Nokea
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: A
Rationale: During pregnancy, the appendix is displaced upward and laterally due to the enlarging uterus, making diagnosis more challenging.
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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.
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.
A woman's obstetric history indicates that she is pregnant for the fourth time and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system?
- A. 3-1-1-1-3
- B. 4-1-2-0-4
- C. 3-0-3-0-3
- D. 4-2-1-0-3
Correct Answer: B
Rationale: The GTPAL system calculates gravidity and parity as follows: G (total pregnancies) = 4, T (term births) = 1, P (preterm births) = 2, A (abortions/miscarriages) = 0, L (living children) = 4.
Human chorionic gonadotropin (hCG) is an important biochemical marker for pregnancy and the basis for many tests. A maternity nurse should be aware that:
- A. hCG can be detected 2.5 weeks after conception.
- B. the hCG level increases gradually and uniformly throughout pregnancy.
- C. much lower than normal increases in the level of hCG may indicate a postdate pregnancy.
- D. a higher than normal level of hCG may indicate an ectopic pregnancy or Down
Correct Answer: A
Rationale: The correct answer is A because hCG can be detected in the blood as early as 2.5 weeks after conception. This is because hCG is produced by the placenta shortly after implantation of the fertilized egg in the uterus. The other choices are incorrect. B is incorrect because hCG levels do not increase gradually and uniformly; they rise rapidly in early pregnancy and peak around 8-11 weeks before stabilizing. C is incorrect because lower than normal increases in hCG may indicate a potential issue with the pregnancy, such as a possible miscarriage, rather than a postdate pregnancy. D is incorrect because a higher than normal level of hCG may indicate conditions such as a molar pregnancy or twins, not necessarily ectopic pregnancy or Down syndrome.
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.