Nokea
A client is complaining of heartburn. The nurse understands this is caused by which change of pregnancy?
- A. An increase in water reabsorption by the colon
- B. The relaxation of the lower esophageal ('cardiac') sphincter
- C. A decrease in the capacity of the stomach
- D. An increase in stomach acid production
Correct Answer: B
Rationale: The correct answer is B: The relaxation of the lower esophageal ('cardiac') sphincter. During pregnancy, hormonal changes can cause the lower esophageal sphincter to relax, allowing stomach acid to flow back up into the esophagus, leading to heartburn. This is known as gastroesophageal reflux. The other choices are incorrect because heartburn in pregnancy is not caused by an increase in water reabsorption by the colon (A), a decrease in the capacity of the stomach (C), or an increase in stomach acid production (D). The key factor in pregnancy-related heartburn is the relaxation of the lower esophageal sphincter, which allows acid reflux into the esophagus.
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Which physiologic adaptation of pregnancy may lead to increased constipation during the pregnancy?
- A. Increased emptying time in the intestines
- B. Abdominal distention and bloating
- C. Decreased absorption of water
- D. Decreased motility in the intestines
Correct Answer: D
Rationale: The correct answer is D: Decreased motility in the intestines. During pregnancy, hormonal changes, specifically increased levels of progesterone, can lead to decreased intestinal motility. This slower movement of food through the intestines can result in constipation. The other choices are incorrect because increased emptying time in the intestines (choice A) would actually help prevent constipation, abdominal distention and bloating (choice B) are symptoms of constipation rather than causes, and decreased absorption of water (choice C) would not directly lead to increased constipation.
A woman is in her seventh month of pregnancy. She has been reporting nasal congestion and occasional epistaxis. The nurse suspects that:
- A. this is a normal respiratory change in pregnancy caused by elevated levels of estrogen.
- B. this is an abnormal cardiovascular change, and the nosebleeds are an ominous sign.
- C. the woman is a victim of domestic violence and is being hit in the face by her partner.
- D. the woman has been using cocaine intranasally.
Correct Answer: A
Rationale: Elevated levels of estrogen cause capillaries to become engorged in the respiratory tract. This may result in edema in the nose, larynx, trachea, and bronchi. This congestion may cause nasal stuffiness and epistaxis.
Which finding is a positive sign of pregnancy?
- A. Amenorrhea
- B. Breast changes
- C. Fetal movement felt by the woman
- D. Visualization of fetus by ultrasound
Correct Answer: B
Rationale: The correct answer is B: Breast changes. During pregnancy, hormonal changes cause breast enlargement, tenderness, and darkening of the areolas. This is considered a positive sign of pregnancy because it is a direct physiological response to the hormonal changes associated with pregnancy. Amenorrhea (choice A) is a common early sign of pregnancy but can also be due to other factors. Fetal movement (choice C) and visualization of fetus by ultrasound (choice D) are considered presumptive and probable signs of pregnancy, respectively, but not definitive positive signs like breast changes.
A 31-year-old woman believes that she may be pregnant. She took an OTC pregnancy test 1 week ago after missing her period; the test was positive. During her assessment interview, the nurse enquires about the woman's last menstrual period and asks whether she is taking any medications. The woman states that she takes medicine for epilepsy. She has been under considerable stress lately at work and has not been sleeping well. She also has a history of irregular periods. Her physical examination does not indicate that she is pregnant. She has an ultrasound scan that reveals she is not pregnant. What is the most likely cause of the false-positive pregnancy test result?
- A. She took the pregnancy test too early
- B. She takes anticonvulsants
- C. She has a fibroid tumor
- D. She has been under considerable stress and has a hormone imbalance
Correct Answer: B
Rationale: Anticonvulsant medications can cause false-positive pregnancy test results by interfering with hormone assays.
What is true of family-centered care? (Select one that does not apply.)
- A. The nurse's role is to enter into a partnership with the family.
- B. The health care professionals are the primary decision makers.
- C. The family's involvement during pregnancy and birth is seen as constructive necessary for bonding and support.
- D. Families contribute their ability to accept and maintain control over the health care of family members.
Correct Answer: B
Rationale: Family-centered care emphasizes collaboration between healthcare providers and families, recognizing the family's crucial role in patient care and decision-making.