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To reassure and educate pregnant patients about changes in their breasts, nurses should be aware that:
- A. the visibility of blood vessels that form an intertwining blue network indicates full function of Montgomery's tubercles and possibly infection of the tubercles.
- B. the mammary glands do not develop until 2 weeks before labor.
- C. lactation is inhibited until the estrogen level declines after birth.
- D. colostrum is the yellowish oily substance used to lubricate the nipples for breastfeeding.
Correct Answer: A
Rationale: Rationale for Correct Answer A:
1. Montgomery's tubercles are sebaceous glands on the areola.
2. Blood vessels becoming visible indicates increased blood supply due to hormonal changes during pregnancy.
3. The intertwining blue network reflects full function of Montgomery's tubercles.
4. Infection may cause inflammation and increased visibility of blood vessels.
Summary of Incorrect Choices:
B: Incorrect, mammary glands develop during puberty, not right before labor.
C: Incorrect, lactation is primarily influenced by prolactin, not estrogen.
D: Incorrect, colostrum is a thick, yellowish fluid containing antibodies, not an oily substance for lubrication.
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A woman is at 14 weeks of gestation. The nurse would expect to palpate the fundus at which level?
- A. Not palpable above the symphysis at this time
- B. Slightly above the symphysis pubis
- C. At the level of the umbilicus
- D. Slightly above the umbilicus
Correct Answer: B
Rationale: In normal pregnancies, the uterus grows at a predictable rate. It may be palpated above the symphysis pubis sometime between the 12th and 14th weeks of pregnancy.
A first-time mother at 18 weeks of gestation comes for her regularly scheduled prenatal visit. The patient tells the nurse that she is afraid that she is going into premature labor because she is beginning to have regular contractions. The nurse explains that this is the Braxton Hicks sign and teaches the patient that this type of contraction:
- A. is painless.
- B. increases with walking.
- C. causes cervical dilation.
- D. impedes oxygen flow to the fetus.
Correct Answer: A
Rationale: The correct answer is A: is painless. Braxton Hicks contractions are practice contractions that are usually painless and irregular. They do not lead to cervical dilation or impede oxygen flow to the fetus. By educating the patient that these contractions are normal and not a cause for concern, the nurse can help alleviate the patient's fears. Choices B, C, and D are incorrect because Braxton Hicks contractions do not increase with walking, cause cervical dilation, or impact oxygen flow to the fetus. It is important for the patient to understand the difference between Braxton Hicks contractions and true labor contractions to avoid unnecessary anxiety and stress.
Dysmenorrhea is otherwise known as:
- A. Inflammation of the breast
- B. The inability to conceive
- C. Painful periods
- D. The onset of puberty
Correct Answer: C
Rationale: Dysmenorrhea refers to painful menstrual periods, often caused by uterine contractions.
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: The correct answer is C: pica. Pica is a condition where individuals crave and consume non-food items like dirt or gravel, which can indicate underlying anemia due to iron deficiency. In this case, the patient's cravings for dirt and gravel are concerning as it may suggest she is lacking essential nutrients like iron.
A: Ptyalism is excessive saliva production and not related to cravings for non-food items.
B: Pyrosis is a medical term for heartburn and is not associated with cravings for dirt or gravel.
D: Decreased peristalsis refers to reduced movement of the intestines and is not directly related to cravings for non-food items.
A client in her third trimester reports increased perineal pressure. Which is the clinical cause for this complaint?
- A. Fundal height
- B. Urinary infection
- C. Constipation
- D. Hydramnios
Correct Answer: A
Rationale: The correct answer is A: Fundal height. In the third trimester, the growing uterus causes increased pressure on the pelvic organs, leading to perineal pressure. Fundal height measures the height of the uterus and correlates with gestational age, indicating the position and size of the fetus. As the uterus grows, fundal height increases, causing pressure on the perineal area. Urinary infection (B) can cause discomfort but would present with other symptoms like burning urination. Constipation (C) may cause discomfort but typically does not lead to increased perineal pressure. Hydramnios (D) refers to excess amniotic fluid, which can lead to abdominal distension but is not directly related to perineal pressure.