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: Small amounts of glucose (glycosuria) can occur normally during pregnancy. Proteinuria, bacteria, and ketones indicate potential complications.
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Human chorionic gonadotropin (hCG) is an important biochemical marker for pregnancy and the basis for many tests. A maternity nurse should be aware that:
- A. hCG can be detected 2.5 weeks after conception.
- B. the hCG level increases gradually and uniformly throughout pregnancy.
- C. much lower than normal increases in the level of hCG may indicate a postdate pregnancy.
- D. a higher than normal level of hCG may indicate an ectopic pregnancy or Down
Correct Answer: A
Rationale: The correct answer is A because hCG can be detected in the blood as early as 2.5 weeks after conception. This is because hCG is produced by the placenta shortly after implantation of the fertilized egg in the uterus. The other choices are incorrect. B is incorrect because hCG levels do not increase gradually and uniformly; they rise rapidly in early pregnancy and peak around 8-11 weeks before stabilizing. C is incorrect because lower than normal increases in hCG may indicate a potential issue with the pregnancy, such as a possible miscarriage, rather than a postdate pregnancy. D is incorrect because a higher than normal level of hCG may indicate conditions such as a molar pregnancy or twins, not necessarily ectopic pregnancy or Down syndrome.
Human chorionic gonadotropin (hCG) is an important biochemical marker for pregnancy and the basis for many tests. A maternity nurse should be aware that:
- A. hCG can be detected 2.5 weeks after conception.
- B. the hCG level increases gradually and uniformly throughout pregnancy.
- C. much lower than normal increases in the level of hCG may indicate a postdate pregnancy.
- D. a higher than normal level of hCG may indicate an ectopic pregnancy or Down syndrome.
Correct Answer: D
Rationale: Higher levels also could be a sign of multiple gestation. hCG can be detected 7 to 8 days after conception. The hCG level fluctuates during pregnancy.
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.
A woman's obstetric history indicates that she is pregnant for the fourth time and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system?
- A. 3-1-1-1-3
- B. 4-1-2-0-4
- C. 3-0-3-0-3
- D. 4-2-1-0-3
Correct Answer: B
Rationale: The GTPAL system calculates gravidity and parity as follows: G (total pregnancies) = 4, T (term births) = 1, P (preterm births) = 2, A (abortions/miscarriages) = 0, L (living children) = 4.
What is the term for the step in maternal role attainment that relates to the woman giving up certain aspects of her previous life?
- A. Fantasy
- B. Grief work
- C. Role playing
- D. Looking for a fit
Correct Answer: B
Rationale: The correct answer is B: Grief work. In the process of maternal role attainment, giving up certain aspects of her previous life involves experiencing grief over the losses associated with the new role. This step is essential for the woman to fully embrace her new identity as a mother. Fantasy (A) refers to imagining scenarios, role playing (C) involves acting out behaviors, and looking for a fit (D) focuses on finding a balance between personal needs and the demands of the maternal role. Grief work is the most appropriate term that specifically addresses the emotional process of letting go and adjusting to the new responsibilities of motherhood.