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Some pregnant patients may complain of changes in their voice and impaired hearing. The nurse can tell these patients that these are common reactions to:
- A. a decreased estrogen level.
- B. displacement of the diaphragm, resulting in thoracic breathing.
- C. congestion and swelling, which occur because the upper respiratory tract has become more vascular.
- D. increased blood volum
Correct Answer: C
Rationale: The correct answer is C because during pregnancy, hormonal changes can lead to congestion and swelling in the upper respiratory tract due to increased vascularity. This can result in changes in voice and impaired hearing. Estrogen levels (choice A) typically increase during pregnancy and do not directly cause these symptoms. Displacement of the diaphragm (choice B) may occur but is more related to breathing changes rather than voice and hearing issues. Increased blood volume (choice D) is a common physiological change in pregnancy but is not directly associated with voice and hearing changes.
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Human chorionic gonadotropin (hCG) is an important biochemical marker for pregnancy and the basis for many tests. A maternity nurse should be aware that:
- A. hCG can be detected 2.5 weeks after conception
- B. the hCG level increases gradually and uniformly throughout pregnancy
- C. much lower than normal increases in the level of hCG may indicate a postdate pregnancy
- D. a higher than normal level of hCG may indicate an ectopic pregnancy or Down syndrome
Correct Answer: D
Rationale: Higher hCG levels may indicate conditions such as multiple gestation, ectopic pregnancy, or Down syndrome. hCG levels fluctuate during pregnancy and peak around 8-10 weeks.
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: Increased vascular volume ensures adequate placental perfusion to support fetal growth and oxygenation.
A patient in her first trimester complains of nausea and vomiting. The patient asks, “Why is
this happening?” What is the nurse’s best response?
- A. "It is due to an increase in gastric motility."
- B. "It may be due to changes in hormones."
- C. "It is related to an increase in glucose levels."
- D. "It is caused by a decrease in gastric secretions."
Correct Answer: B
Rationale: The correct answer is B: "It may be due to changes in hormones." During the first trimester of pregnancy, hormonal changes, particularly an increase in human chorionic gonadotropin (hCG) and estrogen levels, can trigger nausea and vomiting. This is known as morning sickness. These hormonal fluctuations can affect the gastrointestinal system, leading to symptoms of nausea and vomiting.
Choice A (increase in gastric motility) is incorrect because nausea and vomiting in pregnancy are more commonly attributed to hormonal changes rather than an increase in gastric motility.
Choice C (increase in glucose levels) is also incorrect as there is no direct link between elevated glucose levels and nausea and vomiting in pregnancy.
Choice D (decrease in gastric secretions) is incorrect as there is no evidence to support that a decrease in gastric secretions causes nausea and vomiting in pregnancy.
To reassure and educate pregnant patients about changes in the uterus, nurses should be aware that:
- A. lightening occurs near the end of the second trimester as the uterus rises into a different position.
- B. the woman's increased urinary frequency in the first trimester is the result of exaggerated uterine anteflexion caused by softening.
- C. Braxton Hicks contractions become more painful in the third trimester,
particularly if the woman tries to exercise - D. the uterine souffle is the movement of the fetus.
Correct Answer: B
Rationale: The correct answer is B. Increased urinary frequency in the first trimester is due to exaggerated uterine anteflexion caused by softening. This is because the growing uterus exerts pressure on the bladder, leading to the need for more frequent urination. This is a common physiological change in early pregnancy due to the hormonal effects on the pelvic floor muscles and bladder capacity.
A: Lightening typically occurs near the end of the third trimester, not the second trimester, as the baby drops lower into the pelvis in preparation for birth.
C: Braxton Hicks contractions are typically painless and irregular in the third trimester, not more painful. Pain with exercise could indicate preterm labor.
D: Uterine souffle refers to the sound of blood flow through the uterine arteries, not movement of the fetus.
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.