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Some pregnant patients may complain of changes in their voice and impaired hearing. The nurse can tell these patients that these are common reactions to:
- A. a decreased estrogen level
- B. displacement of the diaphragm, resulting in thoracic breathing
- C. congestion and swelling, which occur because the upper respiratory tract has become more vascular
- D. increased blood volume
Correct Answer: C
Rationale: Increased estrogen levels cause vascular congestion and swelling in the upper respiratory tract, affecting voice and hearing.
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Which comment made by a patient in her first trimester indicates ambivalent feelings?
- A. "My body is changing so quickly."
- B. "I haven't felt well since this pregnancy began."
- C. "I'm concerned about the amount of weight I've gaine
- D. "I wanted to become pregnant, but I'm scared about being a mother."
Correct Answer: D
Rationale: The correct answer is D because the patient expresses conflicting emotions of wanting to become pregnant but feeling scared about being a mother, indicating ambivalence. Choice A indicates awareness of physical changes, not necessarily ambivalence. Choice B reflects physical discomfort, not emotional conflict. Choice C shows concern about weight gain, not conflicting feelings. Overall, D is the only option reflecting mixed emotions about pregnancy and motherhood.
A client at 10 weeks gestation is being seen by the nurse. The client reports that she has nausea and vomiting each morning. Which is the nurse's best response?
- A. Drink a large glass of milk before you get out of bed.
- B. Eat crackers before you get out of bed.
- C. Eat dinner before 6:00 p.m. every night.
- D. Eat small meals during the day.
Correct Answer: B
Rationale: The correct answer is B: Eat crackers before you get out of bed. This is the best response because eating crackers before getting out of bed can help alleviate nausea and vomiting associated with morning sickness in early pregnancy. The crackers can help stabilize blood sugar levels and settle the stomach. Drinking a large glass of milk (choice A) may exacerbate nausea for some individuals. Eating dinner before 6:00 p.m. (choice C) is not directly related to morning sickness. Eating small meals during the day (choice D) is generally a good strategy, but specifically eating crackers before getting out of bed is more effective for morning sickness.
To reassure and educate pregnant patients about changes in the cervix, vagina, and position of the fetus, nurses should be aware that:
- A. because of a number of changes in the cervix, abnormal Papanicolaou (Pap) tests are much easier to evaluate.
- B. Quickening is a technique of palpating the fetus to engage it in passive movement.
- C. the deepening color of the vaginal mucosa and cervix (Chadwick's sign) usually appears in the second trimester or later as the vagina prepares to stretch during labor.
- D. increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester.
Correct Answer: D
Rationale: Increased sensitivity and an increased interest in sex sometimes go together. This frequently occurs during the second trimester.
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.
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.