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To reassure and educate pregnant patients about changes in their cardiovascular system, maternity nurses should be aware that:
- A. a pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia requires close medical and obstetric observation, no matter how healthy she otherwise may appear
- B. changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term
- C. palpitations are twice as likely to occur in twin gestations
- D. all of the above changes will likely occur
Correct Answer: B
Rationale: Auditory changes in the heart occur due to positional and structural changes during pregnancy. Sinus arrhythmia is common and benign unless accompanied by other symptoms.
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To reassure and educate pregnant patients about changes in the cervix, vagina, and position of the fetus, nurses should be aware that:
- A. because of a number of changes in the cervix, abnormal Papanicolaou (Pap) tests
are much easier to evaluate. - B. Quickening is a technique of palpating the fetus to engage it in passive movement.
- C. the deepening color of the vaginal mucosa and cervix (Chadwick's sign) usually appears in the second trimester or later as the vagina prepares to stretch during labor.
- D. increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester.
Correct Answer: D
Rationale: The correct answer is D because increased vascularity of the vagina during pregnancy leads to heightened sensitivity and can result in increased arousal, especially in the second trimester. This is due to increased blood flow and hormonal changes affecting the vaginal tissues. This physiological response is a normal part of pregnancy and can enhance sexual experiences for some women.
A is incorrect because changes in the cervix do not impact the evaluation of abnormal Pap tests. B is incorrect as quickening refers to the first perception of fetal movements by the pregnant woman, not palpating the fetus. C is incorrect as Chadwick's sign, the deepening color of the vaginal mucosa and cervix, typically appears in the first trimester, not the second trimester.
During a patient's physical examination, the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as:
- A. Hegar's sign
- B. McDonald's sign
- C. Chadwick's sign
- D. Goodell's sign
Correct Answer: A
Rationale: Hegar's sign refers to the softening and compressibility of the lower uterine segment, typically occurring around 6 weeks of gestation.
A client is complaining of heartburn. The nurse understands this is caused by which change of pregnancy?
- A. An increase in water reabsorption by the colon
- B. The relaxation of the lower esophageal ('cardiac') sphincter
- C. A decrease in the capacity of the stomach
- D. An increase in stomach acid production
Correct Answer: B
Rationale: The correct answer is B: The relaxation of the lower esophageal ('cardiac') sphincter. During pregnancy, hormonal changes can cause the lower esophageal sphincter to relax, allowing stomach acid to flow back up into the esophagus, leading to heartburn. This is known as gastroesophageal reflux. The other choices are incorrect because heartburn in pregnancy is not caused by an increase in water reabsorption by the colon (A), a decrease in the capacity of the stomach (C), or an increase in stomach acid production (D). The key factor in pregnancy-related heartburn is the relaxation of the lower esophageal sphincter, which allows acid reflux into the esophagus.
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.
The fallopian tubes are:
- A. Hollow, muscular, pear-shaped organs located posterior and superior to the urinary bladder
- B. A pair of muscular tubes that extend from the left and right superior corners of the uterus to the edge of the ovaries
- C. The lower, narrow part of the uterus (womb), forming a canal that opens into the vagina, which leads to the outside of the body
Correct Answer: B
Rationale: The fallopian tubes transport eggs from the ovaries to the uterus and are the site of fertilisation.