Nokea
The nurse is assessing a patient in her 37th week of pregnancy for the psychological responses commonly experienced as birth nears. Which psychological responses should the nurse expect to evaluate? (Select all that apply.)
- A. The patient is excited to see her baby.
- B. The patient has not started to prepare the nursery for the new baby.
- C. The patient expresses concern about how to know if labor has started
- D. The patient and her spouse are concerned about getting to the birth center in time
Correct Answer: A
Rationale: Rationale for Answer A (Correct): The patient being excited to see her baby is a common psychological response as birth nears. This anticipation and eagerness are typical emotions experienced by expectant mothers as they approach the end of their pregnancy journey. It reflects positive emotional preparation for the upcoming birth.
Summary of Incorrect Choices:
B: Not preparing the nursery may indicate lack of readiness or emotional readiness for the baby's arrival, but it does not directly relate to the psychological responses commonly experienced as birth nears.
C: Expressing concern about recognizing labor signs is a common worry but does not directly point to the psychological responses commonly experienced as birth nears.
D: Being concerned about reaching the birth center in time is more related to logistical or practical considerations rather than the psychological responses typically associated with impending childbirth.
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The mucous plug that forms in the endocervical canal is called the:
- A. operculum.
- B. leukorrhe
- C. funic souffle
- D. ballottement.
Correct Answer: A
Rationale: The correct answer is A: operculum. The mucous plug in the endocervical canal is called the operculum because it acts as a protective barrier to prevent pathogens from entering the uterus during pregnancy. This plug seals the cervix to protect the developing fetus. The other choices are incorrect because leukorrhea (choice B) refers to vaginal discharge, funic souffle (choice C) is a term related to fetal heart sounds, and ballottement (choice D) is a physical examination technique used to assess for floating objects in the uterus.
A young woman comes to the neighborhood clinic explaining that she had a negative urine pregnancy test last week but a positive test today. What is the best explanation?
- A. It is probable that the hCG levels were not high enough to be detected last week.
- B. It is likely that you may not be pregnant, so wait to see if you get your period.
- C. Don't worry, this happens sometimes. You should perform another test in a few days.
- D. Shall we set up a complete examination to see if you are really pregnant?
Correct Answer: A
Rationale: The correct answer is A: It is probable that the hCG levels were not high enough to be detected last week. This is because hCG (human chorionic gonadotropin) is the hormone produced during pregnancy that is detected in pregnancy tests. In early pregnancy, hCG levels can be low and may not be detectable by a urine test until they reach a certain threshold. Therefore, a negative test last week could be due to the hCG levels being below the detection threshold at that time. A positive test today indicates that the hCG levels have increased and are now detectable.
Summary of why the other choices are incorrect:
B: It is likely that you may not be pregnant, so wait to see if you get your period. This is incorrect because a positive test indicates pregnancy, and waiting for a period may not be appropriate if the woman is indeed pregnant.
C: Don't worry, this happens sometimes. You should perform another test in a few days. This
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: D
Rationale: The correct answer is D because during pregnancy, the enlarging uterus pushes the appendix downward and laterally, making it low and to the right. This displacement can lead to atypical presentation of appendicitis symptoms. Choices A and B are incorrect as the appendix is not displaced high and to either side. Choice C is incorrect as the McBurney point is a specific location for appendicitis pain but does not describe the actual position of the appendix during pregnancy.
What is the best explanation that the nurse can provide to a patient who is concerned that she has "pseudoanemia" of pregnancy?
- A. Have her write down her concerns and tell her that you will ask the physician to
respond once the lab results have been evaluated. - B. Tell her that this is a benign self-limiting condition that can be easily corrected by switching to a high-iron diet.
- C. Inform her that because of the pregnancy, her blood volume has increased, leading
- D. Contact the physician and get a prescription for iron pills to correct this condition.
Correct Answer: C
Rationale: The correct answer is C because pseudoanemia of pregnancy is a normal physiological change where the blood volume expands more rapidly than red blood cell production, leading to a relative decrease in the concentration of red blood cells. By informing the patient that due to the pregnancy, her blood volume has increased, the nurse is addressing the underlying cause of the condition. This explanation reassures the patient that the pseudoanemia is a common occurrence during pregnancy and does not indicate a true anemia requiring treatment.
Choice A is incorrect as it does not address the patient's concerns about pseudoanemia and delays providing a clear explanation. Choice B is incorrect because pseudoanemia does not require a high-iron diet for correction. Choice D is incorrect as prescribing iron pills is unnecessary for pseudoanemia, which is a normal variant of pregnancy.
The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is:
- A. a positive pregnancy test.
- B. fetal movement palpated by the nurse-midwife
- C. Braxton Hicks contractions.
- D. quickening.
Correct Answer: B
Rationale: The correct answer is B: fetal movement palpated by the nurse-midwife. This is a positive sign of pregnancy because it is a direct indication of the presence of a fetus. Fetal movements can only be felt once the baby has developed enough to be physically palpable, typically around 18-20 weeks of gestation. This sign is considered reliable and conclusive evidence of pregnancy.
A: A positive pregnancy test is a presumptive sign, as it indicates the possibility of pregnancy but is not definitive.
C: Braxton Hicks contractions are probable signs, as they are common in pregnancy but do not confirm the presence of a fetus.
D: Quickening, the mother's first perception of fetal movements, is a probable sign and does not provide definitive proof of pregnancy.