Nokea
Physiologic anemia often occurs during pregnancy as a result of:
- A. inadequate intake of iron
- B. dilution of hemoglobin concentration
- C. the fetus establishing iron stores
- D. decreased production of erythrocytes
Correct Answer: B
Rationale: Physiologic anemia results from plasma volume expansion outpacing red blood cell production, diluting hemoglobin concentration.
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The patient has just learned that she is pregnant and overhears the gynecologist saying that she has a positive Chadwick's sign. When the patient asks the nurse what this means, how would the nurse respond?
- A. "Chadwick's sign signifies an increased risk of blood clots in pregnant women
- B. “That sign means the cervix has softened as the result of tissue changes that
naturally occur with pregnancy.” - C. "This means that a mucus plug has formed in the cervical canal to help protect you from uterine infection."
- D. "This sign occurs normally in pregnancy, when estrogen causes increased blood flow in the area of the cervix."
Correct Answer: C
Rationale: The correct answer is C. Chadwick's sign refers to the bluish discoloration of the cervix, vagina, and labia due to increased blood flow, a result of pregnancy hormones. The mucus plug forming in the cervical canal indicates protection from uterine infections, a crucial function during pregnancy. This response directly correlates Chadwick's sign with its physiological significance, showing the nurse's knowledge and ability to educate the patient effectively. Other choices are incorrect because they do not accurately describe Chadwick's sign or its implications in pregnancy.
A client at 20 weeks gestation has just been examined during a prenatal visit. Which assessment should the nurse recognize as an abnormal finding and the need for further testing?
- A. Fundal height of 26 cm
- B. Pulse rate 15 bpm higher than her prepregnancy pulse
- C. Blood pressure of 128/68
- D. Deep tendon reflexes +2
Correct Answer: A
Rationale: The correct answer is A. At 20 weeks gestation, the fundal height should correspond closely to the number of weeks pregnant (around 20 cm). A fundal height of 26 cm indicates potential fetal growth abnormalities or incorrect dating. Further testing, such as an ultrasound, is needed to assess fetal growth and well-being.
Choice B (Pulse rate 15 bpm higher) is not typically concerning during pregnancy as pulse rate can increase due to physiological changes. Choice C (Blood pressure of 128/68) falls within the normal range for pregnancy. Choice D (Deep tendon reflexes +2) is a normal finding and not an indication for further testing.
The nurse is teaching a pregnant patient about signs of possible pregnancy complications. Which should the nurse include in the teaching plan? (Select all that apply.)
- A. Report watery vaginal discharge
- B. Report puffiness of the face or around the eyes.
- C. Report any bloody show when you go into labor.
- D. Report visual disturbances, such as spots before the eyes.
Correct Answer: A
Rationale: The correct answer is A: Report watery vaginal discharge. This is important as it could indicate premature rupture of membranes, which can lead to infection or preterm labor. Puffiness of the face or around the eyes (B) could be a sign of preeclampsia, not just a pregnancy complication. Bloody show during labor (C) is a normal sign of labor progression. Visual disturbances like spots (D) are more commonly associated with conditions like preeclampsia rather than general pregnancy complications.
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: The primary function of increased vascular volume is to transport oxygen and nutrients to the fetus via the placenta.
The woman who is primigravida is in the clinic for her first prenatal visit. She states that she has experienced dizziness when she gets out of bed and sometimes when she stands up from a sitting position. What is the reason for this?
- A. She is experiencing hypoglycemia from being diabetic.
- B. She is standing up too quickly and must be careful to avoid injury.
- C. She needs to drink more fluids to prevent orthostatic hypotension and it will clear up soon.
- D. She is not getting enough exercise, so circulation to the head and upper extremities is less than optimal.
Correct Answer: B
Rationale: The correct answer is B: She is standing up too quickly and must be careful to avoid injury. When a person stands up quickly, blood pools in the lower extremities, causing a momentary drop in blood pressure. This sudden drop can lead to dizziness or lightheadedness. This phenomenon is known as orthostatic hypotension. It is common during pregnancy due to the hormonal and physiological changes that affect blood pressure regulation.
Explanation for why other choices are incorrect:
A: She is experiencing hypoglycemia from being diabetic - There is no information provided in the scenario to suggest that the woman is diabetic or experiencing low blood sugar levels.
C: She needs to drink more fluids to prevent orthostatic hypotension and it will clear up soon - While staying hydrated is important, simply drinking more fluids may not address the underlying issue of orthostatic hypotension caused by rapid changes in position.
D: She is not getting enough exercise, so circulation to the