilk fluid that can be expressed from the nipples before birth.

Quiz 7: Anatomy and Physiology of Pregnancy