Nokea
A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have:
- A. amenorrhe
- B. positive pregnancy test.
- C. Chadwick's sign.
- D. Hegar's sign.
Correct Answer: A
Rationale: The correct answer is A: amenorrhea. At 10 weeks of gestation, a woman should have missed at least two menstrual periods, indicating amenorrhea. This is a presumptive sign of pregnancy as it is a common early pregnancy symptom. Positive pregnancy test (B) confirms pregnancy but is not specific to 10 weeks. Chadwick's sign (C) is a bluish discoloration of the cervix and vagina, typically seen around 6-8 weeks, not specifically at 10 weeks. Hegar's sign (D) is softening of the lower uterine segment, usually felt around 6-12 weeks, not specifically at 10 weeks.
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What is the physiologic reason for vascular volume increasing by 40% to 60% during pregnancy?
- A. Prevents maternal and fetal dehydration
- B. Eliminates metabolic wastes of the mother
- C. Provides adequate perfusion of the placenta
- D. Compensates for decreased renal plasma flow
Correct Answer: C
Rationale: The correct answer is C: Provides adequate perfusion of the placenta. During pregnancy, the increased vascular volume ensures sufficient blood flow to the placenta, supplying oxygen and nutrients to the developing fetus. This is crucial for fetal growth and development. The other choices are incorrect because:
A: Preventing maternal and fetal dehydration is not the main reason for the significant increase in vascular volume during pregnancy.
B: Eliminating metabolic wastes of the mother does not require such a substantial increase in vascular volume.
D: Compensating for decreased renal plasma flow is not the primary physiologic reason for the vascular volume expansion during pregnancy.
The maternity nurse understands that vascular volume increases 40% to 45% during pregnancy to:
- A. compensate for decreased renal plasma flow.
- B. provide adequate perfusion of the placenta
- C. eliminate metabolic wastes of the mother.
- D. prevent maternal and fetal dehydration.
Correct Answer: B
Rationale: The correct answer is B because the increased vascular volume during pregnancy is essential to provide adequate perfusion of the placenta, ensuring proper nutrient and oxygen exchange between the mother and fetus. This is crucial for the optimal growth and development of the fetus.
A: The increased vascular volume during pregnancy does not compensate for decreased renal plasma flow but rather supports the increased metabolic demands of pregnancy.
C: The elimination of metabolic wastes of the mother is primarily carried out by the kidneys and liver, not solely through increased vascular volume.
D: Preventing maternal and fetal dehydration is more related to adequate fluid intake and retention, rather than the increase in vascular volume during pregnancy.
To reassure and educate pregnant patients about the functioning of their kidneys in eliminating waste products, maternity nurses should be aware that:
- A. increased urinary output makes pregnant women less susceptible to urinary infection.
- B. increased bladder sensitivity and then compression of the bladder by the enlarging uterus results in the urge to urinate even if the bladder is almost empty.
- C. renal (kidney) function is more efficient when the woman assumes a supine position.
- D. using diuretics during pregnancy can help keep kidney function regular.
Correct Answer: B
Rationale: First bladder sensitivity and then compression of the bladder by the uterus result in the urge to urinate more often.
Dysmenorrhea is otherwise known as:
- A. Inflammation of the breast
- B. The inability to conceive
- C. Painful periods
- D. The onset of puberty
Correct Answer: C
Rationale: Dysmenorrhea refers to painful menstrual periods, often caused by uterine contractions.
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?
- A. 3-1-1-1-3
- B. 4-1-2-0-4
- C. 3-0-3-0-3
- D. 4-2-1-0-3
Correct Answer: B
Rationale: The GTPAL system calculates gravidity and parity as follows: G (total pregnancies) = 4, T (term births) = 1, P (preterm births) = 2, A (abortions/miscarriages) = 0, L (living children) = 4.