Nokea
To reassure and educate pregnant patients about changes in the uterus, nurses should be aware that:
- A. lightening occurs near the end of the second trimester as the uterus rises into a different position
- B. the woman's increased urinary frequency in the first trimester is the result of exaggerated uterine anteflexion caused by softening
- C. Braxton Hicks contractions become more painful in the third trimester, particularly if the woman tries to exercise
- D. the uterine souffle is the movement of the fetus
Correct Answer: B
Rationale: Softening of the lower uterine segment (Hegar's sign) causes increased urinary frequency in the first trimester. Lightening occurs late in pregnancy, Braxton Hicks contractions are not typically painful, and the uterine souffle refers to blood flow sounds.
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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: The GTPAL system calculates gravidity and parity as follows: G (total pregnancies) = 4, T (term births) = 1, P (preterm births) = 2, A (abortions/miscarriages) = 0, L (living children) = 4.
Male infertility can be caused by:
- A. Vasectomy
- B. Low sperm count
- C. Sexual dysfunction
- D. All of the above
Correct Answer: D
Rationale: Male infertility may result from various factors, including vasectomy, low sperm count, or sexual dysfunction.
To reassure and educate their pregnant patients about changes in their blood pressure, maternity nurses should be aware that:
- A. a blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high.
- B. shifting the patient's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit.
- C. the systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant.
- D. compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy.
Correct Answer: D
Rationale: Compression of the iliac veins and inferior vena cava also leads to varicose veins in the legs and vulva.
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 results from plasma volume expansion outpacing red blood cell production, diluting hemoglobin concentration.
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.