Nokea
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. amenorrhe
- B. positive pregnancy test.
- C. Chadwick's sign.
- D. Hegar's sign.
Correct Answer: A
Rationale: The correct answer is A: amenorrhea. At 10 weeks of gestation, a woman should have missed at least two menstrual periods, indicating amenorrhea. This is a presumptive sign of pregnancy as it is a common early pregnancy symptom. Positive pregnancy test (B) confirms pregnancy but is not specific to 10 weeks. Chadwick's sign (C) is a bluish discoloration of the cervix and vagina, typically seen around 6-8 weeks, not specifically at 10 weeks. Hegar's sign (D) is softening of the lower uterine segment, usually felt around 6-12 weeks, not specifically at 10 weeks.
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To reassure and educate pregnant patients about changes in the cervix, vagina, and position of the fetus, nurses should be aware that:
- A. because of a number of changes in the cervix, abnormal Papanicolaou (Pap) tests are much easier to evaluate.
- B. Quickening is a technique of palpating the fetus to engage it in passive movement.
- C. the deepening color of the vaginal mucosa and cervix (Chadwick's sign) usually appears in the second trimester or later as the vagina prepares to stretch during labor.
- D. increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester.
Correct Answer: D
Rationale: Increased sensitivity and an increased interest in sex sometimes go together. This frequently occurs during the second trimester.
To reassure and educate their pregnant patients about changes in their blood pressure, maternity nurses should be aware that:
- A. a blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high.
- B. shifting the patient's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit.
- C. the systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant.
- D. compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy.
Correct Answer: C
Rationale: The correct answer is C because during pregnancy, the systolic blood pressure tends to increase slightly as pregnancy progresses due to increased cardiac output and decreased systemic vascular resistance. On the other hand, the diastolic pressure typically remains constant or may even decrease slightly. This physiological change is important for maternity nurses to be aware of in order to differentiate normal pregnancy-related changes from potential complications like preeclampsia.
Choices A, B, and D are incorrect:
A: This choice discusses the effect of cuff size on blood pressure readings, which is important but not directly related to the changes in blood pressure during pregnancy.
B: Shifting positions and changing arms for measurements may affect accuracy but is not specifically related to blood pressure changes during pregnancy.
D: Compression of iliac veins and inferior vena cava by the uterus leading to hemorrhoids is unrelated to changes in blood pressure during pregnancy.
Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester?
- A. Less audible heart sounds (S , S ) 1 2
- B. Increased pulse rate
- C. Increased blood pressure
- D. Decreased red blood cell (RBC) production
Correct Answer: B
Rationale: The correct answer is B: Increased pulse rate. During the second trimester of pregnancy, it is normal for a woman's heart rate to increase due to the increased blood volume and cardiac output needed to support the growing fetus. This physiological change helps meet the increased metabolic demands of both the mother and the baby.
A: Less audible heart sounds (S1, S2) is incorrect because heart sounds are typically more audible during pregnancy due to the increased blood flow and volume in the cardiovascular system.
C: Increased blood pressure is incorrect because blood pressure tends to decrease slightly during the second trimester before rising again in the third trimester.
D: Decreased red blood cell (RBC) production is incorrect because RBC production actually increases during pregnancy to support the increased oxygen-carrying capacity required for the mother and the fetus.
During pregnancy, oxygen and nutrients diffuse across the from the mother to the foetus:
- A. Placenta
- B. Kidneys
- C. Lungs
- D. Cervix
Correct Answer: A
Rationale: The placenta facilitates the exchange of oxygen, nutrients, and waste products between the mother and fetus.
What is the physiologic reason for vascular volume increasing by 40% to 60% during pregnancy?
- A. Prevents maternal and fetal dehydration
- B. Eliminates metabolic wastes of the mother
- C. Provides adequate perfusion of the placenta
- D. Compensates for decreased renal plasma flow
Correct Answer: C
Rationale: The correct answer is C: Provides adequate perfusion of the placenta. During pregnancy, the increased vascular volume ensures sufficient blood flow to the placenta, supplying oxygen and nutrients to the developing fetus. This is crucial for fetal growth and development. The other choices are incorrect because:
A: Preventing maternal and fetal dehydration is not the main reason for the significant increase in vascular volume during pregnancy.
B: Eliminating metabolic wastes of the mother does not require such a substantial increase in vascular volume.
D: Compensating for decreased renal plasma flow is not the primary physiologic reason for the vascular volume expansion during pregnancy.