Anatomy and Physiology of Pregnancy

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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: Step 1: Increased bladder sensitivity and compression by the enlarging uterus lead to the urge to urinate even if the bladder is almost empty. This is due to the pressure exerted on the bladder by the growing fetus, causing increased frequency of urination.

Step 2: This phenomenon is a common experience for pregnant women as their uterus expands and places pressure on the bladder, making them feel the urge to urinate frequently.

Step 3: Maternity nurses should be aware of this physiological change to reassure pregnant patients that this urge to urinate is normal during pregnancy and not necessarily indicative of a urinary tract infection.

Summary:
Choice A is incorrect because increased urinary output in pregnant women does not necessarily make them less susceptible to urinary infection. Choice C is incorrect because renal function is not more efficient when a pregnant woman assumes a supine position; actually, lying on the back can reduce blood flow to the baby. Choice D is incorrect because using diuretics during pregnancy is generally not recommended as it

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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.

The breast includes:

  • A. The nipple
  • B. The ovaries
  • C. The testes
  • D. The scrotum
Correct Answer: A

Rationale: The nipple is a key anatomical feature of the breast, involved in lactation and feeding.

Which statement about a condition of pregnancy is accurate?

  • A. Insufficient salivation (ptyalism) is caused by increases in estrogen
  • B. Acid indigestion (pyrosis) begins early but declines throughout pregnancy
  • C. Hyperthyroidism often develops (temporarily) because hormone production increases
  • D. Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial
Correct Answer: D

Rationale: Nausea and vomiting are common and rarely harmful, potentially offering protective benefits. Ptyalism involves excessive salivation, pyrosis worsens later in pregnancy, and hyperthyroidism does not typically develop.

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.

Some pregnant patients may complain of changes in their voice and impaired hearing. The nurse can tell these patients that these are common reactions to:

  • A. a decreased estrogen level
  • B. displacement of the diaphragm, resulting in thoracic breathing
  • C. congestion and swelling, which occur because the upper respiratory tract has become more vascular
  • D. increased blood volume
Correct Answer: C

Rationale: Increased estrogen levels cause vascular congestion and swelling in the upper respiratory tract, affecting voice and hearing.

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