Nokea
Which finding in the urine analysis of a pregnant woman is considered a variation of normal?
- A. Proteinuria
- B. Glycosuria
- C. Bacteria in the urine
- D. Ketones in the urine
Correct Answer: B
Rationale: The correct answer is B: Glycosuria. In pregnant women, glycosuria is considered a variation of normal due to the hormonal changes affecting glucose metabolism. During pregnancy, the renal threshold for glucose is lowered, leading to glucose spillage in urine without significant pathology. Proteinuria (A) can indicate kidney damage. Bacteria in the urine (C) suggest a possible urinary tract infection. Ketones in the urine (D) may indicate a metabolic disorder or inadequate carbohydrate intake. Glycosuria in pregnancy is a physiological adaptation and not necessarily a cause for concern.
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A physician has just documented on a prenatal client. The nurse notices that the physician notes the presence of Goodell's sign. The nurse understands that this sign indicates which of the following?
- A. Changes in the cervix
- B. Changes in the uterus
- C. Passive movement of an unengaged fetus
- D. Fetus that has begun to descend and engage in the pelvis
Correct Answer: A
Rationale: The correct answer is A, changes in the cervix. Goodell's sign refers to the softening of the cervix that occurs during early pregnancy due to increased vascularity and hormonal changes. This sign is an important indicator of pregnancy and is typically observed during the first trimester. Choice B, changes in the uterus, is incorrect because Goodell's sign specifically refers to changes in the cervix, not the uterus as a whole. Choice C, passive movement of an unengaged fetus, is incorrect as Goodell's sign is not related to fetal movement. Choice D, fetus that has begun to descend and engage in the pelvis, is also incorrect as Goodell's sign occurs much earlier in pregnancy before the fetus engages in the pelvis.
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: Increased vascular volume ensures adequate placental perfusion to support fetal growth and oxygenation.
Numerous changes in the integumentary system occur during pregnancy. Which change persists after birth?
- A. Epulis
- B. Chloasma
- C. Telangiectasia
- D. Striae gravidarum
Correct Answer: D
Rationale: Striae gravidarum, or stretch marks, reflect separation within the underlying connective tissue of the skin. They usually fade after birth, although they never disappear completely.
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 during pregnancy occurs due to the expansion of plasma volume, causing a dilution of hemoglobin concentration. Increased blood volume is necessary to support the growing fetus, leading to a relative decrease in hemoglobin levels. Inadequate iron intake (Choice A) can cause iron-deficiency anemia but is not the primary reason for physiologic anemia in pregnancy. The fetus establishing iron stores (Choice C) is unrelated to the maternal anemia. Decreased production of erythrocytes (Choice D) is not the main cause of anemia in pregnancy; rather, it is the dilution effect from increased plasma volume.
What is the best explanation that the nurse can provide to a patient who is concerned that she has "pseudoanemia" of pregnancy?
- A. Have her write down her concerns and tell her that you will ask the physician to
respond once the lab results have been evaluated. - B. Tell her that this is a benign self-limiting condition that can be easily corrected by switching to a high-iron diet.
- C. Inform her that because of the pregnancy, her blood volume has increased, leading
- D. Contact the physician and get a prescription for iron pills to correct this condition.
Correct Answer: C
Rationale: The correct answer is C because pseudoanemia of pregnancy is a normal physiological change where the blood volume expands more rapidly than red blood cell production, leading to a relative decrease in the concentration of red blood cells. By informing the patient that due to the pregnancy, her blood volume has increased, the nurse is addressing the underlying cause of the condition. This explanation reassures the patient that the pseudoanemia is a common occurrence during pregnancy and does not indicate a true anemia requiring treatment.
Choice A is incorrect as it does not address the patient's concerns about pseudoanemia and delays providing a clear explanation. Choice B is incorrect because pseudoanemia does not require a high-iron diet for correction. Choice D is incorrect as prescribing iron pills is unnecessary for pseudoanemia, which is a normal variant of pregnancy.