Nokea
A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a:
- A. primipara
- B. primigravida
- C. multipara
- D. nulligravida
Correct Answer: A
Rationale: A primipara is a woman who has completed one pregnancy with a viable fetus. Primigravida refers to a woman pregnant for the first time.
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The maternity nurse understands that vascular volume increases 40% to 45% during pregnancy to:
- A. compensate for decreased renal plasma flow
- B. provide adequate perfusion of the placenta
- C. eliminate metabolic wastes of the mother
- D. prevent maternal and fetal dehydration
Correct Answer: B
Rationale: Increased vascular volume ensures adequate placental perfusion to support fetal growth and oxygenation.
Appendicitis may be difficult to diagnose in pregnancy because the appendix is:
- A. displaced upward and laterally, high and to the right.
- B. displaced upward and laterally, high and to the left.
- C. deep at McBurney point.
- D. displaced downward and laterally, low and to the right.
Correct Answer: D
Rationale: The correct answer is D because during pregnancy, the enlarging uterus pushes the appendix downward and laterally, making it low and to the right. This displacement can lead to atypical presentation of appendicitis symptoms. Choices A and B are incorrect as the appendix is not displaced high and to either side. Choice C is incorrect as the McBurney point is a specific location for appendicitis pain but does not describe the actual position of the appendix during pregnancy.
The nurse caring for the pregnant patient must understand that the hormone essential for maintaining pregnancy is:
- A. estrogen.
- B. human chorionic gonadotropin (hCG).
- C. oxytocin.
- D. progesterone.
Correct Answer: D
Rationale: Progesterone is essential for maintaining pregnancy; it does so by relaxing smooth muscles. This reduces uterine activity and prevents miscarriage.
What is the best explanation that the nurse can provide to a patient who is concerned that she has "pseudoanemia" of pregnancy?
- A. Have her write down her concerns and tell her that you will ask the physician to
respond once the lab results have been evaluated. - B. Tell her that this is a benign self-limiting condition that can be easily corrected by switching to a high-iron diet.
- C. Inform her that because of the pregnancy, her blood volume has increased, leading
- D. Contact the physician and get a prescription for iron pills to correct this condition.
Correct Answer: C
Rationale: The correct answer is C because pseudoanemia of pregnancy is a normal physiological change where the blood volume expands more rapidly than red blood cell production, leading to a relative decrease in the concentration of red blood cells. By informing the patient that due to the pregnancy, her blood volume has increased, the nurse is addressing the underlying cause of the condition. This explanation reassures the patient that the pseudoanemia is a common occurrence during pregnancy and does not indicate a true anemia requiring treatment.
Choice A is incorrect as it does not address the patient's concerns about pseudoanemia and delays providing a clear explanation. Choice B is incorrect because pseudoanemia does not require a high-iron diet for correction. Choice D is incorrect as prescribing iron pills is unnecessary for pseudoanemia, which is a normal variant of pregnancy.
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.