chapter 10-anatomy, and physiology of pregnancy

Question 1

A woman’s obstetrical 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

Answer 1

B

Question 2

A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity using the GTPAL system?
a. 2-0-0-1-1
b. 2-1-0-1-0
c. 3-1-0-1-0
d. 3-0-1-1-0

Answer 2

C

Question 3

Over-the-counter (OTC) pregnancy tests usually rely on which technology to test for human chorionic gonadotropin (hCG)?
a. Radioimmunoassay
b. Radioreceptor assay
c. Latex agglutination test
d. Enzyme-linked immunosorbent assay (ELISA)

Answer 3

D

Question 4

Which presumptive sign or symptom of pregnancy would a woman at 10 weeks of gestation most likely have?
a. Amenorrhea
b. Positive pregnancy test
c. Chadwick’s sign
d. Hegar’s sign

Answer 4

A

Question 5

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 which is a positive sign of pregnancy?
a. A positive pregnancy test
b. Fetal movement palpated by the nurse
c. Braxton Hicks contractions
d. Quickening

Answer 5

B

Question 6

A woman is at 14 weeks of gestation. The nurse would expect to palpate the fundus at which level?
a. The fundus is not palpable above the symphysis at this time.
b. Slightly above the symphysis pubis
c. At the level of the umbilicus
d. Slightly above the umbilicus

Answer 6

B

Question 7

During a patient’s physical examination the nurse notes that the lower uterine segment is soft on palpation. How would the nurse document this finding?
a. Hegar’s sign
b. McDonald’s sign
c. Chadwick’s sign
d. Goodell’s sign

Answer 7

A

Question 8

Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester?
a. Less audible heart sounds (S1, S2)
b. Increased pulse rate
c. Increased blood pressure
d. Decreased red blood cell (RBC) production

Answer 8

B

Question 9

A number of changes in the integumentary system occur during pregnancy. What change persists after birth?
a. Epulis
b. Chloasma
c. Telangiectasia
d. Striae gravidarum

Answer 9

D

Question 10

The musculoskeletal system adapts to the changes that occur during pregnancy. A pregnant woman can expect to experience which change?
a. Her centre 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.

Answer 10

B

Question 11

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 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?
a. She took the pregnancy test too early.
b. She takes anticonvulsants.
c. She has a fibroid tumour.
d. She has been under considerable stress and has a hormone imbalance.

Answer 11

B

Question 12

A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. How should the nurse interpret this complaint?
a. This is a normal change in pregnancy caused by elevated levels of estrogen.
b. This is an abnormal cardiovascular alteration as nosebleeds are an ominous sign.
c. She is a victim of domestic violence and is being hit in the face by her partner.
d. She has most likely been using cocaine intranasally.

Answer 12

A

Question 13

Which hormone is essential for maintaining pregnancy?
a. Estrogen
b. Human chorionic gonadotropin (hCG)
c. Oxytocin
d. Progesterone

Answer 13

D

Question 14

Which gastrointestinal change during pregnancy would alert the nurse that the woman requires further assessment?
a. Ptyalism
b. Pyrosis
c. Pica
d. Decreased peristalsis

Answer 14

C-DESIRE TO EAT NONFOOD SUBSTANCES

Question 15

Why may appendicitis be difficult to diagnose in pregnancy?
a. The appendix is displaced upward and laterally, high and to the right.
b. The appendix is displaced upward and laterally, high and to the left.
c. The appendix is deep at McBurney point.
d. The appendix is displaced downward and laterally, low and to the right.

Answer 15

A

Question 16

What is the term given to a woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability?
a. Primipara
b. Primigravida
c. Multipara
d. Nulligravida

Answer 16

A

Question 17

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 greater than 500 g)
b. Term—pregnancy from the beginning of week 37 to the end of week 40 plus 6 days’ gestation
c. Preterm—pregnancy from 20 to 28 weeks
d. Postdate—pregnancy that extends beyond 38 weeks

Answer 17

B

Question 18

Human chorionic gonadotropin (hCG) is an important biochemical marker for pregnancy and is thus the basis for many tests. Which should the nurse be aware of in relation to hCG?
a. hCG can be detected as early as 2.5 weeks after conception.
b. 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.

Answer 18

D

Question 19

Which should the nurse be aware of in order to reassure and educate pregnant patients about changes in the uterus during pregnancy?
a. Lightening occurs near the end of the second trimester as the uterus rises into a different position.
b. The woman’s increased urinary frequency in the first trimester is the result of exaggerated uterine anteflexion.
c. Braxton Hicks contractions become more painful in the third trimester, particularly if the woman tries to exercise.
d. The uterine souffle is the movement of the fetus.

Answer 19

B

Question 20

Which should the nurse be aware of in order to reassure and educate pregnant patients about changes in the cervix, vagina, and position of the fetus during pregnancy?
a. Because of a number of changes in the cervix, abnormal Papanicolaou (Pap) tests are much easier to evaluate.
b. Quickening is a technique of palpating the fetus to engage it in passive movement.
c. The deepening colour of the vaginal mucosa and cervix (Chadwick’s sign) usually appears in the second trimester or later as the vagina prepares to stretch during labour.
d. Increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester.

Answer 20

D

Question 21

What is the term given to the mucous plug that forms in the endocervical canal?
a. Operculum
b. Leucorrhea
c. Funic souffle
d. Ballottement

Answer 21

A

Question 22

Which is important for the nurse to know in order to be able to reassure and educate pregnant patients about changes in their breasts?
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 labour.
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.

Answer 22

C

Question 23

Which is important for the nurse to know in order to be able to reassure and educate pregnant patients about changes in their cardiovascular system during pregnancy?
a. A pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia, requires close medical and obstetrical observation.
b. Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term.
c. Palpitations are twice as likely to occur in twin gestations.
d. Blood pressure increases until about 24 to 32 weeks of gestation.

Answer 23

B

Question 24

Which change in the blood pressure of pregnant women should the nurse be aware of in order to educate the patient?
a. A blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high.
b. Shifting the patient’s position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading.
c. The systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant.
d. Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy.

Answer 24

D

Question 25

Some pregnant patients may complain of changes in their voice and impaired hearing. To what can the nurse ascribe these common reactions?
a. Decreased estrogen level
b. Displacement of the diaphragm, resulting in abdominal breathing
c. Increased vascularity of the upper respiratory tract
d. Increased blood volume

Answer 25

C

Question 26

Which is important for the nurse to know in order to be able to reassure and educate pregnant patients about the functioning of their kidneys in eliminating waste products during pregnancy?
a. Increased urinary output makes pregnant women less susceptible to urinary infection.
b. Increased bladder sensitivity and later compression of the bladder by the enlarging uterus result in the urge to urinate even if the bladder is almost empty.
c. Renal (kidney) function is more efficient when the woman assumes a supine position.
d. Using diuretics during pregnancy can help keep kidney function regular.

Answer 26

B

Question 27

Which statement about a condition of pregnancy is accurate?
a. Insufficient salivation (ptyalism) is caused by increases in estrogen.
b. Acid indigestion (pyrosis) begins early but declines throughout pregnancy.
c. Hyperthyroidism often develops (temporarily) because hormone production increases.
d. Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial.

Answer 27

D

Question 28

What should the nurse teach the patient in relation to Braxton Hicks contractions?
a. They are painless.
b. They increase with walking.
c. They cause cervical dilation.
d. They impede oxygen flow to the fetus.

Answer 28

A

Question 29

The diagnosis of pregnancy is based on which positive sign of pregnancy?
a. Positive hCG test
b. Palpation of fetal outline
c. Ballottement
d. Verification of fetal movement

Answer 29

D

Question 30

A woman is in for a routine prenatal checkup. You are assessing her urinary system. Which finding is considered abnormal?
a. Decreased blood urea nitrogen (BUN)
b. Increased glomerular filtration rate (GFR)
c. Increased bladder capacity
d. Increased proteinuria

Answer 30

D