Nokea
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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Which physiologic adaptation of pregnancy may lead to increased constipation during the pregnancy?
- A. Increased emptying time in the intestines
- B. Abdominal distention and bloating
- C. Decreased absorption of water
- D. Decreased motility in the intestines
Correct Answer: D
Rationale: The correct answer is D: Decreased motility in the intestines. During pregnancy, hormonal changes, specifically increased levels of progesterone, can lead to decreased intestinal motility. This slower movement of food through the intestines can result in constipation. The other choices are incorrect because increased emptying time in the intestines (choice A) would actually help prevent constipation, abdominal distention and bloating (choice B) are symptoms of constipation rather than causes, and decreased absorption of water (choice C) would not directly lead to increased constipation.
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: Rationale:
A: Correct. Nasal congestion and epistaxis are common in pregnancy due to increased estrogen causing mucosal swelling and vasodilation.
B: Incorrect. Nosebleeds are not typically indicative of cardiovascular issues in pregnancy.
C: Incorrect. There is no evidence to suggest domestic violence based on the symptoms provided.
D: Incorrect. Cocaine use would have more severe implications beyond just nasal congestion and epistaxis in pregnancy.
During pregnancy, many changes occur as a direct result of the presence of the fetus. Which of these adaptations meet this criterion? (Select all that apply.)
- A. Leukorrhea
- B. Development of the operculum
- C. Quickening
- D. Ballottement
Correct Answer: B
Rationale: The correct answer is B: Development of the operculum. This adaptation refers to the formation of a mucus plug in the cervix during pregnancy, which helps protect the fetus from infections. It is a direct result of the presence of the fetus as it serves as a physical barrier.
A: Leukorrhea is the increased vaginal discharge during pregnancy, but it is not a direct result of the fetus presence.
C: Quickening is the first fetal movements felt by the mother, but it is a fetal activity, not a direct adaptation.
D: Ballottement is a palpation technique used to assess the fetus position, not an adaptation directly caused by the fetus.
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: C
Rationale: The correct answer is C because during pregnancy, the systolic blood pressure tends to increase slightly as pregnancy progresses due to increased cardiac output and decreased systemic vascular resistance. On the other hand, the diastolic pressure typically remains constant or may even decrease slightly. This physiological change is important for maternity nurses to be aware of in order to differentiate normal pregnancy-related changes from potential complications like preeclampsia.
Choices A, B, and D are incorrect:
A: This choice discusses the effect of cuff size on blood pressure readings, which is important but not directly related to the changes in blood pressure during pregnancy.
B: Shifting positions and changing arms for measurements may affect accuracy but is not specifically related to blood pressure changes during pregnancy.
D: Compression of iliac veins and inferior vena cava by the uterus leading to hemorrhoids is unrelated to changes in blood pressure during pregnancy.
The maternity nurse understands that vascular volume increases 40% to 45% during pregnancy to:
- A. compensate for decreased renal plasma flow.
- B. provide adequate perfusion of the placenta.
- C. eliminate metabolic wastes of the mother.
- D. prevent maternal and fetal dehydration.
Correct Answer: B
Rationale: The primary function of increased vascular volume is to transport oxygen and nutrients to the fetus via the placenta.