Chapter 11:Maternal Adaptation During Pregnancy

During a vaginal exam, the nurse notes that the cervix has a bluish color. The nurse documents this finding

as:

A)Hegars sign

B) Goodells sign

C) Chadwicks sign

D)Ortolanis sign

Chadwicks sign

The nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. The mother will most likely experience which of the following at that time?

A)Dysuria

B) Dyspnea

C) Constipation

D)Urinary frequency

Urinary frequency

A gravida 2 para 1 client in the 10th week of her pregnancy says to the nurse, Ive never urinated as often as I have for the past three weeks. Which response would be most appropriate for the nurse to make?

A)Having to urinate so often is annoying. I suggest that you watch how much fluid you are drinking and limit

it.

B) You shouldn't be urinating this frequently now; it usually stops by the time youre eight weeks pregnant. Is

there anything else bothering you?

C) By the time you are 12 weeks pregnant, this frequent urination should no longer be a problem, but it is

likely to return toward the end of your pregnancy.

D)Women having their second child generally don't have frequent urination. Are you experiencing any

burning sensations?

By the time you are 12 weeks pregnant, this frequent urination should no longer be a problem, but it is

likely to return toward the end of your pregnancy.

In a clients seventh month of pregnancy, she reports feeling dizzy, like I'm going to pass out, when I lie down flat on my back. The nurse integrates which of the following in to the explanation?

A)Pressure of the gravid uterus on the vena cava

B) A 50% increase in blood volume

C) Physiologic anemia due to hemoglobin decrease

D)Pressure of the presenting fetal part on the diaphragm

Pressure of the gravid uterus on the vena cava

A primiparous client is being seen in the clinic for her first prenatal visit. It is determined that she is 11 weeks pregnant. The nurse develops a teaching plan to educate the client about what she will most likely experience during this period. Which of the following would the nurse include?

A)Ankle edema

B) Urinary frequency

C) Backache

D)Hemorrhoids

Urinary frequency

A pregnant client in her second trimester has a hemoglobin level of 11 g/dL. The nurse interprets this as indicating which of the following?

A)Iron-deficiency anemia

B) A multiple gestation pregnancy

C) Greater-than-expected weight gain

D)Hemodilution of pregnancy

Hemodilution of pregnancy

The nurse is discussing the insulin needs of a primaparous client with diabetes who has been using insulin for the past few years. The nurse informs the client that her insulin needs will increase during pregnancy based on the nurses understanding that the placenta produces:

A)hCG, which increases maternal glucose levels

B) hPL, which deceases the effectiveness of insulin

C) Estriol, which interferes with insulin crossing the placenta

D)Relaxin, which decreases the amount of insulin produced

hPL, which deceases the effectiveness of insulin

When teaching a pregnant client about the physiologic changes of pregnancy, the nurse reviews the effect of pregnancy on glucose metabolism. Which of the following would the nurse include as the underlying reason for the effect?

A)Pancreatic function is affected by pregnancy.

B) Glucose is utilized more rapidly during a pregnancy.

C) The pregnant woman increases her dietary intake.

D)Glucose moves through the placenta to assist the fetus.

Glucose moves through the placenta to assist the fetus.

When assessing a woman in her first trimester, which emotional response would the nurse most likely expect to find?

A)Ambivalence

B) Introversion

C) Acceptance

D)Emotional lability

Ambivalence

The nurse is assessing a pregnant woman in the second trimester. Which of the following tasks would indicate to the nurse that the client is incorporating the maternal role into her personality?

A) The woman demonstrates concern for herself and her fetus as a unit.

B) The client identifies what she must give up to assume her new role.

C) The woman acknowledges the fetus as a separate entity within her.

D) The client demonstrates unconditional acceptance without rejection.

The woman acknowledges the fetus as a separate entity within her.

A woman comes to the prenatal clinic suspecting that she is pregnant, and assessment reveals probable signs of pregnancy. Which of the following would be included as part of this assessment? (Select all that apply.)

A) Positive pregnancy test

B) Ultrasound visualization of the fetus

C) Auscultation of a fetal heart beat

D) Ballottement

E) Absence of menstruation

F) Softening of the cervix

Positive pregnancy test

Ballottement

Softening of the cervix

The nurse is teaching a pregnant woman about recommended weight gain. The woman has a prepregnancy

body mass index of 26. The nurse determines that the teaching was successful when the woman states that

she should gain no more than which amount during pregnancy?

A) 35 to 40 pounds

B) 25 to 35 pounds

C) 28 to 40 pounds

D) 15 to 25 pounds

15 to 25 pounds

A nurse strongly encourages a pregnant client to avoid eating swordfish and tilefish because these fish contain which of the following?

A) Excess folic acid, which could increase the risk for neural tube defects

B) Mercury, which could harm the developing fetus if eaten in large amounts

C) Lactose, which leads to abdominal discomfort, gas, and diarrhea

D) Low-quality protein that does not meet the woman's requirements

Mercury, which could harm the developing fetus if eaten in large amounts

Which of the following changes in the musculoskeletal system would the nurse mention when teaching a group of pregnant women about the physiologic changes of pregnancy?

A) Ligament tightening

B) Decreased swayback

C) Increased lordosis

D) Joint contraction

Increased lordosis

Assessment of a pregnant woman reveals a pigmented line down the middle of her abdomen. The nurse documents this as which of the following?

A) Linea nigra

B) Striae gravidarum

C) Melasma

D) Vascular spiders

Linea nigra

A nurse is assessing a pregnant woman on a routine checkup. When assessing the woman's gastrointestinal

tract, which of the following would the nurse expect to find? (Select all that apply.)

A) Hyperemic gums

B) Increased peristalsis

C) Complaints of bloating

D) Heartburn

E) Nausea

Hyperemic gums

Complaints of bloating

Heartburn

Nausea

A woman suspecting she is pregnant asks the nurse about which signs would confirm her pregnancy. The

nurse would explain that which of the following would confirm the pregnancy?

A) Absence of menstrual period

B) Abdominal enlargement

C) Palpable fetal movement

D) Morning sickness

Palpable fetal movement

A nurse is developing a teaching plan about nutrition for a group of pregnant women. Which of the

following would the nurse include in the discussion? (Select all that apply.)

A) Keep weight gain to 15 lb

B) Eat three meals with snacking

C) Limit the use of salt in cooking

D) Avoid using diuretics

E) Participate in physical activity

Eat three meals with snacking

Avoid using diuretics

Participate in physical activity

Assessment of a pregnant woman reveals that she compulsively craves ice. The nurse documents this finding as which of the following?

A) Quickening

B) Pica

C) Ballottement

D) Linea nigra

Pica

A woman in her second trimester comes for a follow-up visit and says to the nurse, I feel like I'm on an emotional roller-coaster. Which response by the nurse would be most appropriate?

A) How often has this been happening to you?

B) Maybe you need some medication to level things out.

C) Mood swings are completely normal during pregnancy.

D) Have you been experiencing any thoughts of harming yourself?

Mood swings are completely normal during pregnancy.

21.While talking with a woman in her third trimester, which behavior indicates to the nurse that the woman is learning to give of oneself?

A) Showing concern for self and fetus as a unit

B) Unconditionally accepting the pregnancy without rejection

C) Longing to hold infant

D) Questioning ability to become a good mother

Longing to hold infant

A group of students are reviewing the signs of pregnancy. The students demonstrate understanding of the information when they identify which as presumptive signs? (Select all that apply.)

A) Amenorrhea

B) Nausea

C) Abdominal enlargement

D) Braxton-Hicks contractions

E) Fetal heart sounds

Amenorrhea

Nausea

A nursing instructor is teaching a class to a group of students about pregnancy, insulin, and glucose. Which of the following would the instructor least likely include as opposing insulin?

A) Prolactin

B) Estrogen

C) Progesterone

D) Cortisol

Cortisol

A woman is at 20 weeks gestation. The nurse would expect to find the fundus at which of the following?

A) Just above the symphysis pubis

B) Mid-way between the pubis and umbilicus

C) At the level of the umbilicus

D) Mid-way between the umbilicus and xiphoid process

At the level of the umbilicus

A pregnant woman comes to the clinic and tells the nurse that she has been having a whitish vaginal discharge. The nurse suspects vulvovaginal candidiasis based on which assessment finding?

A) Fever

B) Vaginal itching

C) Urinary frequency

D) Incontinence

Vaginal itching