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 estrogen levels during pregnancy cause capillary engorgement in the respiratory tract, leading to nasal congestion and occasional epistaxis.
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A patient who is 7 months pregnant states, "I'm worried that something will happen to my baby." Which is the nurse's best response?
- A. "Your baby is doing fin
- B. "Tell me about your concerns."
- C. "There is nothing to worry about."
- D. "The doctor is taking good care of you and your baby."
Correct Answer: C
Rationale: The correct response is C: "There is nothing to worry about." This answer acknowledges the patient's concerns while providing reassurance. By stating that there is nothing to worry about, the nurse addresses the patient's anxiety and helps alleviate her fears without dismissing them. Option A is too dismissive, B encourages the patient to share concerns but doesn't provide immediate reassurance, and D shifts the focus to the doctor instead of directly addressing the patient's worries.
The uterus (also known as the womb) in the female reproductive system is located:
- A. Posterior and superior to the urinary bladder
- B. On the lateral side of the mammary glands
- C. Posterior to the testes
- D. Inferior to the vagina
Correct Answer: A
Rationale: The uterus is anatomically located above and behind the urinary bladder in the pelvic cavity.
Which statement about a condition of pregnancy is accurate?
- A. Insufficient salivation (ptyalism) is caused by increases in estrogen.
- B. Acid indigestion (pyrosis) begins early but declines throughout pregnancy.
- C. Hyperthyroidism often develops (temporarily) because hormone production increases.
- D. Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial.
Correct Answer: C
Rationale: The correct answer is C because hyperthyroidism can indeed develop during pregnancy due to the increase in hormone production, specifically human chorionic gonadotropin (hCG) stimulating the thyroid gland. This can lead to symptoms such as weight loss, anxiety, and palpitations. Other choices are incorrect because A is false - ptyalism is actually linked to progesterone levels, not estrogen. B is incorrect because acid indigestion tends to worsen as pregnancy progresses, not decline. D is incorrect as severe nausea and vomiting, known as hyperemesis gravidarum, can have harmful effects on both the mother and fetus if not properly managed.
To reassure and educate pregnant patients about changes in their cardiovascular system, maternity nurses should be aware that:
- A. a pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia requires close medical and obstetric observation, no matter how healthy she otherwise may appear.
- B. changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term.
- C. palpitations are twice as likely to occur in twin gestations.
- D. all of the above changes will likely occur.
Correct Answer: B
Rationale: Auscultatory changes should be discernible after 20 weeks of gestation.
To reassure and educate 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: D
Rationale: Compression of pelvic veins by the enlarging uterus contributes to varicosities, including hemorrhoids. Blood pressure trends vary, but systolic pressure generally remains stable while diastolic pressure decreases initially.