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Which physiologic findings related to gallbladder function may lead to the development of gallstones during pregnancy?
- A. Decrease in alkaline phosphatase levels compared with nonpregnant women
- B. Increase in albumin and total protein as a result of hemodilution
- C. Hypertonicity of gallbladder tissue
- D. Prolonged emptying time
Correct Answer: D
Rationale: The correct answer is D: Prolonged emptying time. During pregnancy, hormonal changes can lead to gallbladder stasis, causing bile to become concentrated and leading to the formation of gallstones. Prolonged emptying time indicates poor gallbladder motility, increasing the risk of gallstone formation.
A: Decrease in alkaline phosphatase levels is not directly related to gallstone formation during pregnancy.
B: Increase in albumin and total protein is a common finding in pregnancy due to hemodilution, but it is not directly linked to gallstone development.
C: Hypertonicity of gallbladder tissue is not a typical physiologic finding related to gallbladder function during pregnancy and is not a known risk factor for gallstone formation.
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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.
The nurse is assessing a patient in her 37th week of pregnancy for the psychological responses commonly experienced as birth nears. Which psychological responses should the nurse expect to evaluate? (Select all that apply.)
- A. The patient is excited to see her baby.
- B. The patient has not started to prepare the nursery for the new baby.
- C. The patient expresses concern about how to know if labor has started
- D. The patient and her spouse are concerned about getting to the birth center in time
Correct Answer: A
Rationale: Rationale for Answer A (Correct): The patient being excited to see her baby is a common psychological response as birth nears. This anticipation and eagerness are typical emotions experienced by expectant mothers as they approach the end of their pregnancy journey. It reflects positive emotional preparation for the upcoming birth.
Summary of Incorrect Choices:
B: Not preparing the nursery may indicate lack of readiness or emotional readiness for the baby's arrival, but it does not directly relate to the psychological responses commonly experienced as birth nears.
C: Expressing concern about recognizing labor signs is a common worry but does not directly point to the psychological responses commonly experienced as birth nears.
D: Being concerned about reaching the birth center in time is more related to logistical or practical considerations rather than the psychological responses typically associated with impending childbirth.
A woman is in her seventh month of pregnancy. She has been reporting nasal congestion and occasional epistaxis. The nurse suspects that:
- A. this is a normal respiratory change in pregnancy caused by elevated levels of estrogen
- B. this is an abnormal cardiovascular change, and the nosebleeds are an ominous sign
- C. the woman is a victim of domestic violence and is being hit in the face by her partner
- D. the woman has been using cocaine intranasally
Correct Answer: A
Rationale: Elevated estrogen levels during pregnancy cause capillary engorgement in the respiratory tract, leading to nasal congestion and occasional epistaxis.
The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is:
- A. a positive pregnancy test.
- B. fetal movement palpated by the nurse-midwife.
- C. Braxton Hicks contractions.
- D. quickening.
Correct Answer: B
Rationale: Positive signs of pregnancy are attributed to the presence of a fetus, such as hearing the fetal heartbeat or palpating fetal movement.
The nurse is educating a pregnant client about common discomforts during the third trimester. Which statement by the nurse is appropriate?
- A. Perform pelvic-tilt exercises.
- B. Eat crackers prior to getting out of bed in the morning.
- C. Use humidifiers or saline nose drops.
- D. Wear a supportive bra.
Correct Answer: A
Rationale: The correct answer is A: Perform pelvic-tilt exercises. Pelvic-tilt exercises help alleviate back pain common in the third trimester by strengthening abdominal muscles and reducing strain on the lower back. This is appropriate for addressing discomforts during pregnancy.
B: Eating crackers before getting out of bed helps with morning sickness, not third-trimester discomforts.
C: Using humidifiers or saline nose drops is more related to nasal congestion, not common discomforts in the third trimester.
D: Wearing a supportive bra is important during pregnancy but does not directly address common discomforts in the third trimester.