Nokea
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.
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Which comment made by a patient in her first trimester indicates ambivalent feelings?
- A. "My body is changing so quickly."
- B. "I haven't felt well since this pregnancy began."
- C. "I'm concerned about the amount of weight I've gaine
- D. "I wanted to become pregnant, but I'm scared about being a mother."
Correct Answer: D
Rationale: The correct answer is D because the patient expresses conflicting emotions of wanting to become pregnant but feeling scared about being a mother, indicating ambivalence. Choice A indicates awareness of physical changes, not necessarily ambivalence. Choice B reflects physical discomfort, not emotional conflict. Choice C shows concern about weight gain, not conflicting feelings. Overall, D is the only option reflecting mixed emotions about pregnancy and motherhood.
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.
Some pregnant patients may complain of changes in their voice and impaired hearing. The nurse can tell these patients that these are common reactions to:
- A. a decreased estrogen level
- B. displacement of the diaphragm, resulting in thoracic breathing
- C. congestion and swelling, which occur because the upper respiratory tract has become more vascular
- D. increased blood volume
Correct Answer: C
Rationale: Increased estrogen levels cause vascular congestion and swelling in the upper respiratory tract, affecting voice and hearing.
Male infertility can be caused by:
- A. Vasectomy
- B. Low sperm count
- C. Sexual dysfunction
- D. All of the above
Correct Answer: D
Rationale: Male infertility may result from various factors, including vasectomy, low sperm count, or sexual dysfunction.
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: A
Rationale: Rationale for Correct Answer A:
1. Montgomery's tubercles are sebaceous glands on the areola.
2. Blood vessels becoming visible indicates increased blood supply due to hormonal changes during pregnancy.
3. The intertwining blue network reflects full function of Montgomery's tubercles.
4. Infection may cause inflammation and increased visibility of blood vessels.
Summary of Incorrect Choices:
B: Incorrect, mammary glands develop during puberty, not right before labor.
C: Incorrect, lactation is primarily influenced by prolactin, not estrogen.
D: Incorrect, colostrum is a thick, yellowish fluid containing antibodies, not an oily substance for lubrication.