Nokea
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 correct answer is B because the increased vascular volume during pregnancy is essential to provide adequate perfusion of the placenta, ensuring proper nutrient and oxygen exchange between the mother and fetus. This is crucial for the optimal growth and development of the fetus.
A: The increased vascular volume during pregnancy does not compensate for decreased renal plasma flow but rather supports the increased metabolic demands of pregnancy.
C: The elimination of metabolic wastes of the mother is primarily carried out by the kidneys and liver, not solely through increased vascular volume.
D: Preventing maternal and fetal dehydration is more related to adequate fluid intake and retention, rather than the increase in vascular volume during pregnancy.
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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 (S1, S2)
- B. Increased pulse rate
- C. Increased blood pressure
- D. Decreased red blood cell (RBC) production
Correct Answer: B
Rationale: Between 14 and 20 weeks of gestation, the pulse increases about 10 to 15 beats/min, which persists to term.
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 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.
A patient at 24 weeks of gestation contacts the nurse at her obstetric provider's office to complain that she has cravings for dirt and gravel. The nurse is aware that this condition is known as and may indicate anemia.
- A. ptyalism
- B. pyrosis
- C. pica
- D. decreased peristalsis
Correct Answer: C
Rationale: Pica (a desire to eat nonfood substances) is an indication of iron deficiency and should be evaluated.
A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have:
- A. amenorrhe
- B. positive pregnancy test.
- C. Chadwick's sign.
- D. Hegar's sign.
Correct Answer: A
Rationale: The correct answer is A: amenorrhea. At 10 weeks of gestation, a woman should have missed at least two menstrual periods, indicating amenorrhea. This is a presumptive sign of pregnancy as it is a common early pregnancy symptom. Positive pregnancy test (B) confirms pregnancy but is not specific to 10 weeks. Chadwick's sign (C) is a bluish discoloration of the cervix and vagina, typically seen around 6-8 weeks, not specifically at 10 weeks. Hegar's sign (D) is softening of the lower uterine segment, usually felt around 6-12 weeks, not specifically at 10 weeks.