Nokea
The nurse is educating a client about varicosities during pregnancy. Which statement by the client indicates effective teaching?
- A. I need to wear knee-high hose every day to increase my leg circulation.
- B. When I sit at my desk, both of my feet should be resting on the floor.
- C. I should perform Kegel exercises twice a day.
- D. I should call the physician if I do not feel my baby move.
Correct Answer: B
Rationale: The correct answer is B because when sitting with both feet on the floor, it promotes proper circulation and reduces the risk of developing varicose veins. Elevating legs and avoiding crossing them also help. Choice A is incorrect as knee-high hose may constrict circulation. Choice C is irrelevant to varicosities. Choice D is important for monitoring fetal health but not directly related to varicose veins.
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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: Estrogen levels increase, causing the upper respiratory tract to become more vascular producing swelling and congestion in the nose and ears leading to voice changes and impaired hearing.
The vagina is:
- A. Used to fertilise an ovum before moving onto the fallopian tubes
- B. A mass of glandular tissue situated over the pectoral muscles
- C. An elastic muscular tube, connecting the cervix to the uterus
- D. Used to stop the menstrual flow from leaving the body
Correct Answer: C
Rationale: The vagina is a muscular tube that connects the cervix to the external genitalia, serving as a passage for menstrual flow and childbirth.
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.
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 during pregnancy occurs due to the expansion of plasma volume, causing a dilution of hemoglobin concentration. Increased blood volume is necessary to support the growing fetus, leading to a relative decrease in hemoglobin levels. Inadequate iron intake (Choice A) can cause iron-deficiency anemia but is not the primary reason for physiologic anemia in pregnancy. The fetus establishing iron stores (Choice C) is unrelated to the maternal anemia. Decreased production of erythrocytes (Choice D) is not the main cause of anemia in pregnancy; rather, it is the dilution effect from increased plasma volume.
A woman's obstetric history indicates that she is pregnant for the fourth time and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system?
- A. 3-1-1-1-3
- B. 4-1-2-0-4
- C. 3-0-3-0-3
- D. 4-2-1-0-3
Correct Answer: B
Rationale: Rationale for Answer B (4-1-2-0-4):
1. Gravidity: Total number of pregnancies - She is pregnant for the 4th time (G=4).
2. Term Births: Number of pregnancies reaching 37 weeks or more - She had 1 term birth (T=1).
3. Preterm Births: Number of pregnancies ending between 20-36 weeks - She had twins born at 34 weeks (P=2).
4. Abortions: Number of pregnancies ending before 20 weeks - She has no reported abortions (A=0).
5. Living Children: Number of living children - She has all her children from previous pregnancies living (L=4).
Summary of other choices:
A: Incorrect because it indicates 3 term births, which is not accurate.
C: Incorrect as it suggests 3 living children, which is not consistent with the scenario.
D: Incorrect due to incorrect number of preterm births and living