Nokea
The nurse is educating a client about varicosities during pregnancy. Which statement by the client indicates effective teaching?
- A. I need to wear knee-high hose every day to increase my leg circulation.
- B. When I sit at my desk, both of my feet should be resting on the floor.
- C. I should perform Kegel exercises twice a day.
- D. I should call the physician if I do not feel my baby move.
Correct Answer: B
Rationale: The correct answer is B because when sitting with both feet on the floor, it promotes proper circulation and reduces the risk of developing varicose veins. Elevating legs and avoiding crossing them also help. Choice A is incorrect as knee-high hose may constrict circulation. Choice C is irrelevant to varicosities. Choice D is important for monitoring fetal health but not directly related to varicose veins.
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A nurse is reviewing the laboratory results for a prenatal client. She notices that her hemoglobin is 10.5. The nurse realizes this laboratory result indicates which of the following?
- A. Low vitamin intake has resulted in a decrease in red blood cell production.
- B. Plasma volume increase is greater than red blood cell production and has resulted in a decrease in hemoglobin.
- C. This is a serious problem that might harm the fetus.
- D. A repeat blood test should be done immediately to confirm that the client has anemia
Correct Answer: B
Rationale: The correct answer is B because a hemoglobin level of 10.5 indicates a decrease in hemoglobin concentration, which is typically caused by an increase in plasma volume during pregnancy. This dilution effect results in a lower concentration of red blood cells in the blood, leading to lower hemoglobin levels. This physiological change is normal during pregnancy and is known as physiological anemia.
Choice A is incorrect because low vitamin intake would not directly result in a decrease in red blood cell production leading to low hemoglobin levels.
Choice C is incorrect because a hemoglobin level of 10.5, although lower than normal, does not necessarily indicate a serious problem that would harm the fetus.
Choice D is incorrect because a repeat blood test is not immediately necessary to confirm anemia as the low hemoglobin level can be explained by the normal increase in plasma volume during pregnancy.
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. Decreased red blood cell (RBC) production
- D. Increased blood pressure
Correct Answer: B
Rationale: During the second trimester, the pulse rate increases by 10-15 beats per minute, while blood pressure typically decreases slightly due to hormonal and circulatory changes.
During a patient's physical examination the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as:
- A. Hegar's sign.
- B. McDonald's sign.
- C. Chadwick's sign.
- D. Goodell's sign.
Correct Answer: A
Rationale: At approximately 6 weeks of gestation, softening and compressibility of the lower uterine segment occurs; this is called Hegar's sign.
Which physiologic findings related to gallbladder function may lead to the development of gallstones during pregnancy?
- A. Decrease in alkaline phosphatase levels compared with nonpregnant women
- B. Increase in albumin and total protein as a result of hemodilution
- C. Hypertonicity of gallbladder tissue
- D. Prolonged emptying time
Correct Answer: D
Rationale: The correct answer is D: Prolonged emptying time. During pregnancy, hormonal changes can lead to gallbladder stasis, causing bile to become concentrated and leading to the formation of gallstones. Prolonged emptying time indicates poor gallbladder motility, increasing the risk of gallstone formation.
A: Decrease in alkaline phosphatase levels is not directly related to gallstone formation during pregnancy.
B: Increase in albumin and total protein is a common finding in pregnancy due to hemodilution, but it is not directly linked to gallstone development.
C: Hypertonicity of gallbladder tissue is not a typical physiologic finding related to gallbladder function during pregnancy and is not a known risk factor for gallstone formation.
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 will likely occur.
Correct Answer: D
Rationale: The correct answer is D because all the statements in choices A, B, and C are true regarding changes in the cardiovascular system during pregnancy.
A: Pregnant women with disturbed cardiac rhythm, such as sinus arrhythmia, should be closely monitored as it can impact both the mother and the fetus, regardless of the mother's overall health status.
B: Changes in heart size, position, and blood volume lead to auditory changes from 20 weeks to term, which is important for nurses to be aware of in order to monitor the cardiovascular health of pregnant patients.
C: Palpitations are more likely to occur in twin gestations due to the increased demands on the cardiovascular system.
In summary, all the changes mentioned in choices A, B, and C are common occurrences in pregnancy and it is crucial for maternity nurses to be aware of them in order to provide appropriate care and education to pregnant patients.