Nokea
The nurse is educating a client at her first prenatal visit about hormone changes. The nurse explains that which of the following is the purpose of progesterone?
- A. Stimulates uterine development
- B. Relaxes pelvic ligaments and joints
- C. Prepares breasts for lactation
- D. Relaxes smooth muscles
Correct Answer: D
Rationale: The correct answer is D: Progesterone relaxes smooth muscles. Progesterone is essential during pregnancy to maintain the uterine lining and prevent contractions that could lead to miscarriage. It also relaxes smooth muscles in the gastrointestinal tract to prevent premature labor. Choices A, B, and C are incorrect because progesterone's primary role is not to stimulate uterine development, relax pelvic ligaments and joints, or prepare breasts for lactation.
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A woman is in her seventh month of pregnancy. She has been reporting nasal congestion and occasional epistaxis. The nurse suspects that:
- A. this is a normal respiratory change in pregnancy caused by elevated levels of estrogen.
- B. this is an abnormal cardiovascular change, and the nosebleeds are an ominous sign.
- C. the woman is a victim of domestic violence and is being hit in the face by her partner.
- D. the woman has been using cocaine intranasally.
Correct Answer: A
Rationale: Elevated levels of estrogen cause capillaries to become engorged in the respiratory tract. This may result in edema in the nose, larynx, trachea, and bronchi. This congestion may cause nasal stuffiness and epistaxis.
Which of these findings would indicate a potential complication related to renal function during pregnancy?
- A. Increase in glomerular filtration rate (GFR)
- B. Increase in serum creatinine level
- C. Decrease in blood urea nitrogen (BUN)
- D. Mild proteinuria
Correct Answer: B
Rationale: Step-by-step rationale:
1. In a healthy pregnancy, GFR increases to accommodate the increased metabolic demands.
2. An increase in serum creatinine level indicates impaired renal function, as creatinine clearance decreases during pregnancy.
3. Decrease in BUN is normal due to increased GFR.
4. Mild proteinuria can be common in pregnancy without indicating a complication.
Therefore, an increase in serum creatinine level (Choice B) suggests a potential renal complication during pregnancy.
What is the physiologic reason for vascular volume increasing by 40% to 60% during pregnancy?
- A. Prevents maternal and fetal dehydration
- B. Eliminates metabolic wastes of the mother
- C. Provides adequate perfusion of the placenta
- D. Compensates for decreased renal plasma flow
Correct Answer: C
Rationale: The correct answer is C: Provides adequate perfusion of the placenta. During pregnancy, the increased vascular volume ensures sufficient blood flow to the placenta, supplying oxygen and nutrients to the developing fetus. This is crucial for fetal growth and development. The other choices are incorrect because:
A: Preventing maternal and fetal dehydration is not the main reason for the significant increase in vascular volume during pregnancy.
B: Eliminating metabolic wastes of the mother does not require such a substantial increase in vascular volume.
D: Compensating for decreased renal plasma flow is not the primary physiologic reason for the vascular volume expansion during pregnancy.
To reassure and educate pregnant patients about the functioning of their kidneys in eliminating waste products, maternity nurses should be aware that:
- A. increased urinary output makes pregnant women less susceptible to urinary infection.
- B. increased bladder sensitivity and then compression of the bladder by the enlarging uterus results in the urge to urinate even if the bladder is almost empty.
- C. renal (kidney) function is more efficient when the woman assumes a supine position.
- D. using diuretics during pregnancy can help keep kidney function regular.
Correct Answer: B
Rationale: First bladder sensitivity and then compression of the bladder by the uterus result in the urge to urinate more often.
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.