Question 1

The nursing instructor explains to a class of students that the pituitary gland has many functions related to pregnancy.Which of the following functions are performed by hormones secreted by this gland?

Accepted Answer

The pituitary gland secretes hormones that influence ovarian follicular development,prompt ovulation,and stimulate the uterine lining to prepare for pregnancy.After implantation,the trophoblast secretes human chorionic gonadotropin,which prompts the corpus luteum to continue progesterone production until the placenta takes over this action.

Question 2

In providing anticipatory guidance to a couple expecting their first child,which tasks and activities does the nurse discuss with the parents?

Accepted Answer

According to Duvall,members of the expectant family have many tasks to do as they set about preparing for the birth of their child.Some of these include negotiating household roles,reorganizing the home,reviewing (and possibly changing)patterns of money management,adapting the sexual relationship to the physical changes of pregnancy,and reorienting roles with family and friends.As emotional responses can be unpredictable,good communication skills are vital.

Question 3

To provide anticipatory psychosocial guidance to a woman entering her third trimester,what topic should the nurse plan to include?

Accepted Answer

Around the seventh month of pregnancy,the woman begins to feel extremely vulnerable and worries about the impending labor and birth.At the same time,she is exhausted and sees this event as delivering her from the pregnancy.This contradiction can be disconcerting for some women who have not been educated about the normalcy of its occurrence.Fatigue is not the driving force for the vulnerability,although it can contribute to it.Uncertainty about one's ability to be a parent can continue past childbirth.Concern with physical discomforts is more acute in the first trimester for most women.

Question 4

The nurse is explaining to a student that a pregnant woman needs to complete a process called "binding in." Which is the best explanation of this phenomenon?

Accepted Answer

"Binding in" is the process in which the woman accepts the pregnancy and incorporates it into her total reality and self-concept.The other options are all small parts of this process.

Question 5

A woman is in the first trimester of her first pregnancy and confides to the nurse that she is not really sure if she is happy because so many things in her life will change.She is not sure she is willing to alter her current lifestyle.What action by the nurse is most appropriate?

Accepted Answer

An expectant mother must learn to give to her unborn child in the process of successfully negotiating the tasks of pregnancy.It is normal for a first-time mother to grieve for the impending loss of her lifestyle.The nurse should reassure the woman.A referral to a support group may be helpful for some women.The woman probably does not need a counselor.Telling the woman to think of the unborn child is disrespectful and dismissive.

Question 6

A woman in the first trimester of her first pregnancy is upset and worried about physical changes,the labor and birth process,and being able to care for a newborn.Which action by the nurse is best?

Accepted Answer

The importance of childbirth education classes cannot be overemphasized by the nurse.The other options may be helpful,but they are not nearly as beneficial as getting the woman involved in childbirth education classes.Simple reassurance that fears are normal does not help the woman care for herself.Asking about exposure to newborns is likely to be of little help.The woman should be assessed for a support system,but this is not as important as attending classes.

Question 7

A woman has given birth to a child with a cleft lip.What action by the patient would best indicate that goals for the diagnosis of dysfunctional grieving have been at least partially met?

Accepted Answer

Dysfunctional grieving (or other types of grieving)can occur with perinatal loss,including birth of a "less-than-perfect" child.When the parents demonstrate acceptance of the child as he or she is,they are meeting a goal for this diagnosis.Sending birth announcements with photos and wording to explain the anomaly demonstrate that they accept the child and expect others to do so as well.Passively accepting information about a support group or watching a feeding demonstration do not show real parental involvement.Most parents have concerns about their abilities to care for a baby,"perfect" or not.

Question 8

A pregnant woman has the nursing diagnosis of risk for ineffective role performance.What statement by the patient indicates that she is meeting a maternal task associated with the second trimester?

Accepted Answer

In the second trimester,a woman begins to feel the baby's movement,and this makes her truly aware of the fetus as a separate being.Being concerned with one's own well-being rather than that of the fetus is common in the first trimester.Being drawn to other pregnant women is a general principle and is not tied to a specific trimester.Giving up favorite activities,or accepting other trade-offs for the baby,generally occurs in the first trimester.

Question 9

A nurse is providing anticipatory guidance regarding psychosocial adaptations to pregnancy to a group of women.Which topics are consistent with their associated trimesters?

Accepted Answer

During the first trimester,the woman may feel ambivalent about the pregnancy.In the second trimester,active dreams and fantasy life are common.Separation from the fetus is a task of the third trimester,as is becoming more introspective.Realignment of roles and tasks typically occurs in the second trimester.

Question 10

A nurse is providing anticipatory guidance to a pregnant woman regarding normal changes in the nose and nasal passages.What information should the nurse provide?

Accepted Answer

Nasal stuffiness and congestion are common complaints in pregnancy.Increased fluid intake can help thin the mucus and mobilize it.Decongestant sprays should be avoided due to the rebound effect.Blowing the nose gently can help prevent nosebleeds that are common due to nasal edema.

Question 11

The nurse is explaining to a student that several physiological factors cause a pregnant woman to be prone to venous thrombosis and embolic phenomena.What factors are included?

Accepted Answer

Blood factors VII,VIII,IX,and X increase during pregnancy,which leads to a hypercoagulable state in pregnancy.Poor blood return from the lower extremities (venous stasis)combine with this hypercoagulable state to make the pregnant woman more prone to thrombosis and embolic events.Sedentary lifestyle is not a physiological factor,and most pregnant women are not sedentary.Volume status is not directly related.

Question 12

A patient is complaining of constipation.What teaching should the nurse plan to provide?

Accepted Answer

Constipation is a common problem in pregnant women.Nurses should advise women to drink 8 to 10 glasses of water a day,avoid straining to have a bowel movement,and increase their fiber intake.Exercise is important to prevent constipation.Small,frequent meals are not related.

Question 13

A woman is in her fourth month of pregnancy and is in the clinic for a scheduled visit.She confides to the nurse that her husband seems detached and is no longer interested in hearing about the pregnancy.Which action by the nurse is best?

Accepted Answer

Men's reactions to pregnancy and impending childbirth vary widely,from alienation to nurturing to dominance.The nurse should provide guidance by explaining the different paternal responses.A referral to a marriage counselor may or may not be needed.Simply reassuring the woman that this behavior will go away is not accurate or helpful.Stating that men are usually jealous is stereotypical and inaccurate.

Question 14

A nurse manager on the high-risk OB unit wants to improve the experience of women admitted for lengthy stays.What action by the manager is best?

Accepted Answer

Although all options can be very beneficial,the biggest challenge women in the high-tech environment of this unit face is stress that hinders development of their maternal role.One solution may be a program specifically designed to help women negotiate their roles and prepare for parenting.Of course,spiritual care should be respectful of individual beliefs.

Question 15

A woman is in her second trimester of pregnancy.Which behaviors by the woman's family or friends would best indicate to the nurse that they are accepting the unborn child?

Accepted Answer

Accepting the unborn child is critical to adjusting successfully to the pregnancy.For this woman in her second trimester,having immediate family members begin relating to the unborn child is consistent with their place in the family.A sibling talking about being a big sister or big brother to the new baby is an example.In the first trimester friends and family need to accept the pregnancy and unborn child.In the third trimester,the woman must develop unconditional acceptance of the child.

Question 16

A nurse works with pregnant adolescents during pregnancy and for the first 2 years afterward.Which teen demonstrates the most successful resolution of the conflict between normal growth and development tasks and tasks associated with being a new mother?

Accepted Answer

The teen mother has conflicting developmental tasks to negotiate.Adolescents must develop a personal value system; choose a vocation/career; develop body image,sexuality,and a stable identity; and attain independence from their parents.The teen who continues to go to school with an on-site day care is providing child care for her baby and finishing her education,both of which are role-appropriate.The teen whose parents care for the infant is not fully involved as a mother.The teen who needs strong encouragement to keep appointments and the teen who only plans activities one day at a time are not future oriented.

Question 17

A nurse is working with a woman in her second trimester and her partner.The partner comes to clinic appointments but spends his time texting on his cell phone in the waiting room.The woman states that this behavior makes her sad.Which action by the nurse is best?

Accepted Answer

Fathers have developmental tasks to accomplish during a woman's pregnancy.During the second trimester,a father may seem disconnected and binding in may take longer than it did for the mother.This may be due to the "remoteness" of the fetus and father.Actions that can make the baby seem more real to the father will be helpful.A warm invitation to come into the exam room and listen to fetal heart tones is the best option.Asking the father to turn off his cell phone is likely to be perceived as disrespectful and will not be helpful.Assessing for relationship problems and referring the couple for counseling may be indicated in some situations,but is not the best choice here.

Question 18

A pregnant woman had several urinary tract infections (UTIs)in her last pregnancy and wants to avoid them during this pregnancy.What advice by the nurse is best?

Accepted Answer

To avoid UTIs,women should be encouraged to drink 8 to 10 glasses of water a day,to void every 2 to 3 hours while awake,and to void immediately after intercourse.Drinking apple juice and voiding every 1 to 2 hours are not recommended.

Question 19

A nurse is providing anticipatory guidance to a pregnant woman who has another child.Which information should the nurse plan to include?

Accepted Answer

Toddlers typically inhabit their own little world in which they are the center.They may react with indifference and also may regress in their behavior.School-age children may be interested,but they are unable to fully grasp the situation.Sibling preparation classes are a good way to involve and educate them.The teenager may feel resentment or be embarrassed that his or her parents are sexual beings.

Quiz 8: Physiological and Psychosocial Changes During Pregnancy