Anatomy and Physiology of Pregnancy

Anatomy and Physiology of Pregnancy Related

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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.

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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.

The musculoskeletal system adapts to the changes that occur during pregnancy. A woman can expect to experience what change?

  • A. Her center of gravity will shift backward.
  • B. She will have increased lordosis.
  • C. She will have increased abdominal muscle tone.
  • D. She will notice decreased mobility of her pelvic joints.
Correct Answer: B

Rationale: An increase in the normal lumbosacral curve (lordosis) develops, and a compensatory curvature in the cervicodorsal region develops to help the woman maintain her balance.

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: Auditory changes in the heart occur due to positional and structural changes during pregnancy. Sinus arrhythmia is common and benign unless accompanied by other symptoms.

To reassure and educate pregnant patients about changes in the uterus, nurses should be aware that:

  • A. lightening occurs near the end of the second trimester as the uterus rises into a different position
  • B. the woman's increased urinary frequency in the first trimester is the result of exaggerated uterine anteflexion caused by softening
  • C. Braxton Hicks contractions become more painful in the third trimester, particularly if the woman tries to exercise
  • D. the uterine souffle is the movement of the fetus
Correct Answer: B

Rationale: Softening of the lower uterine segment (Hegar's sign) causes increased urinary frequency in the first trimester. Lightening occurs late in pregnancy, Braxton Hicks contractions are not typically painful, and the uterine souffle refers to blood flow sounds.

Which finding is a positive sign of pregnancy?

  • A. Amenorrhea
  • B. Breast changes
  • C. Fetal movement felt by the woman
  • D. Visualization of fetus by ultrasound
Correct Answer: B

Rationale: The correct answer is B: Breast changes. During pregnancy, hormonal changes cause breast enlargement, tenderness, and darkening of the areolas. This is considered a positive sign of pregnancy because it is a direct physiological response to the hormonal changes associated with pregnancy. Amenorrhea (choice A) is a common early sign of pregnancy but can also be due to other factors. Fetal movement (choice C) and visualization of fetus by ultrasound (choice D) are considered presumptive and probable signs of pregnancy, respectively, but not definitive positive signs like breast changes.

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