Anatomy and Physiology of Pregnancy

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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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Which time-based description of a stage of development in pregnancy is accurate?

  • A. Viability—22 to 37 weeks since the last menstrual period (LMP) (assuming a fetal weight >500 g)
  • B. Full Term—Pregnancy from the beginning of week 39 of gestation to the end of week 40
  • C. Preterm—Pregnancy from 20 to 28 weeks
  • D. Postdate—Pregnancy that extends beyond 38 weeks
Correct Answer: B

Rationale: Full term is defined as pregnancy from the beginning of week 39 to the end of week 40. Viability occurs at 22-24 weeks, preterm is before 37 weeks, and postdate is beyond 42 weeks.

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.

Now in her second trimester of pregnancy, the client, who was a marathon runner before nausea and overwhelming tiredness kept her from exercising regularly, is wondering whether she can run now. What is the nurse's best response?

  • A. Certainly, if you feel up to it.
  • B. Your level of exercise will be somewhat modified by the changes occurring in your body.
  • C. Your primary health care provider will need to give you permission.
  • D. Because your body is meeting the needs of two people now, you should avoid too much exercise.
Correct Answer: B

Rationale: The correct answer is B: "Your level of exercise will be somewhat modified by the changes occurring in your body."

Rationale:
1. Pregnancy impacts a woman's body significantly, including changes in hormones, weight distribution, and center of gravity.
2. These changes can affect a woman's ability to engage in high-impact activities like running.
3. The nurse's response acknowledges the need for modification in exercise routine to accommodate these changes.
4. It promotes a balanced approach to exercise during pregnancy, considering both the benefits of physical activity and the safety of the mother and baby.

Summary of Other Choices:
A: "Certainly, if you feel up to it." - This response oversimplifies the situation and does not consider the specific physiological changes during pregnancy that may impact the woman's ability to run safely.
C: "Your primary health care provider will need to give you permission." - While consulting a healthcare provider is important, this response does not address the specific concerns related to exercise during pregnancy.

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.

The musculoskeletal system adapts to the changes that occur during pregnancy. A woman can expect to experience what change?

  • A. Her center of gravity will shift backward.
  • B. She will have increased lordosis.
  • C. She will have increased abdominal muscle tone.
  • D. She will notice decreased mobility of her pelvic joints.
Correct Answer: B

Rationale: An increase in the normal lumbosacral curve (lordosis) develops, and a compensatory curvature in the cervicodorsal region develops to help the woman maintain her balance.