Nokea
A first-time mother at 18 weeks of gestation comes for her regularly scheduled prenatal visit. The patient tells the nurse that she is afraid that she is going into premature labor because she is beginning to have regular contractions. The nurse explains that this is the Braxton Hicks sign and teaches the patient that this type of contraction:
- A. is painless.
- B. increases with walking.
- C. causes cervical dilation.
- D. impedes oxygen flow to the fetus.
Correct Answer: A
Rationale: Uterine contractions can be felt through the abdominal wall soon after the fourth month of gestation. Braxton Hicks contractions are regular and painless and continue throughout the pregnancy.
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A patient relates a story of how her boyfriend is feeling her aches and pains associated with her pregnancy. She is concerned that her boyfriend is making fun of her concerns. How would you respond to this patient statement?
- A. Tell her not to worry because it is natural for her boyfriend to make her feel better by identifying with her pregnancy.
- B. Refer the patient to a psychologist for counseling to deal with this problem because it is clearly upsetting her.
- C. Explain that her boyfriend may be experiencing couvade syndrome and that this is a normal finding seen with male partners.
- D. Ask the patient specifically to define her concerns related to her relationship with her boyfriend and suggest methods to stop this type of behavior by her significant other.
Correct Answer: C
Rationale: The correct answer is C because couvade syndrome is a real phenomenon where male partners experience similar symptoms to their pregnant partners. By explaining this to the patient, it validates her concerns and normalizes her boyfriend's behavior.
Choice A is incorrect because it dismisses the patient's concerns and does not address the underlying issue. Choice B is incorrect because referring the patient to a psychologist may be premature without exploring the possibility of couvade syndrome first. Choice D is incorrect because it does not address the potential root cause of the boyfriend's behavior and may not provide a satisfactory resolution for the patient.
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.
During pregnancy, many changes occur as a direct result of the presence of the fetus. Which of these adaptations meet this criterion? (Select all that apply.)
- A. Leukorrhea
- B. Development of the operculum
- C. Quickening
- D. Ballottement
Correct Answer: B
Rationale: The correct answer is B: Development of the operculum. This adaptation refers to the formation of a mucus plug in the cervix during pregnancy, which helps protect the fetus from infections. It is a direct result of the presence of the fetus as it serves as a physical barrier.
A: Leukorrhea is the increased vaginal discharge during pregnancy, but it is not a direct result of the fetus presence.
C: Quickening is the first fetal movements felt by the mother, but it is a fetal activity, not a direct adaptation.
D: Ballottement is a palpation technique used to assess the fetus position, not an adaptation directly caused by the fetus.
To reassure and educate pregnant patients about changes in their breasts, nurses should be aware that:
- A. the visibility of blood vessels that form an intertwining blue network indicates full function of Montgomery's tubercles and possibly infection of the tubercles.
- B. the mammary glands do not develop until 2 weeks before labor.
- C. lactation is inhibited until the estrogen level declines after birth.
- D. colostrum is the yellowish oily substance used to lubricate the nipples for breastfeeding.
Correct Answer: C
Rationale: Lactation is inhibited until after birth. The visible blue network of blood vessels is a normal outgrowth of a richer blood supply.
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.