Nokea
During a patient's physical examination, the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as:
- A. Hegar's sign
- B. McDonald's sign
- C. Chadwick's sign
- D. Goodell's sign
Correct Answer: A
Rationale: Hegar's sign refers to the softening and compressibility of the lower uterine segment, typically occurring around 6 weeks of gestation.
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A patient in her first trimester complains of nausea and vomiting. She asks, 'Why does this happen?' The nurse's best response is:
- A. It is due to an increase in gastric motility.'
- B. It may be due to changes in hormones.'
- C. It is related to an increase in glucose levels.'
- D. It is caused by a decrease in gastric secretions.'
Correct Answer: B
Rationale: Nausea and vomiting are believed to be caused by increased levels of hormones, decreased gastric motility, and hypoglycemia.
What is the physiologic reason for vascular volume increasing by 40% to 60% during pregnancy?
- A. Prevents maternal and fetal dehydration
- B. Eliminates metabolic wastes of the mother
- C. Provides adequate perfusion of the placenta
- D. Compensates for decreased renal plasma flow
Correct Answer: C
Rationale: The correct answer is C: Provides adequate perfusion of the placenta. During pregnancy, the increased vascular volume ensures sufficient blood flow to the placenta, supplying oxygen and nutrients to the developing fetus. This is crucial for fetal growth and development. The other choices are incorrect because:
A: Preventing maternal and fetal dehydration is not the main reason for the significant increase in vascular volume during pregnancy.
B: Eliminating metabolic wastes of the mother does not require such a substantial increase in vascular volume.
D: Compensating for decreased renal plasma flow is not the primary physiologic reason for the vascular volume expansion during pregnancy.
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 syndrome.
Correct Answer: D
Rationale: Higher levels also could be a sign of multiple gestation. hCG can be detected 7 to 8 days after conception. The hCG level fluctuates during pregnancy.
Which physiologic finding is consistent with normal pregnancy?
- A. Systemic vascular resistance increases as blood pressure decreases.
- B. Cardiac output increases during pregnancy.
- C. Blood pressure remains consistent independent of position changes
- D. Maternal vasoconstriction occurs in response to increased metabolism.
Correct Answer: B
Rationale: The correct answer is B because during pregnancy, the body's demand for oxygen and nutrients increases, leading to an increase in cardiac output to meet these needs. This is due to the expansion of blood volume and the need to supply the growing fetus. Systemic vascular resistance decreases to accommodate the increased blood flow, so choice A is incorrect. Blood pressure typically decreases in early pregnancy but may change with position due to the weight of the uterus on the vena cava, making choice C incorrect. Maternal vasodilation, not vasoconstriction, occurs in response to increased metabolism to support the increased blood flow needed for the growing fetus, making choice D incorrect.
Which of these findings would indicate a potential complication related to renal function during pregnancy?
- A. Increase in glomerular filtration rate (GFR)
- B. Increase in serum creatinine level
- C. Decrease in blood urea nitrogen (BUN)
- D. Mild proteinuria
Correct Answer: B
Rationale: Step-by-step rationale:
1. In a healthy pregnancy, GFR increases to accommodate the increased metabolic demands.
2. An increase in serum creatinine level indicates impaired renal function, as creatinine clearance decreases during pregnancy.
3. Decrease in BUN is normal due to increased GFR.
4. Mild proteinuria can be common in pregnancy without indicating a complication.
Therefore, an increase in serum creatinine level (Choice B) suggests a potential renal complication during pregnancy.