Question 1

Appendicitis may be difficult to diagnose in pregnancy because the appendix is:

Accepted Answer

The appendix is displaced high and to the right.The appendix is displaced high and to the right,rather than to the left.The appendix is displaced beyond McBurney's point.The appendix is not displaced in a downward direction;it will be high and to the right.

Question 2

Which statement about a condition of pregnancy is accurate?

Accepted Answer

Normal nausea and vomiting rarely produce harmful effects and may be less likely to result in miscarriage or preterm labor.Ptyalism is excessive salivation that may be caused by a decrease in unconscious swallowing or by stimulation of the salivary glands.Pyrosis begins as early as the first trimester and intensifies through the third trimester.Increased hormone production does not lead to hyperthyroidism in pregnant women.

Question 3

In order to reassure and educate pregnant clients about the functioning of their kidneys in eliminating waste products,maternity nurses should be aware that:

Accepted Answer

First bladder sensitivity and then compression of the bladder by the uterus result in the urge to urinate more often.A number of anatomic changes make a pregnant woman more susceptible to urinary tract infection.Renal function is more efficient when the woman lies in the lateral recumbent position and less efficient when she is supine.Diuretic use during pregnancy can overstress the system and cause problems.

Question 4

A pregnant woman tells her nurse that she is worried about the blotchy,brownish coloring over her cheeks,nose,and forehead.The nurse can reassure her that this is a normal condition related to hormonal change,commonly called the mask of pregnancy or,scientifically:

Accepted Answer

Chloasma,the mask of pregnancy,usually fades after birth.Linea nigra is a pigmented line that runs vertically up the abdomen.Striae gravidarum are also known as stretch marks.Palmar erythema is signified by pinkish red blotches on the hands.

Question 5

A woman is in her seventh month of pregnancy.She has been complaining of nasal congestion and occasional epistaxis.The nurse suspects that:

Accepted Answer

Elevated levels of estrogen cause capillaries to become engorged in the respiratory tract,which may result in edema in the nose,larynx,trachea,and bronchi.This congestion may cause nasal stuffiness and epistaxis.Cardiovascular changes in pregnancy may cause edema in lower extremities.Domestic violence cannot be determined based on the sparse facts provided.If the woman had been hit in the face,she most likely would have additional physical findings.Cocaine use cannot be determined based on the sparse facts provided.

Question 6

The mucous plug that forms in the endocervical canal is called the:

Accepted Answer

The operculum protects against bacterial invasion.Leukorrhea is the mucus that forms the endocervical plug (the operculum).The funic souffle is the sound of blood flowing through the umbilical vessels.Ballottement is a technique for palpating the fetus.

Question 7

A 31-year-old woman believes that she may be pregnant.She took an over-the-counter (OTC)pregnancy test 1 week ago after missing her period;the test was positive.During her assessment interview,the nurse inquires about the woman's last menstrual period (LMP)and asks whether she is taking any medications.The woman states that she takes medicine for epilepsy.She has been under considerable stress lately at work and has not been sleeping well.She also has a history of irregular periods.Her physical examination does not indicate that she is pregnant.She has an ultrasound scan,which reveals that she is not pregnant.What is the most likely cause of the false-positive pregnancy test result?

Accepted Answer

Anticonvulsants may cause false-positive pregnancy test results.OTC pregnancy tests use enzyme-linked immunosorbent assay (ELISA)technology,which can yield positive results as soon as 4 days after implantation.Implantation occurs 6 to 10 days after conception.If the woman were pregnant,she would be into her third week at this point (having missed her period 1 week ago).Fibroid tumors do not produce hormones and have no bearing on human chorionic gonadotropin (hCG)pregnancy tests.Although stress may interrupt normal hormone cycles (menstrual cycles),it does not affect hCG levels or produce positive pregnancy test results.

Question 8

Some pregnant clients may complain of changes in their voice and impaired hearing.The nurse can tell these clients that these are common reactions to:

Accepted Answer

Estrogen levels increase,causing the upper respiratory tract to become more vascular;this produces swelling and congestion in the nose and ears and therefore voice changes and impaired hearing.Estrogen levels increase,not decrease.The diaphragm is displaced.However,the key is that estrogen levels increase,causing the upper respiratory tract to become more vascular;this produces swelling and congestion in the nose and ears and therefore voice changes and impaired hearing.The volume of blood is increased.However,the key here is that estrogen levels increase,causing the upper respiratory tract to become more vascular;this produces swelling and congestion in the nose and ears and therefore voice changes and impaired hearing.

Question 9

A nurse caring for a pregnant client must understand that the hormone essential for maintaining pregnancy is:

Accepted Answer

Progesterone is essential for maintaining pregnancy;it does so by relaxing smooth muscles.This reduces uterine activity and prevents miscarriage.Estrogen plays a vital role in pregnancy,but it is not the primary hormone for maintaining pregnancy.hCG levels rise at implantation but decline after 60 to 70 days.Oxytocin stimulates uterine contractions.

Question 10

In order to reassure and educate pregnant clients about changes in their cardiovascular system,maternity nurses should be aware that:

Accepted Answer

These auscultatory changes should be discernible after 20 weeks of gestation.A healthy woman with no underlying heart disease does not need any therapy.The maternal heart rate increases in the third trimester,but palpitations may not necessarily occur,let alone double.Auditory changes are discernible at 20 weeks.

Question 11

A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely has:

Accepted Answer

Amenorrhea is a presumptive sign of pregnancy.Presumptive signs of pregnancy are those felt by the woman.A positive pregnancy test is a probable sign of pregnancy.The presence of the Chadwick sign is a probable sign of pregnancy.The presence of the Hegar sign is a probable sign of pregnancy.

Question 12

A woman's obstetric history indicates that she is pregnant for the fourth time,and all 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?

Accepted Answer

4-1-2-0-4 is the correct calculation of this woman's gravidity and parity.The numbers reflect the woman's gravidity and parity information.Using the GPTAL system,her information is calculated as:
G reflects the total number of times the woman has been pregnant;she is pregnant for the fourth time.T indicates the number of pregnancies carried to term,not the number of deliveries at term;only one of her pregnancies has resulted in a fetus at term.P is the number of pregnancies that resulted in a preterm birth;the woman has had two pregnancies in which she delivered preterm.A signifies whether the woman has had any abortions or miscarriages before the period of viability;she has not.L signifies the number of children born that currently are living;the woman has four children.3-1-1-1-3 is an incorrect calculation of this woman's gravidity and parity.3-0-3-0-3 is an incorrect calculation of this woman's gravidity and parity.4-2-1-0-3 is an incorrect calculation of this woman's gravidity and parity.

Question 13

In order to reassure and educate pregnant clients about changes in the uterus,nurses should be aware that:

Accepted Answer

The softening of the lower uterine segment is called the Hegar sign.Lightening occurs in the last 2 weeks of pregnancy,when the fetus descends.Braxton Hicks contractions become more defined in the final trimester but are not painful.Walking or exercise usually causes them to stop.The uterine souffle is the sound made by blood in the uterine arteries;it can be heard with a fetal stethoscope.

Question 14

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

Accepted Answer

An increase in the normal lumbosacral curve (lordosis)develops,and a compensatory curvature in the cervicodorsal region develops to help her maintain her balance.The center of gravity shifts forward.She will have decreased muscle tone.She will notice increased mobility of her pelvic joints.

Question 15

A nurse providing care to a pregnant woman should know that all are normal gastrointestinal changes in pregnancy except:

Accepted Answer

Pica (a desire to eat nonfood substances)is an indication of iron deficiency and should be evaluated.Ptyalism (excessive salivation)is a normal finding.Pyrosis (heartburn)is a normal finding.Decreased peristalsis is a normal finding.

Question 16

A woman is at 14 weeks of gestation.The nurse expects to palpate the fundus at which level?

Accepted Answer

In normal pregnancies the uterus grows at a predictable rate.It may be palpated above the symphysis pubis sometime between the twelfth and fourteenth weeks of pregnancy.As the uterus grows it may be palpated above the symphysis pubis sometime between the twelfth and fourteenth weeks of pregnancy.At 14 weeks the uterus is not yet at the level of the umbilicus.The fundus is not palpable above the umbilicus until 22 to 24 weeks of gestation.

Question 17

Probable signs of pregnancy are:

Accepted Answer

Probable signs are those detected through trained examination.Fetal visualization is a positive sign of pregnancy.Presumptive signs are those reported by the client.The term diagnostic tests is open for interpretation.To actually diagnose pregnancy,one would have to see positive signs of pregnancy.

Question 18

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

Accepted Answer

Term is 38 to 42 weeks of gestation.Viability is the ability of the fetus to live outside the uterus before coming to term,or 22 to 24 weeks since the last menstrual period.Preterm is 20 to 37 weeks of gestation.Postdate or postterm is a pregnancy that extends beyond 42 weeks or what is considered the limit of full term.

Question 19

In order to reassure and educate pregnant clients about changes in their breasts,nurses should be aware that:

Accepted Answer

Lactation is inhibited until after birth.The visible blue network of blood vessels is a normal outgrowth of a richer blood supply.The mammary glands are functionally complete by midpregnancy.Colostrum is a creamy white-to-yellow premilk fluid that can be expressed from the nipples before birth.

Question 20

Human chorionic gonadotropin (hCG)is an important biochemical marker for pregnancy and therefore the basis for many tests.A maternity nurse should be aware that:

Accepted Answer

Higher levels also could be a sign of multiple gestation.hCG can be detected as early as 7 to 10 days after conception.The hCG level fluctuates during pregnancy,peaking,declining,stabilizing,and then increasing again.Abnormally slow increases may indicate impending miscarriage.

Quiz 13: Anatomy and Physiology of Pregnancy