Anatomy and Physiology of Pregnancy

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A client in her third trimester reports increased perineal pressure. Which is the clinical cause for this complaint?

  • A. Fundal height
  • B. Urinary infection
  • C. Constipation
  • D. Hydramnios
Correct Answer: A

Rationale: The correct answer is A: Fundal height. In the third trimester, the growing uterus causes increased pressure on the pelvic organs, leading to perineal pressure. Fundal height measures the height of the uterus and correlates with gestational age, indicating the position and size of the fetus. As the uterus grows, fundal height increases, causing pressure on the perineal area. Urinary infection (B) can cause discomfort but would present with other symptoms like burning urination. Constipation (C) may cause discomfort but typically does not lead to increased perineal pressure. Hydramnios (D) refers to excess amniotic fluid, which can lead to abdominal distension but is not directly related to perineal pressure.

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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 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.

A client at 10 weeks gestation is being seen by the nurse. The client reports that she has nausea and vomiting each morning. Which is the nurse's best response?

  • A. Drink a large glass of milk before you get out of bed.
  • B. Eat crackers before you get out of bed.
  • C. Eat dinner before 6:00 p.m. every night.
  • D. Eat small meals during the day.
Correct Answer: B

Rationale: The correct answer is B: Eat crackers before you get out of bed. This is the best response because eating crackers before getting out of bed can help alleviate nausea and vomiting associated with morning sickness in early pregnancy. The crackers can help stabilize blood sugar levels and settle the stomach. Drinking a large glass of milk (choice A) may exacerbate nausea for some individuals. Eating dinner before 6:00 p.m. (choice C) is not directly related to morning sickness. Eating small meals during the day (choice D) is generally a good strategy, but specifically eating crackers before getting out of bed is more effective for morning sickness.

The nurse is educating a client at her first prenatal visit about hormone changes. The nurse explains that which of the following is the purpose of progesterone?

  • A. Stimulates uterine development
  • B. Relaxes pelvic ligaments and joints
  • C. Prepares breasts for lactation
  • D. Relaxes smooth muscles
Correct Answer: D

Rationale: The correct answer is D: Progesterone relaxes smooth muscles. Progesterone is essential during pregnancy to maintain the uterine lining and prevent contractions that could lead to miscarriage. It also relaxes smooth muscles in the gastrointestinal tract to prevent premature labor. Choices A, B, and C are incorrect because progesterone's primary role is not to stimulate uterine development, relax pelvic ligaments and joints, or prepare breasts for lactation.

Which government department is responsible for overseeing the administration of the WIC program?

  • A. Social Security Administration
  • B. Department of Health and Human Services
  • C. Department of Public Health
  • D. Children's Bureau
Correct Answer: B

Rationale: The WIC (Women, Infants, and Children) program is administered by the Department of Health and Human Services, which oversees public health initiatives and services.

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. amenorrhea.
  • B. positive pregnancy test.
  • C. Chadwick's sign.
  • D. Hegar's sign.
Correct Answer: A

Rationale: Amenorrhea is a presumptive sign of pregnancy. Presumptive signs of pregnancy are felt by the woman.

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