Nokea
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.
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Which comment made by a new mother to her own mother is most likely to encourage the grandmother's participation in the infant's care?
- A. "Could you help me with the housework today?"
- B. "The baby is spitting up a lot. What should I do?"
- C. "I know you are busy, so I'll get John's mother to help me
- D. “The baby has a stomachache. I’ll call the nurse to find out what to do.
Correct Answer: B
Rationale: The correct answer is B because it directly involves the grandmother in the baby's care by seeking advice and guidance. Asking for help with a specific issue shows trust and respect for the grandmother's experience. Choice A is about housework, not infant care. Choice C suggests seeking help elsewhere. Choice D involves a healthcare professional, not the grandmother.
Which time-based description of a stage of development in pregnancy is accurate?
- A. Viability—22 to 37 weeks since the last menstrual period (LMP) (assuming a fetal weight >500 g)
- B. Full Term—Pregnancy from the beginning of week 39 of gestation to the end of week 40
- C. Preterm—Pregnancy from 20 to 28 weeks
- D. Postdate—Pregnancy that extends beyond 38 weeks
Correct Answer: B
Rationale: Full term is defined as pregnancy from the beginning of week 39 to the end of week 40. Viability occurs at 22-24 weeks, preterm is before 37 weeks, and postdate is beyond 42 weeks.
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.
The patient has just learned that she is pregnant and overhears the gynecologist saying that she has a positive Chadwick's sign. When the patient asks the nurse what this means, how would the nurse respond?
- A. "Chadwick's sign signifies an increased risk of blood clots in pregnant women
- B. “That sign means the cervix has softened as the result of tissue changes that
naturally occur with pregnancy.” - C. "This means that a mucus plug has formed in the cervical canal to help protect you from uterine infection."
- D. "This sign occurs normally in pregnancy, when estrogen causes increased blood flow in the area of the cervix."
Correct Answer: C
Rationale: The correct answer is C. Chadwick's sign refers to the bluish discoloration of the cervix, vagina, and labia due to increased blood flow, a result of pregnancy hormones. The mucus plug forming in the cervical canal indicates protection from uterine infections, a crucial function during pregnancy. This response directly correlates Chadwick's sign with its physiological significance, showing the nurse's knowledge and ability to educate the patient effectively. Other choices are incorrect because they do not accurately describe Chadwick's sign or its implications in pregnancy.
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.