Nokea
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 hCG levels may indicate conditions such as multiple gestation, ectopic pregnancy, or Down syndrome. hCG levels fluctuate during pregnancy and peak around 8-10 weeks.
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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: Increased lordosis (curvature of the lower spine) occurs to help balance the growing uterus. Abdominal muscles stretch and weaken, and pelvic joint mobility increases.
A nurse is reviewing the laboratory results for a prenatal client. She notices that her hemoglobin is 10.5. The nurse realizes this laboratory result indicates which of the following?
- A. Low vitamin intake has resulted in a decrease in red blood cell production.
- B. Plasma volume increase is greater than red blood cell production and has resulted in a decrease in hemoglobin.
- C. This is a serious problem that might harm the fetus.
- D. A repeat blood test should be done immediately to confirm that the client has anemia
Correct Answer: B
Rationale: The correct answer is B because a hemoglobin level of 10.5 indicates a decrease in hemoglobin concentration, which is typically caused by an increase in plasma volume during pregnancy. This dilution effect results in a lower concentration of red blood cells in the blood, leading to lower hemoglobin levels. This physiological change is normal during pregnancy and is known as physiological anemia.
Choice A is incorrect because low vitamin intake would not directly result in a decrease in red blood cell production leading to low hemoglobin levels.
Choice C is incorrect because a hemoglobin level of 10.5, although lower than normal, does not necessarily indicate a serious problem that would harm the fetus.
Choice D is incorrect because a repeat blood test is not immediately necessary to confirm anemia as the low hemoglobin level can be explained by the normal increase in plasma volume during pregnancy.
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.
Which physiologic findings related to gallbladder function may lead to the development of gallstones during pregnancy?
- A. Decrease in alkaline phosphatase levels compared with nonpregnant women
- B. Increase in albumin and total protein as a result of hemodilution
- C. Hypertonicity of gallbladder tissue
- D. Prolonged emptying time
Correct Answer: D
Rationale: The correct answer is D: Prolonged emptying time. During pregnancy, hormonal changes can lead to gallbladder stasis, causing bile to become concentrated and leading to the formation of gallstones. Prolonged emptying time indicates poor gallbladder motility, increasing the risk of gallstone formation.
A: Decrease in alkaline phosphatase levels is not directly related to gallstone formation during pregnancy.
B: Increase in albumin and total protein is a common finding in pregnancy due to hemodilution, but it is not directly linked to gallstone development.
C: Hypertonicity of gallbladder tissue is not a typical physiologic finding related to gallbladder function during pregnancy and is not a known risk factor for gallstone formation.
A 31-year-old woman believes that she may be pregnant. She took an OTC pregnancy test 1 week ago after missing her period; the test was positive. During her assessment interview, the nurse enquires about the woman's last menstrual period and asks whether she is taking any medications. The woman states that she takes medicine for epilepsy. She has been under considerable stress lately at work and has not been sleeping well. She also has a history of irregular periods. Her physical examination does not indicate that she is pregnant. She has an ultrasound scan that reveals she is not pregnant. What is the most likely cause of the false-positive pregnancy test result?
- A. She took the pregnancy test too early.
- B. She takes anticonvulsants.
- C. She has a fibroid tumor.
- D. She has been under considerable stress and has a hormone imbalance.
Correct Answer: B
Rationale: Anticonvulsants may cause false-positive pregnancy test results.