Exam 1 Flashcards

Question

Where does the placenta most commonly develop in a healthy pregnancy? A. Lower uterine segment B. Cervical os C. Fundus of the uterus D. Posterior uterine wall

Answer 1

C. Fundus of the uterus Rationale: The placenta most commonly develops in the fundus of the uterus, which is the upper portion. This location supports optimal fetal development and uterine contractions during delivery. Placental implantation near the cervix or lower uterine segment can lead to complications such as placenta previa.

Answer 2

C. Human chorionic gonadotropin (hCG) Rationale: The placenta produces human chorionic gonadotropin (hCG) to maintain the corpus luteum, which secretes progesterone necessary for pregnancy maintenance in the early stages. While estrogen is also produced, hCG plays a critical early role.

Answer 3

B. Preventing maternal antibodies from attacking fetal cells Rationale: The placenta provides immune tolerance by preventing maternal immune cells from attacking the genetically distinct fetus. This immunological protection ensures fetal development proceeds without rejection from the mother’s immune system.

Answer 4

A. Providing oxygen and nutrients via the maternal blood supply Rationale: The placenta functions as the site of nutrient and oxygen transfer from the mother to the fetus since the fetal lungs remain collapsed and non-functional for oxygen exchange during intrauterine life.

Answer 5

C. By secreting immunosuppressive factors Rationale: The placenta secretes immunosuppressive factors and hormones that help modulate the maternal immune system, reducing the risk of an immune attack against the fetus.

Answer 6

B. Human placental lactogen (hPL) Rationale: Human placental lactogen (hPL) is produced by the placenta and plays a significant role in fetal growth by modulating maternal metabolism, increasing nutrient availability to the fetus.

Answer 7

A. It acts as a surrogate lung for oxygen exchange Rationale: The placenta acts as a surrogate lung for the fetus, allowing oxygen and carbon dioxide exchange while the fetal lungs remain collapsed and non-functional in utero.

Answer 8

a. Human placental lactogen (HPL)

Answer 9

a. Human placental lactogen (HPL)

Answer 10

a. Human placental lactogen (HPL)

Answer 11

b. Estrogen

Answer 12

c. Progesterone

Answer 13

d. Relaxin

Answer 14

a. Human chorionic gonadotropin (hCG)

Answer 15

B. Refer the patient to community support groups and parental counseling. Rationale: Transitioning into parental roles can be challenging. Providing support groups and parental counseling can help the mother feel less isolated and better equipped to handle her new responsibilities. Encouraging community support is effective in promoting adaptive coping mechanisms. Options A, C, and D either limit the patient’s choices or are inappropriate for fostering a supportive and adaptive environment.

Answer 16

B. “Genetic counseling can help you better understand the risk and testing options available for your child.” Rationale: Genetic counseling is the most appropriate option for helping the patient understand genetic risks, inheritance patterns, and available tests. It respects the patient’s autonomy and helps in informed decision-making. Option A is incorrect as cystic fibrosis affects both genders. Option C is inaccurate as prenatal testing is possible, and Option D is not an appropriate response and fails to provide supportive guidance.

Answer 17

C. Addressing immediate safety and providing referrals to shelters if needed. Rationale: Patient safety is a priority when addressing healthcare needs in high-violence communities. Ensuring access to shelters or safety resources can protect the patient from harm. While community advocacy (Option B) and recreational activities (Option A) may have long-term value, immediate safety concerns must be prioritized. Option D is impractical and may not be a feasible solution for many patients.

Answer 18

B. “My social role as a caregiver makes it easier for me to prioritize self-care.” Rationale: This statement requires further education, as caregiving roles often lead to challenges in self-care prioritization due to demanding responsibilities. Media and social roles can contribute to stressors and influence self-perception and body image, but caregivers often struggle to balance responsibilities with personal health needs.

Answer 19

false; Health Screenings are part of Secondary Prevention

Answer 20

primary prevention

Answer 21

secondary prevention

Answer 22

tertiary prevention

Answer 23

cultural humility

Answer 24

absent variability

Answer 25

marked variability

Answer 26

minimal variability

Answer 27

moderate variability

Answer 28

acceleration

Answer 29

deceleration

Answer 30

acceleration

Answer 31

cord compression

Answer 32

head compression

Answer 33

oxygen or okay

Answer 34

placental insufficiency

Answer 35

left side lying

Answer 36

IV fluid bolus (lactated Ringer's 500)

Answer 37

notifty provider

Answer 38

stop pitocin

Answer 39

genetic counseling

Answer 40

50 years or older

Answer 41

b. Contractions lasting 40-90 seconds, occurring every 2-5 minutes rationale: In active labor, a normal contraction pattern includes contractions lasting 40-90 seconds with a frequency of 2-5 minutes. Patterns lasting too long or too frequent may indicate hyperstimulation, which can cause fetal distress.

Answer 42

d. Discontinue oxytocin and notify the healthcare provider Rationale: Contractions that occur every minute and last 100 seconds represent uterine tachysystole, which may compromise uteroplacental perfusion. Discontinuing oxytocin is a priority to reduce contraction frequency and prevent fetal compromise.

Answer 43

a. Adequate labor progression Rationale: In active labor, contractions lasting around 60-90 seconds and occurring every 2-5 minutes are typical. This pattern is adequate for effective labor.

Answer 44

a. Stay at home and time contractions Rationale: Contractions every 10 minutes are typical of early labor. The client should be instructed to stay at home and monitor contraction timing and intensity until they become closer together and more regular.

Answer 45

a. Contractions with normal duration and frequency Rationale: Contractions every 2-5 minutes, lasting 40-90 seconds, are expected during active labor. The documented pattern is within the normal range.

Answer 46

b. Contractions every 2 minutes lasting 120 seconds Rationale: Contractions lasting over 90 seconds and occurring every 2 minutes or less can lead to uterine hyperstimulation and fetal distress, requiring immediate intervention.

Answer 47

c. Continue to monitor the client without intervention Rationale: Contractions every 2-5 minutes, lasting 60-90 seconds, indicate effective labor progression and generally do not require immediate intervention unless there are signs of fetal or maternal distress.

Answer 48

a. Latent phase Rationale: In the latent phase of labor, contractions are less frequent (every 5-20 minutes) and shorter in duration (up to 30-45 seconds).

Answer 49

c. Continue monitoring labor progress and fetal status Rationale: Contractions every 2-5 minutes, lasting 60-90 seconds, are typical for active labor, especially with a normal fetal heart rate. No intervention is required other than continued monitoring.

Answer 50

B. To assess for potential genetic disorders within the family Rationale: Constructing a pedigree focuses on tracing the family history across multiple generations to identify patterns that may suggest a hereditary genetic disorder. This is essential for genetic counseling, especially if there are known genetic disorders in the family.

Answer 51

D. The chance of chromosomal abnormalities increases with maternal age.

Answer 52

C. Conduct genetic testing to determine possible hereditary causes for recurrent pregnancy loss. Rationale: Recurrent pregnancy loss (more than five miscarriages) may indicate an underlying genetic disorder. Genetic counseling and testing can help identify potential chromosomal or genetic issues that could be contributing factors.

Answer 53

C. Provide education on genetic inheritance patterns and testing options for at-risk individuals. Rationale: Genetic counseling involves educating the patient about genetic inheritance, assessing risks, and offering testing options to those who may be at risk of passing or inheriting the genetic disorder. This enables informed decision-making regarding health and reproduction.

Answer 54

chromosomal abnormalities

Answer 55

B. Deletion or imprinting defect on paternal chromosome 15 Rationale: Prader-Willi syndrome occurs due to a deletion or imprinting defect on the paternal chromosome 15 or when two maternal copies are present, leading to absent paternal genetic information.

Answer 56

D. Males and females equally Rationale: Prader-Willi syndrome affects males and females equally.

Answer 57

A. Excessive eating and obesity Rationale: Children with Prader-Willi syndrome often have excessive eating, leading to obesity, along with behavioral and compulsive challenges.

Answer 58

B. Compulsive behaviors and tantrums Rationale: Patients with Prader-Willi syndrome often experience compulsive behaviors and behavioral challenges, including tantrums.

Answer 59

B. It may involve having two copies of chromosome 15 from the mother. Rationale: Prader-Willi syndrome can occur due to two copies of chromosome 15 being inherited from the mother (uniparental disomy), resulting in the absence of a functional paternal copy.

Answer 60

D. 1 in 10,000 to 1 in 15,000 individuals

Answer 61

C. Decreased muscle tone and poor muscle strength Rationale: Hypotonia, or decreased muscle tone, is a common symptom in Prader-Willi syndrome and often manifests as poor muscle strength and reduced tone.

Answer 62

B. Focusing on weight management and balanced nutrition Rationale: Children with Prader-Willi syndrome require a structured plan to prevent excessive eating and obesity, including weight management and balanced nutrition.

Answer 63

C. DNA methylation testing Rationale: DNA methylation testing is used to detect Prader-Willi syndrome by identifying abnormal methylation patterns associated with paternal chromosome 15.

Answer 64

B. "The disorder affects the brain's ability to control hunger." Rationale: In Prader-Willi syndrome, the hypothalamus in the brain does not properly signal hunger and satiety, leading to constant hunger and excessive eating.

Answer 65

a) Hyperactivity and a large head Rationale: Fragile X syndrome often presents with hyperactivity, large head size, long face, and intellectual disability, among other features. Seizures and short stature, early Alzheimer’s, and immune deficiency are not the most characteristic features of fragile X syndrome.

Answer 66

b) Females can be carriers and are typically mildly affected, while males exhibit the full effects of the syndrome. Rationale: Fragile X syndrome is an X-linked disorder; females are often carriers with milder symptoms due to their second normal X chromosome, while males with a single affected X chromosome tend to exhibit more severe symptoms.

Answer 67

c) Occupational, speech, and physical therapy Rationale: There is no cure for fragile X syndrome, so treatment focuses on supportive therapies such as occupational, speech, and physical therapy to help manage developmental delays and improve quality of life.

Answer 68

a) Perseverative speech and poor eye contact Rationale: Fragile X syndrome commonly manifests as perseverative speech (repeating words/phrases), poor eye contact, and other behaviors such as tactile defensiveness and hyperactivity, making it distinct from unrelated conditions.

Answer 69

b) Promoting speech and occupational therapy to address developmental delays Rationale: Supporting therapies, including speech and occupational therapy, are critical interventions for children with fragile X syndrome to address developmental delays and enhance skills.

Answer 70

a) Lifespan of the individual Rationale: Fragile X syndrome is associated with intellectual and behavioral disabilities but typically does not affect the lifespan.

Answer 71

a) Fragile sites on the X chromosome causing breaks and gaps Rationale: Fragile X syndrome results from structural abnormalities on the X chromosome, such as breaks and gaps, which are associated with intellectual disability.

Answer 72

b) “The disorder is not included because it does not meet established criteria for newborn screening recommendations.” Rationale: Fragile X syndrome does not meet the established criteria for inclusion in newborn screening panels, despite its impact, because of factors such as testing feasibility and public health implications.

Answer 73

d) Females only Rationale: Turner syndrome affects only females and results from a missing or partially missing X chromosome. Males are not affected by this condition.

Answer 74

b) Infertility and underdeveloped sex organs Rationale: Turner syndrome commonly leads to infertility and underdevelopment of sex organs, including the failure to develop secondary sexual characteristics such as breasts and ovaries.

Answer 75

c) Short stature and delayed puberty Rationale: Girls with Turner syndrome often experience short stature, delayed puberty, and underdeveloped sex organs. Development of breasts and normal ovaries typically does not occur without intervention.

Answer 76

a) During prenatal screening/testing Rationale: Turner syndrome can be identified during prenatal testing, as well as at other stages of development such as in childhood or adolescence, depending on symptom presentation.

Answer 77

d) Absence or structural defect of one X chromosome Rationale: Turner syndrome is caused by a missing or structurally altered X chromosome in females, leading to a range of developmental issues.

Answer 78

a) Hormone replacement therapy Rationale: Hormone replacement therapy, such as estrogen therapy, is often used to promote secondary sexual characteristics and overall health in girls with Turner syndrome.

Answer 79

c) Cardiovascular anomalies Rationale: Girls with Turner syndrome may experience cardiovascular complications, such as congenital heart defects, in addition to other health issues like kidney malformations and hearing problems.

Answer 80

b) “I may need assisted reproductive technology due to infertility.” Rationale: Turner syndrome can lead to infertility, and many women with the condition require assisted reproductive technology if they wish to conceive.

Answer 81

d) Growth hormone therapy to stimulate height Rationale: Growth hormone therapy is commonly used to promote height and growth in children with Turner syndrome, as they typically experience short stature due to the condition.

Answer 82

c) XXY Rationale: Klinefelter syndrome occurs in males who have an extra X chromosome (XXY pattern), leading to the characteristic features of this condition.

Answer 83

b) Tall stature with sparse body hair Rationale: Males with Klinefelter syndrome often have tall stature, sparse body hair, and other features such as enlarged breasts (gynecomastia) and abnormal testicular development.

Answer 84

d) Infertility due to abnormal testicular development Rationale: Infertility is common in males with Klinefelter syndrome due to the abnormal development of the testes, leading to decreased sperm production and low testosterone levels.

Answer 85

c) At puberty, when physical symptoms such as gynecomastia may appear Rationale: Klinefelter syndrome is often diagnosed around puberty when signs like enlarged breasts (gynecomastia) and other developmental abnormalities become more apparent.

Answer 86

a) Surgical removal of breast tissue Rationale: Surgical removal of breast tissue (mastectomy) is an option for males with Klinefelter syndrome who develop gynecomastia and wish to address this issue for cosmetic or health reasons.

Answer 87

b) Klinefelter syndrome Rationale: The symptoms described, including tall stature, sparse body hair, and potential learning difficulties, align with features of Klinefelter syndrome, a condition affecting males with an extra X chromosome.

Answer 88

c) Testosterone replacement therapy Rationale: Testosterone replacement therapy is often used in males with Klinefelter syndrome to address symptoms related to low testosterone, such as sparse body hair, reduced muscle mass, and energy levels.

Answer 89

c) Mild intellectual disabilities, such as learning difficulties Rationale: Males with Klinefelter syndrome may experience mild intellectual disabilities, often manifesting as learning difficulties, language delays, or challenges with executive functioning, though severity can vary.

Answer 90

C. Three copies of chromosome 21 in all cells. Rationale: Trisomy 21 occurs when there are three copies of chromosome 21 in all cells, making it the most common cause of Down syndrome.

Answer 91

C. Risk increases with advancing maternal age. Rationale: The risk of having a baby with Down syndrome increases with maternal age, particularly after the age of 35.

Answer 92

C. Absence of palmar creases. Rationale: Small, low-set ears that may fold over at the pinna are among the characteristic features seen in individuals with Down syndrome.

Answer 93

B. Poor muscle tone and flexibility. Rationale: Hypotonia, or poor muscle tone, is common in children with Down syndrome and often results in increased flexibility.

Answer 94

B. Part of chromosome 21 becoming attached to another chromosome. Rationale: A translocation involves part of chromosome 21 attaching to another chromosome, resulting in an extra piece of chromosome 21 in affected cells.

Answer 95

D. A deep crease that runs across the palm. Rationale: A simian crease is characterized by a single deep crease that runs across the palm and is commonly seen in individuals with Down syndrome.

Answer 96

A. The average lifespan of individuals with Down syndrome is approaching 60 years. Rationale: The life expectancy of individuals with Down syndrome has increased significantly in recent years, with an average lifespan approaching 60 years.

Answer 97

B. Early intervention programs and special education. Rationale: Early intervention and special education programs play a crucial role in promoting cognitive and developmental progress for children with Down syndrome.

Answer 98

C. “The risk is approximately one in 353.” Rationale: The risk of having a baby with Down syndrome at age 35 is approximately one in 353.

Answer 99

B. They frequently result in severe structural abnormalities. Rationale: Trisomy 13 and trisomy 18 result in severe structural abnormalities, which may include microcephaly, cleft lip/palate, and major heart defects, often detected during ultrasound examinations.

Answer 100

C. Survival beyond a few months is rare. Rationale: The prognosis for infants with trisomy 18 is poor, with most affected individuals not surviving beyond a few months.

Answer 101

A. Trisomy 13 or 18 Rationale: Trisomy 13 and trisomy 18 are associated with severe structural abnormalities, such as microcephaly, cleft lip/palate, and major heart defects, often detectable on ultrasound

Answer 102

D. Providing palliative care and managing symptoms for quality of life.

Answer 103

B. Microcephaly and major heart defects Rationale: Common abnormalities associated with trisomy 13 include microcephaly and major heart defects, often detected during prenatal ultrasounds.

Answer 104

C. It is done between 15-20 weeks of pregnancy and has a lower risk of pregnancy loss compared to CVS. Rationale: Amniocentesis is performed between 15-20 weeks of pregnancy and carries a lower risk of pregnancy loss compared to CVS, which is done earlier in the pregnancy.

Answer 105

B. CVS is performed early at 10-12 weeks but carries a higher risk of pregnancy loss compared to amniocentesis. Rationale: Chorionic villi sampling (CVS) is conducted at 10-12 weeks of pregnancy and has a higher risk of pregnancy loss compared to amniocentesis.

Answer 106

C. It analyzes an individual's chromosomes to detect genetic abnormalities. Rationale: A karyotype is a laboratory test that analyzes an individual's chromosomes to identify genetic abnormalities and confirm diagnoses.

Answer 107

D. Microarray analysis Rationale: Microarray analysis is used to diagnose genetic conditions that karyotyping alone cannot identify, offering more detailed genetic information.

Answer 108

B. "Pregnancy should never be terminated based on screening results alone." Rationale: Screening results alone are not definitive and should not be used as the basis for terminating a pregnancy; diagnostic testing is required for confirmation.

Answer 109

C. It provides a karyotype for diagnosing genetic abnormalities and is considered a diagnostic test. Rationale: Amniocentesis is used to obtain a karyotype for diagnosing genetic abnormalities and is considered a diagnostic test. It is performed between 15-20 weeks of pregnancy.

Answer 110

A. Diagnostic tests, such as karyotyping and microarray, confirm genetic conditions, whereas screening tests provide risk assessments. Rationale: Diagnostic tests, such as karyotyping and microarray analysis, confirm the presence of genetic conditions, whereas screening tests assess the risk but do not provide a definitive diagnosis.

Answer 111

B. It provides a more comprehensive risk assessment for chromosomal abnormalities. Rationale: First trimester screening combined with second trimester screening (quad screen) is not limited to women over 35 years old and offers a comprehensive assessment by measuring multiple factors, including blood markers, enhancing the detection of chromosomal abnormalities.

Answer 112

C. Cell-free DNA testing Rationale: Cell-free DNA testing is recommended for women over 35 and uses a sample of the mother’s blood to detect fetal DNA, providing accurate screening results for chromosomal conditions.

Answer 113

C. It may not be as accurate as combined screenings. Rationale: MSAFP alone is less accurate compared to when it is part of combined screenings like the quad screen, which improves the detection of chromosomal abnormalities through additional blood markers.

Answer 114

A. Optimal timing for accuracy varies between tests. Rationale: Many genetic screening tests require specific timing during pregnancy to achieve accurate results. For example, the first trimester combined screening needs to be done within the appropriate gestational age window.

Answer 115

B. Cell-free DNA testing Rationale: Cell-free DNA testing can accurately predict fetal gender and detect chromosomal conditions such as Trisomy 21 (Down syndrome) with a high level of predictive accuracy.

Answer 116

A. "This test can be performed any time after 10 weeks gestation." Rationale: Cell-free DNA testing can be done any time after 10 weeks gestation, making it an early option for detecting chromosomal abnormalities.

Answer 117

D. Blood markers to enhance detection of abnormalities Rationale: Nuchal translucency measurement is combined with blood markers to provide a more accurate assessment of potential chromosomal abnormalities.

Answer 118

B. It detects a fetal fraction of DNA and has 99.7% predictive value for detecting certain chromosomal conditions. Rationale: Cell-free DNA testing detects fetal DNA in the maternal bloodstream and has a high predictive value for conditions like Trisomy 21, 18, and 13, and can also reveal fetal gender.

Answer 119

A. Follicle Stimulating Hormone (FSH) Rationale: FSH increases during the follicular phase, leading to the maturation of multiple follicles in the ovaries and preparing the ovum for potential fertilization

Answer 120

B. Becomes thin, clear, and stretchy Rationale: Cervical mucus changes to a thin, clear, and stretchy consistency during ovulation to facilitate the movement of sperm toward the ovum.

Answer 121

A. High levels of estrogen produced by the mature follicle Rationale: A surge in LH is triggered by rising estrogen levels from the mature follicle, resulting in ovulation.

Answer 122

C. Progesterone Rationale: The corpus luteum produces progesterone during the luteal phase to prepare the endometrium for possible implantation of a fertilized ovum.

Answer 123

B. Degeneration of the corpus luteum Rationale: Without fertilization, the corpus luteum degenerates, leading to a drop in ovarian hormones and triggering menstruation.

Answer 124

B. Ischemic phase Rationale: If fertilization does not occur, a drop in estrogen and progesterone leads to the ischemic phase, resulting in the involution of the endometrium and the onset of menstruation.

Answer 125

B. 3-7 days

Answer 126

A. Estrogen and progesterone Rationale: High levels of estrogen and progesterone suppress LH secretion, maintaining the cycle’s hormonal balance until the corpus luteum’s cessation.

Answer 127

D. Left or right lower quadrant pain Rationale: Ovulation may present with signs such as localized lower abdominal pain, often referred to as mittelschmerz.

Answer 128

B. Estrogen Rationale: Estrogen plays a key role in stimulating the proliferation of the endometrium during the follicular phase leading up to ovulation.

Answer 129

A. Spasm of arterioles and involution of the endometrium Rationale: The ischemic phase involves a drop in these hormones, causing endometrial involution, arteriolar spasms, and ultimately menstruation.

Answer 130

C. Luteinizing Hormone (LH) Rationale: The surge in LH, triggered by high estrogen levels, directly precedes ovulation.

Answer 131

B. Hypothalamus Rationale: GnRH is secreted by the hypothalamus in a pulsatile manner to regulate the release of FSH and LH from the anterior pituitary gland.

Answer 132

A. Ovulation Rationale: The surge in LH levels leads to ovulation by triggering the rupture of the mature follicle.

Answer 133

C. Production of estrogen and progesterone by the corpus luteum Rationale: After the corpus luteum is formed, it begins to secrete estrogen and progesterone to support the luteal phase

Answer 134

B. Causes degeneration Rationale: The absence of LH leads to the degeneration of the corpus luteum, resulting in a decline in estrogen and progesterone levels.

Answer 135

D. The first week of the follicular phase Rationale: FSH secretion peaks during the first week of the follicular phase to promote follicular maturation.

Answer 136

B. Luteinizing Hormone (LH) Rationale: LH is essential for the final maturation and luteinization of preovulatory follicles.

Answer 137

B. Estrogen Rationale: Estrogen is predominant at the end of the proliferative phase, leading to endometrial proliferation and preparation for ovulation.

Answer 138

A. A day before ovulation Rationale: Estrogen levels drop just before ovulation as LH and progesterone become more dominant.

Answer 139

B. Inhibits contractions Rationale: Progesterone is known as the hormone of pregnancy due to its calming effect, reducing uterine contractions to maintain a stable environment for potential pregnancy.

Answer 140

D. Estrogen Rationale: Estrogen induces the proliferation of the endometrial glands and increases the size and weight of the uterus.

Answer 141

C. Estrogen and progesterone Rationale: The decline in ovarian hormones estrogen and progesterone leads to the end of the negative feedback loop on LH secretion, initiating a new menstrual cycle.

Answer 142

B. Damage to estrogen-producing cells Rationale: The LH surge causes damage to estrogen-producing cells, leading to a decline in estrogen levels after ovulation.

Answer 143

D. Luteal phase Rationale: During the luteal phase, progesterone induces swelling and increased secretion of the endometrium, preparing it for potential implantation.

Answer 144

B. Estrogen and progesterone Rationale: High levels of estrogen and progesterone suppress LH output as part of hormonal regulation during the menstrual cycle.

Answer 145

C. 5-7 days after ovulation Rationale: Progesterone levels peak during the luteal phase, typically 5-7 days after ovulation, to support endometrial changes.

Answer 146

C. Estrogen and progesterone Rationale: The corpus luteum produces estrogen and progesterone to maintain the luteal phase and prepare the endometrium for potential implantation.

Answer 147

A. GnRH Rationale: GnRH from the hypothalamus induces the anterior pituitary gland to release FSH and LH, which are crucial for ovulation.

Answer 148

B. Ovulatory phase Rationale: Estrogen levels peak during the ovulatory phase, leading to the LH surge necessary for ovulation.

Answer 149

B. It helps to prevent neural tube defects in the developing fetus. Rationale: Folic acid is critical in preventing neural tube defects such as spina bifida and anencephaly in the developing fetus. It is especially important during early pregnancy.

Answer 150

C. 600 micrograms Rationale: The recommended daily intake for folic acid during pregnancy is 600 micrograms to support fetal development and prevent neural tube defects.

Answer 151

B. "Iron supplementation can help prevent anemia, which is common in pregnancy." Rationale: Iron supplementation is important during pregnancy to prevent iron-deficiency anemia, which can lead to complications such as preterm delivery and low birth weight.

Answer 152

A. Leafy green vegetables and red meat Rationale: Iron-rich foods include leafy green vegetables and red meat. Vitamin C from citrus fruits can enhance iron absorption when consumed together.

Answer 153

B. Take iron supplements on an empty stomach with a glass of orange juice. Rationale: Iron is best absorbed on an empty stomach, and the vitamin C in orange juice enhances iron absorption. Calcium and dairy products inhibit iron absorption.

Answer 154

C. A balanced diet with fruits, vegetables, and whole grains is essential. Rationale: A balanced diet including fruits, vegetables, whole grains, and protein supports maternal and fetal health. Fish low in mercury is also recommended.

Answer 155

B. The fetal neural tube closes within the first month. Rationale: The neural tube forms and closes in the early weeks of pregnancy, making adequate folic acid intake crucial to reduce the risk of neural tube defects.

Answer 156

A. Increase fiber intake and hydration. Rationale: Iron supplements can lead to constipation. Increasing fiber intake and drinking more water can help manage this common side effect.

Answer 157

C. It may contribute to low birth weight and preterm birth. Rationale: Inadequate maternal iron intake is linked to complications such as preterm birth and low birth weight due to maternal anemia.

Answer 158

C. Fill half the plate with fruits and vegetables. Rationale: Healthy eating guidelines for pregnant women emphasize filling half of each plate with fruits and vegetables to ensure adequate intake of essential nutrients.

Answer 159

B. Take iron at bedtime with a snack. Rationale: Taking iron supplements at bedtime with a small snack can help reduce gastrointestinal discomfort, which is a common side effect.

Answer 160

A. Eat at least two servings of fish per week, avoiding high-mercury fish. Rationale: Pregnant women should consume fish to benefit from omega-3 fatty acids but must avoid fish high in mercury for the baby's safety.

Answer 161

B. It must be taken with calcium to work effectively. Rationale: Folic acid does not need to be taken with calcium for effectiveness; its primary benefit is reducing the risk of neural tube defects.

Answer 162

B. Combine supplements with folic acid-rich foods. Rationale: Combining supplements with a diet rich in folic acid ensures adequate intake, supporting fetal development and reducing the risk of birth defects.

Answer 163

C. Eat more high-fiber foods and drink water. Rationale: High-fiber foods and adequate hydration help prevent constipation, a common side effect of iron supplementation during pregnancy.

Answer 164

presumptive

Answer 165

a. thyroid gland

Answer 166

b. pituitary gland

Answer 167

c. pancreas

Answer 168

d. adrenal gland

Answer 169

e. prostaglandin secretion

Answer 170

f. placental secretion

Answer 171

add 7 days and 9 months from the LMP

Answer 172

(gravida): the total number of pregnancies, regardless if terminated or multiples(twins/triplets)

Answer 173

(term births): the number of pregnancies ending >37 weeks’ gestation, at term

Answer 174

(preterm births): the number of preterm pregnancies ending >20 weeks or viability but before completion of 37 weeks

Answer 175

(abortions): the number of pregnancies ending before 20 weeks or viability

Answer 176

L (living children): number of children currently living

Answer 177

dad is experiencing the same symptoms as mom

Answer 178

C) "Sleep on your left side to improve blood flow to the placenta and kidneys." Rationale: Sleeping on the left side improves blood flow to the placenta and kidneys, promoting better oxygen and nutrient supply to the fetus. It also helps reduce the risk of swelling and improves circulation. Sleeping on the back in the second and third trimesters can compress major blood vessels, leading to reduced blood flow and discomfort.

Answer 179

B) "Sexual activity is safe as long as there are no complications like bleeding or preterm labor." Rationale: Sexual activity is generally safe during pregnancy unless complications, such as vaginal bleeding, preterm labor, or ruptured membranes, are present. It’s important to have open communication with the healthcare provider if there are any concerns.

Answer 180

A) "Limit the amount of time spent sitting and take short breaks to stretch and move around." Rationale: To promote self-care, pregnant women should avoid prolonged periods of sitting or standing. Taking frequent breaks to stretch and move around helps reduce the risk of complications such as swelling, varicosities, and back pain. It is generally safe to work throughout pregnancy unless advised otherwise by a healthcare provider.

Answer 181

C) "Make sure to take breaks every 1-2 hours to stretch your legs and avoid deep vein thrombosis (DVT)." Rationale: Traveling by car during the third trimester is generally safe, but long trips should include regular breaks every 1-2 hours to stretch and improve circulation. This helps prevent the development of deep vein thrombosis (DVT) and relieves discomfort. It's important to stay hydrated and wear a seatbelt properly for safety.

Answer 182

B) "Always consult your healthcare provider before using any medications, including over-the-counter drugs." Rationale: Many over-the-counter medications are not recommended during pregnancy due to potential risks to the developing fetus. It is important for pregnant women to consult their healthcare provider before taking any medications to ensure safety for both the mother and the fetus.

Answer 183

C. Presumptive signs of pregnancy Rationale: Presumptive signs of pregnancy are subjective signs that the woman reports, such as amenorrhea, nausea, fatigue, breast tenderness, and urinary frequency. They are the least reliable indicators because these signs can be attributed to other conditions, such as endocrine dysfunction, stress, or infections.

Answer 184

B. They may indicate pregnancy but are not definitive. Rationale: Presumptive signs are subjective changes that may suggest pregnancy but are not conclusive as they can be caused by a variety of conditions. Definitive confirmation requires probable or positive signs.

Answer 185

D. Nausea and vomiting Rationale: Nausea and vomiting are considered a presumptive sign because they can be experienced by pregnant women but may also be due to gastrointestinal disturbances, infections, or other conditions. Positive pregnancy tests, Chadwick’s sign, and palpable fetal movement are more definitive indicators.

Answer 186

A. History of recent sexual activity and missed periods Rationale: Urinary frequency is a presumptive sign that can be related to pregnancy, but it is important to assess other factors, such as missed menstrual periods and sexual history. This can provide more context for the possibility of pregnancy.

Answer 187

B. Many presumptive signs can be explained by other medical or physiological conditions. Rationale: Presumptive signs, such as amenorrhea and fatigue, may occur for reasons unrelated to pregnancy, including stress, endocrine disorders, or nutritional deficiencies. Thus, they are not definitive indicators of pregnancy on their own.

Answer 188

D. Goodell sign Rationale: The softening of the cervix is referred to as Goodell sign and is a probable sign of pregnancy. Chadwick sign is a bluish-purple coloration of the cervix and vaginal mucosa, Hegar sign refers to the softening of the lower uterine segment, and ballottement is the rebounding of the fetus when pushed during an exam.

Answer 189

C. hCG levels double every 48 to 72 hours during early pregnancy. Rationale: In early pregnancy, hCG levels typically double every 48 to 72 hours, making it an important biochemical marker for pregnancy detection. Levels below 5 mIU/mL are considered negative for pregnancy, while levels above 25 mIU/mL are considered positive. hCG is detectable in the serum of over 98% of clients by day 11 after conception.

Answer 190

C. Chadwick sign Rationale: Chadwick sign is a probable sign of pregnancy characterized by a bluish-purple coloration of the vaginal mucosa and cervix due to increased blood flow. Goodell sign refers to cervical softening, and Hegar sign refers to softening of the lower uterine segment. Braxton Hicks contractions are irregular uterine contractions that can occur during pregnancy.

Answer 191

D. “Home pregnancy tests are always 100% accurate and reliable.” Rationale: Home pregnancy tests are not 100% accurate, as their results can be affected by factors such as specimen concentration, the presence of blood, certain drugs, and medical conditions like ovarian cancer or hydatidiform mole. While they detect hCG, false positives and negatives are possible.

Answer 192

A. Ballottement Rationale: Ballottement is a probable sign of pregnancy where, during a pelvic examination, the examiner pushes against the cervix and feels a rebound movement of the fetus. It indicates a floating fetus but is not a definitive sign of pregnancy.

Answer 193

C. “Your hCG level suggests a positive pregnancy result.” Rationale: An hCG level higher than 25 mIU/mL is considered a positive indication of pregnancy. Levels lower than 5 mIU/mL are negative. hCG testing is based on detecting and measuring this glycoprotein in serum or urine to establish probable pregnancy.

Answer 194

D. Visualization of the fetus by ultrasound Rationale: Positive signs of pregnancy are those that provide definitive confirmation of a fetus growing in the uterus and include visualizing the fetus via ultrasound, palpating fetal movements, and hearing the fetal heartbeat. Nausea, a positive urine test, and cervical softening are presumptive or probable signs and are not definitive.

Answer 195

C. Positive sign Rationale: Hearing the fetal heartbeat is a positive sign of pregnancy, as it directly confirms the presence of a fetus. Presumptive signs are subjective symptoms reported by the mother, and probable signs are objective but not definitive.

Answer 196

C. Palpation of fetal movements by a health care provider Rationale: Palpation of fetal movements by a health care provider is a positive sign of pregnancy. This directly confirms the presence of a fetus. Abdominal enlargement, Braxton Hicks contractions, and positive hCG tests are probable signs but do not conclusively confirm a pregnancy.

Answer 197

B. Visualization of the fetus by ultrasound Rationale: Visualization of the fetus by ultrasound is a positive sign that confirms a viable intrauterine pregnancy. Other findings listed (bluish coloration, persistent nausea, and softening of the uterine segment) are either presumptive or probable signs and do not definitively establish viability.

Answer 198

B. Hypertrophy of uterine muscle fibers after mid-gestation Rationale: Uterine growth after mid-gestation is primarily due to the hypertrophy (increase in size) of existing muscle fibers, while hyperplasia (increase in number) occurs early in pregnancy. The growth accommodates the growing fetus and increases uterine size and weight.

Answer 199

B. Compression of the bladder by the expanding uterus Rationale: In early pregnancy, the expanding uterus exerts pressure on the bladder, resulting in increased urinary frequency. Hormonal changes and blood volume elevation also occur but do not directly cause bladder compression.

Answer 200

D. At the level of the umbilicus Rationale: At 20 weeks’ gestation, the fundus is typically at the level of the umbilicus, and it corresponds with a fundal height of approximately 20 cm.

Answer 201

A. Vena cava compression syndrome Rationale: The heavy gravid uterus in the supine position can compress the inferior vena cava, reducing venous return and cardiac output, leading to dizziness, light-headedness, and other symptoms associated with decreased blood flow.

Answer 202

B. Irregular, painless contractions that occur throughout pregnancy Rationale: Braxton Hicks contractions are irregular, painless contractions that begin early in pregnancy and help prepare the uterus for labor. They are not predictive of the timing of labor onset.

Answer 203

B. Compression of the diaphragm by the expanding uterus Rationale: As the uterus expands upward, it presses against the diaphragm, reducing lung capacity and resulting in shortness of breath. This is common in late pregnancy.

Answer 204

A. Fetal head descending into the pelvis Rationale: Lightening refers to the fetal head descending into the pelvis, typically occurring about two weeks before labor in first-time pregnancies and at the onset of labor in subsequent pregnancies.

Answer 205

C. Position her in a side-lying position Rationale: Supine hypotensive syndrome is managed by positioning the woman on her side to relieve pressure on the vena cava, thereby restoring blood flow and alleviating symptoms.

Answer 206

C. Goodell sign Rationale: Goodell sign refers to the softening of the cervix caused by increased vascularization and estrogen influence, typically seen around weeks 6 to 8 of pregnancy.

Answer 207

C. Progesterone Rationale: Progesterone stimulates the formation of a thick mucus plug that serves to protect the cervical opening from bacterial invasion during pregnancy.

Answer 208

A. Chadwick sign Rationale: Chadwick sign refers to the bluish-purple discoloration of the cervix caused by increased vascularity during pregnancy.

Answer 209

B. They become more acidic and white Rationale: During pregnancy, vaginal secretions increase in volume, become more acidic, and appear white due to increased estrogen influence and pelvic congestion.

Answer 210

C. Decrease in vascularity Rationale: During pregnancy, there is an increase, not a decrease, in vaginal vascularity to prepare for childbirth.

Answer 211

A. Vulvovaginal candidiasis Rationale: The glycogen-rich environment of the vagina during pregnancy can lead to vulvovaginal candidiasis, which often presents with itching, irritation, and increased discharge.

Answer 212

B. Ovulation ceases due to elevated estrogen and progesterone levels Rationale: Elevated levels of estrogen and progesterone during pregnancy inhibit the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), resulting in the cessation of ovulation.

Answer 213

D. 6th to 7th week of gestation Rationale: The corpus luteum is responsible for hormone production until about weeks 6 to 7, after which the placenta assumes this role.

Answer 214

C. Prominence of Montgomery’s tubercles Rationale: Montgomery’s tubercles become more prominent to help lubricate the nipples in preparation for breastfeeding.

Answer 215

A. It provides nourishment for the newborn during the first few days after birth Rationale: Colostrum, the yellowish fluid produced by the breasts, provides essential nutrients and antibodies for the newborn during the first few days after birth.

Answer 216

B. Formation of pink to purple striae Rationale: Changes in breast size and connective tissue can lead to the formation of stretch marks (striae), which are initially pink to purple and later fade to a silver color.

Answer 217

C. Estrogen and progesterone Rationale: Estrogen and progesterone contribute to breast changes during pregnancy, including increased vascularization, nipple size, and pigmentation of the areola.

Answer 218

A. Itching and irritation Rationale: While an increase in vaginal discharge (leukorrhea) is normal during pregnancy, itching and irritation may indicate infection, such as candidiasis.

Answer 219

B. Vaginal vault Rationale: The vaginal vault, along with other structures, experiences increased vascularity in preparation for the stretching and distention required for birth.

Answer 220

C. They promote softening and increased distensibility of the cervix Rationale: Prostaglandins, along with other factors, contribute to cervical ripening by softening the cervix and increasing its distensibility in preparation for labor.

Answer 221

A. Reassure the client that this is a normal finding. Rationale: A fundal height measurement that is within 1-2 cm of the number of weeks gestation is considered within normal limits (WNL). No immediate intervention is required unless other concerns arise.

Answer 222

B. A fundal height measuring 30 cm at 32 weeks in an obese patient. Rationale: Fundal height measurements may not be accurate in obese patients due to excess adipose tissue, making ultrasound assessment necessary for accurate evaluation of fetal growth.

Answer 223

C. Polyhydramnios or a multiple pregnancy Rationale: A larger-than-expected fundal height may indicate conditions such as polyhydramnios or multiple pregnancies. Further assessment, such as an ultrasound, is warranted.

Answer 224

D. To monitor fetal growth and detect potential complications. Rationale: Monitoring fundal height helps assess fetal growth patterns and detect potential complications such as growth restriction or macrosomia.

Answer 225

C. Fetal growth restriction or oligohydramnios Rationale: A smaller-than-expected fundal height may indicate fetal growth restriction or a reduced amount of amniotic fluid (oligohydramnios). Further evaluation is recommended.

Answer 226

C. Increased blood volume starting around 6 weeks of gestation Rationale: Blood volume increases starting around 6 weeks of gestation and continues to rise throughout pregnancy. This is necessary to support fetal development and accommodate maternal physiological changes.

Answer 227

C. "This is due to the physiologic anemia of pregnancy caused by increased plasma volume." Rationale: During pregnancy, plasma volume increases more than red blood cell volume, causing hemodilution, known as physiologic anemia. This is normal and not a sign of true anemia in a healthy pregnancy.

Answer 228

C. Increased plasma volume can lead to a drop in hemoglobin concentration. Rationale: The increase in plasma volume relative to red blood cell volume can cause a dilutional drop in hemoglobin concentration, often referred to as physiologic anemia of pregnancy.

Answer 229

A. Rapid increase in plasma volume compared to red blood cell volume Rationale: The plasma volume increases more rapidly and to a greater extent than red blood cell volume, leading to a relative decrease in hemoglobin concentration, which contributes to physiologic anemia.

Answer 230

B. Around 32 weeks gestation Rationale: Plasma volume begins increasing at 6-8 weeks gestation and peaks around 32 weeks, helping to meet the demands of the developing fetus and expanding maternal circulation.

Answer 231

B. Increase in blood and plasma volume Rationale: The increase in blood and plasma volume helps support the growing needs of the fetus by enhancing oxygen and nutrient delivery while also preparing the mother for potential blood loss during childbirth.

Answer 232

C. 50% Rationale: Blood volume during pregnancy increases by about 50% above pre-pregnancy levels to support the growing fetus, placenta, and maternal tissues.

Answer 233

D. Supine hypotensive syndrome Rationale: Supine hypotensive syndrome occurs when the gravid uterus compresses the inferior vena cava, decreasing venous return and causing dizziness or hypotension when the woman lies on her back.

Answer 234

B. Increased fibrinogen and clotting factors Rationale: The increase in fibrinogen and clotting factors during pregnancy prepares the body to form clots quickly, reducing the risk of excessive bleeding during delivery.

Answer 235

C. To meet increased iron demands and prevent anemia Rationale: Pregnancy increases the demand for iron due to increased red blood cell production. Supplementation helps prevent iron deficiency anemia.

Answer 236

D. Increases due to higher blood volume and venous return Rationale: Cardiac output increases during pregnancy as a result of increased blood volume and venous return, supporting the metabolic demands of the fetus and mother.

Answer 237

C. Slight decline in blood pressure, returning to pre-pregnancy levels later Rationale: Blood pressure typically declines slightly during mid-pregnancy due to hormonal and vascular changes, then returns to pre-pregnancy levels in the third trimester.

Answer 238

B. Increased plasma volume relative to red blood cell volume Rationale: Physiologic anemia in pregnancy is due to a greater increase in plasma volume compared to red blood cell volume, causing hemodilution.

Answer 239

C. Pooling of blood in the veins of the legs, vulva, and rectum Rationale: Pooling of blood in deep and superficial veins during pregnancy, particularly in the legs, vulva, and rectum, increases the risk of varicosities and hemorrhoids.

Answer 240

C. It offers protection from hemorrhage but increases clotting risks. Rationale: The hypercoagulable state in pregnancy increases the ability to form clots, offering protection from hemorrhage during childbirth but raising the risk of thrombosis.

Answer 241

C. Kidneys Rationale: Blood flow to the kidneys increases significantly during pregnancy to accommodate increased metabolic waste and fluid volume.

Answer 242

B. Increased blood flow to the skin Rationale: Increased blood flow to the skin during pregnancy helps dissipate heat generated by the increased metabolic activity.

Answer 243

D. Doubling or tripling of blood flow to the breasts Rationale: Blood flow to the breasts increases significantly during pregnancy, often doubling or tripling, leading to engorgement.

Answer 244

A. To protect against hemorrhage during labor and delivery Rationale: Pregnancy induces a hypercoagulable state to help protect against hemorrhage during childbirth, but it also increases the risk of thrombotic events.

Answer 245

C. Increased metabolic waste from the fetus, causing greater kidney activity Rationale: Increased blood flow and metabolic activity during pregnancy lead to higher levels of metabolic waste, requiring greater kidney function.

Answer 246

C. Increased clotting factors and fibrinogen Rationale: Pregnancy leads to an increase in fibrinogen and other clotting factors, raising the risk of thromboembolic events.

Answer 247

C. Cardiac output increases due to increased blood volume. Rationale: Cardiac output increases during pregnancy due to an increase in blood volume and venous return, which supports the maternal and fetal circulation.

Answer 248

A. Increase in cardiac output and blood volume Rationale: An increase in cardiac output and blood volume ensures adequate oxygen and nutrient delivery to the growing fetus.

Answer 249

C. Hormonal changes causing vasodilation Rationale: Hormonal changes during pregnancy cause vasodilation, which may lead to a slight decrease in blood pressure during mid-pregnancy.

Answer 250

D. Relaxin Rationale: Relaxin is a hormone that helps prepare the pelvis for childbirth by softening and stretching the ligaments, leading to increased flexibility in the sacroiliac joints and pubic symphysis.

Answer 251

B. Increased production of relaxin and changes in ligament flexibility Rationale: Increased levels of relaxin during pregnancy lead to the softening and stretching of ligaments, contributing to pelvic discomfort and low back pain.

Answer 252

A. Lordosis, characterized by an increased lumbosacral curve Rationale: Lordosis, or an increased curvature of the lumbosacral spine, is common in pregnant women due to changes in the center of gravity and the weight of the growing uterus.

Answer 253

B. A waddle gait occurs because of the widening of the pelvic joints and altered balance. Rationale: The widening of the pelvic joints due to relaxin and changes in the center of gravity contribute to the characteristic "waddle gait" seen in pregnant women.

Answer 254

A. Forward shifting of the center of gravity and postural changes Rationale: The forward shift in the center of gravity and postural adaptations, including swayback and changes in gait, increase the risk of falls in pregnant women.

Answer 255

C. Left lateral side Rationale: The left lateral position is recommended as it optimizes placental blood flow, enhances cardiac output, and improves kidney function, reducing swelling in the lower extremities.

Answer 256

B. Compresses the great vessels, potentially reducing placental blood flow Rationale: Lying on the back can compress the inferior vena cava and aorta, potentially reducing blood flow to the heart and placenta, which may compromise fetal circulation.

Answer 257

A. An increased risk of stillbirth after 28 weeks of gestation Rationale: Studies indicate that sleeping on the back during late pregnancy may be linked to an increased risk of stillbirth due to impaired blood flow to the placenta.

Answer 258

C. Left lateral positioning promotes optimal blood flow to the placenta and fetus. Rationale: The left lateral position is recommended during pregnancy as it enhances placental blood flow and reduces the risk of vena cava compression compared to the supine position.

Answer 259

B. 25–35 lb Rationale: A woman with a prepregnancy BMI of 18.5–24.9 (normal weight) should aim for a total weight gain of 25–35 lb during pregnancy to support fetal growth and development.

Answer 260

A. “You should aim for a total weight gain of 11–20 lb.” Rationale: For obese women (BMI of 30 or higher), the recommended total weight gain during pregnancy is 11–20 lb to minimize risks while still ensuring necessary fetal and maternal health support.

Answer 261

A. Gain slightly more than 1 lb per week Rationale: For underweight women, weight gain during the second and third trimesters should be slightly more than 1 lb per week to promote healthy fetal growth and maternal health.

Answer 262

B. Cephalopelvic disproportion and high-birth-weight infant Rationale: Women who are overweight (BMI greater than 25 to 29) have an increased risk of having a high-birth-weight infant, potentially leading to cephalopelvic disproportion and an increased likelihood of surgical birth.

Answer 263

D. Severe caloric restriction can lead to a decrease in birth weight and inadequate fetal development. Rationale: Dieting during pregnancy can lead to insufficient calorie intake, which may reduce fetal and placental development, resulting in lower birth weight and other complications.

Answer 264

A. About 3.5 to 5 lb Rationale: For women whose prepregnancy weight falls within the normal BMI range, the recommended weight gain during the first trimester is approximately 3.5 to 5 lb, mainly due to uterine growth and blood volume expansion.

Answer 265

B. Weight, blood pressure, fundal height, fetal heart rate, and urine testing for protein and glucose Rationale: During visits up to 28 weeks’ gestation, it is standard practice to assess weight, blood pressure, fundal height, fetal heart rate, and perform urine testing for protein and glucose.

Answer 266

C. 24-28 weeks Rationale: Screening for gestational diabetes is recommended between 24 and 28 weeks’ gestation, as insulin resistance increases at this point in pregnancy, leading to a higher rate of abnormal test results.

Answer 267

A. Edema of the hands and periorbital edema Rationale: Periorbital edema, edema of the hands, and pretibial edema are abnormal findings that may indicate gestational hypertension and require further evaluation.

Answer 268

B. RhoGAM injection Rationale: RhoGAM is administered to Rh-negative women at 28 weeks’ gestation to prevent the development of antibodies to Rh-positive red cells, especially if fetal cells enter the maternal circulation.

Answer 269

C. Uterine contractions and a feeling of pressure in the pelvic area Rationale: Symptoms such as uterine contractions, a feeling of pressure in the pelvic area, dull backache, or increased vaginal discharge may indicate preterm labor.

Answer 270

C. 3-hour 100-g glucose tolerance test Rationale: If the 1-hour plasma glucose level is above 140 mg/dL, further testing with a 3-hour 100-g glucose tolerance test is warranted to confirm the diagnosis of gestational diabetes.

Answer 271

A. Dependent edema is common, but swelling in the hands and face should be reported. Rationale: Dependent edema of the lower extremities is common due to vascular compression by the gravid uterus, but edema of the hands and face (periorbital edema) could indicate gestational hypertension and should be reported.

Answer 272

D. It is a critical indicator of fetal well-being. Rationale: Daily fetal movement monitoring is emphasized because it is an important indicator of fetal well-being. A decrease in movements may indicate a need for further evaluation.

Answer 273

B. Hepatitis B surface antibody antigen Rationale: Hepatitis B surface antigen is a routine screening test for pregnant women to assess for the presence of hepatitis B. Other tests like glucose tolerance and genetic screening are typically ordered later based on risk factors or patient history, not universally for all pregnant women.

Answer 274

A. The nurse explains the benefits and risks of additional testing, then supports the couple’s decision regardless of their choice. Rationale: Autonomy involves respecting a patient’s right to make decisions about their own health care. The nurse should provide the couple with information, respect their decisions, and support them in making informed choices, even if their choice differs from the nurse’s personal beliefs.

Answer 275

B. Complete blood count (CBC) Rationale: A complete blood count (CBC) is a standard laboratory test for pregnant women to assess hemoglobin, hematocrit, red and white blood cell counts, and platelets. HIV testing and STI screenings are also common but are often secondary to a CBC in the initial screening.

Answer 276

C. Ultrasound Rationale: Ultrasound is routinely used during the early stages of pregnancy to confirm the presence of an intrauterine pregnancy and assess fetal growth. It is not a blood or urine test, unlike the other options listed.

Answer 277

C. Genetic screening Rationale: Genetic screening is often recommended for women with risk factors for genetic diseases or a history of high-risk pregnancies. This test is tailored to the individual’s specific risks, unlike routine screening like CBC or HIV testing.

Answer 278

B. Testing for HIV and STIs is a routine part of prenatal care to prevent transmission to the baby. Rationale: Routine testing for HIV and STIs is recommended during pregnancy to prevent transmission to the baby and to manage the health of the mother. Testing is not based on the presence of symptoms or a history of multiple partners. It is a standard practice in prenatal care.

Answer 279

C. 18-20 weeks Rationale: A detailed anatomy scan is typically performed between 18-20 weeks of gestation to evaluate fetal growth, development, and structural anatomy.

Answer 280

C. Doppler flow studies Rationale: Doppler flow studies use ultrasound to evaluate fetal blood flow, particularly through the umbilical artery, to assess placental function and detect any signs of compromised circulation.

Answer 281

B. Neural tube defects such as spina bifida Rationale: Elevated levels of MSAFP can indicate the presence of neural tube defects such as spina bifida or anencephaly in the fetus.

Answer 282

A. First trimester Rationale: Nuchal translucency screening is performed during the first trimester (around 11-14 weeks) to measure the fluid-filled space at the back of the fetus's neck, which can help identify chromosomal abnormalities.

Answer 283

C. Amniocentesis Rationale: Amniocentesis involves extracting a sample of amniotic fluid, which can be tested for chromosomal abnormalities, fetal lung maturity (at later gestation), or Rh isoimmunization status.

Answer 284

C. In the third trimester, around 32-34 weeks or later if needed Rationale: Amniocentesis for evaluating fetal lung maturity is typically performed during the third trimester (around 32-34 weeks) to assess the readiness of the fetal lungs for birth.

Answer 285

B. Nuchal translucency screening Rationale: Nuchal translucency screening is performed in the first trimester to assess the risk of chromosomal abnormalities such as Down syndrome.

Answer 286

B. 6-8 weeks of gestation Rationale: An early ultrasound for pregnancy confirmation is typically performed around 6-8 weeks of gestation to verify fetal heartbeat and viability.

Answer 287

B. Detect chromosomal and genetic conditions Rationale: Marker screening tests, such as multiple marker screening, can help detect chromosomal abnormalities and other genetic conditions in the developing fetus.

Answer 288

C. To prevent the development of antibodies in an Rh-negative mother Rationale: Rh isoimmunization testing and treatment with RhoGAM are performed to prevent the development of antibodies in an Rh-negative mother that could harm an Rh-positive fetus.

Answer 289

B. The expanding uterus places pressure on the bladder Rationale: In the first and third trimesters, the growing uterus exerts pressure on the bladder, leading to increased urinary frequency and urgency. This is exacerbated in the third trimester by the phenomenon of "lightening," when the baby's head engages in the pelvis.

Answer 290

C. The uterus moving into the abdominal cavity, relieving bladder pressure Rationale: During the second trimester, the uterus moves upward into the abdominal cavity, relieving pressure on the bladder and decreasing urinary urgency.

Answer 291

B. It is when the baby drops into the pelvis, increasing urinary frequency in the third trimester. Rationale: "Lightening" refers to the baby descending into the pelvis toward the end of the third trimester, which often increases urinary frequency due to added pressure on the bladder.

Answer 292

B. Hormones cause relaxation of smooth muscle, including the bladder and ureters. Rationale: Hormonal changes, particularly increased levels of progesterone, cause smooth muscle relaxation, including in the bladder and ureters, which can lead to urinary frequency and incomplete bladder emptying.

Answer 293

C. The uterus has shifted into the abdominal cavity, relieving bladder pressure. Rationale: As the uterus grows and moves into the abdominal cavity during the second trimester, it reduces pressure on the bladder, leading to a decrease in urinary urgency.

Answer 294

D. Increased risk of urinary tract infections (UTIs) Rationale: Increased urinary frequency and hormonal changes during pregnancy can lead to incomplete emptying of the bladder, increasing the risk of urinary tract infections (UTIs) during the third trimester.

Answer 295

C. Linea nigra Rationale: Linea nigra is the dark line that forms on the abdomen during pregnancy, running from the symphysis pubis to the top of the fundus due to hormonal changes and increased melanin production.

Answer 296

C. Hormonal changes, particularly increased estrogen and progesterone Rationale: Hyperpigmentation, including melasma, is caused by hormonal changes during pregnancy, primarily increased levels of estrogen and progesterone, which stimulate melanin production.

Answer 297

C. Varicosities (varicose veins) Rationale: Varicosities, or varicose veins, are common during pregnancy due to increased blood volume, hormonal effects on vessel walls, and poor circulation from prolonged standing.

Answer 298

B. Connective tissue changes and stretching of the skin Rationale: Stretch marks, or striae gravidarum, occur due to changes in the connective tissue and stretching of the skin as the body grows during pregnancy.

Answer 299

A. Increased levels of estrogen causing dilation of small blood vessels Rationale: Vascular spiders, or spider veins, are small, dilated blood vessels caused by elevated levels of estrogen, which promote dilation of capillaries.

Answer 300

C. Increased blood flow and hormonal changes Rationale: Palmar erythema, or redness of the palms, is common in pregnancy due to increased blood flow and hormonal changes that cause capillary dilation.

Answer 301

B. A harmless but itchy skin rash seen late in pregnancy Rationale: PUPPP is a benign skin condition that causes intense itching and a rash, typically developing late in pregnancy, and resolves after delivery.

Answer 302

B. Liver dysfunction leading to severe itching without a rash Rationale: ICP is a liver condition in pregnancy that causes severe itching without a rash due to elevated bile acids and requires careful monitoring due to potential risks to the fetus.

Answer 303

C. Enhanced blood flow and hormonal changes Rationale: Hormonal changes and increased blood flow during pregnancy often lead to increased hair and nail growth, although changes may reverse after delivery.

Answer 304

C. Increased blood volume and poor circulation due to standing Rationale: Varicosities are caused by increased blood volume and poor circulation, especially when standing for long periods, as well as hormonal influences that affect the veins.

Answer 305

C. Ambivalence Rationale: Ambivalence refers to mixed or contradictory feelings, which is common in early pregnancy as women adjust to the impending arrival of a baby and the changes it brings.

Answer 306

D. Introversion Rationale: Introversion is common during pregnancy, involving a heightened focus on the woman's body and physical changes as she adapts to pregnancy.

Answer 307

B. Acceptance Rationale: Acceptance occurs as a woman adapts to the reality of pregnancy and prepares for her role as a mother, reflecting a positive adjustment to her changing situation.

Answer 308

B. Hormonal influences related to pregnancy Rationale: Mood swings during pregnancy are largely influenced by hormonal changes that can cause fluctuations in emotional states, which is normal and expected.

Answer 309

B) Prostaglandins enhance the sensitivity of the uterus to oxytocin, promoting uterine contractions. Rationale: Prostaglandins play a key role in initiating labor by increasing the uterus' sensitivity to oxytocin, which enhances uterine contractions. They also aid in cervical ripening and softening, preparing the cervix for delivery.

Answer 310

B) Stimulate uterine contractions by enhancing oxytocin activity. Rationale: Prostaglandins are used in labor induction because they increase the uterus' responsiveness to oxytocin, stimulating uterine contractions and promoting cervical ripening. This action is critical for initiating labor.

Answer 311

C) Uterine hyperstimulation Rationale: Prostaglandins, such as dinoprostone, can cause uterine hyperstimulation, which is excessive uterine contractions that can lead to fetal distress or uterine rupture. Close monitoring for this complication is essential.

Answer 312

A) The growing uterus is compressing the bladder, causing increased frequency. Rationale: During early pregnancy, hormonal changes and the growing uterus put pressure on the bladder, leading to increased urinary frequency. This symptom typically resolves in the second trimester as the uterus rises out of the pelvic cavity.

Answer 313

B) "Fatigue is a common symptom during the first trimester due to hormonal changes." Rationale: Fatigue is a common discomfort in the first trimester of pregnancy, typically due to rising levels of progesterone and other hormonal changes. It usually improves in the second trimester.

Answer 314

B) Eating small, frequent meals and avoiding greasy foods. Rationale: Nausea and vomiting, often referred to as "morning sickness," are common in the first trimester. It is helpful to eat small, frequent meals, avoid greasy and spicy foods, and keep a light snack available in the morning to manage symptoms.

Answer 315

A) Increased blood flow and hormonal changes preparing the breasts for lactation. Rationale: Breast tenderness and swelling during the first trimester are common due to hormonal changes, particularly increased estrogen and progesterone, which prepare the breasts for lactation.

Answer 316

A) Increase intake of fiber-rich foods and drink plenty of water. Rationale: Constipation is common during pregnancy, especially in the first trimester, due to hormonal changes that slow down the digestive system. Increasing fiber intake, drinking water, and staying active can help alleviate constipation.

Answer 317

A) "These symptoms are typical in pregnancy due to hormonal changes and increased blood flow." Rationale: Nasal stuffiness, bleeding gums, and nosebleeds are common due to increased blood volume and hormonal changes during pregnancy. They typically resolve as the pregnancy progresses.

Answer 318

C) Hormonal changes and the body's need for additional calories. Rationale: Food cravings in pregnancy are thought to be caused by hormonal changes, particularly the increase in hCG and progesterone, and the body's increased nutritional demands, although they are often not tied to actual deficiencies.

Answer 319

B) A normal symptom due to increased blood flow and hormonal changes. Rationale: Leukorrhea, a thin, white vaginal discharge, is common in pregnancy due to hormonal changes and increased blood flow. As long as it is odorless and non-irritating, it is considered normal and does not typically require treatment.

Answer 320

B) Recommend wearing a back support belt and practicing good posture. Rationale: Lower back pain in pregnancy is common due to the growing uterus and changes in posture. Using a back support belt and practicing proper posture can alleviate strain. Bed rest is not typically recommended, and alternating heat or cold may provide temporary relief but does not address the root cause.

Answer 321

A) Avoid prolonged standing and elevate the legs when sitting or lying down. Rationale: Varicosities during pregnancy are caused by increased blood volume and pressure on the veins. Elevating the legs and avoiding prolonged standing or sitting can help reduce swelling and discomfort. Tight-fitting stockings should be avoided unless specifically recommended by a healthcare provider.

Answer 322

B) Suggest warm sitz baths and the use of hemorrhoid cream or witch hazel. Rationale: Hemorrhoids are common during pregnancy due to increased blood volume and pressure from the growing uterus. Warm sitz baths and topical treatments like hemorrhoid creams or witch hazel can relieve discomfort. Constipation management through dietary changes is also beneficial but should be done without over-relying on laxatives.

Answer 323

A) Hormonal changes causing gastrointestinal motility to slow down. Rationale: Flatulence and bloating in pregnancy are commonly caused by hormonal changes, particularly increased progesterone, which slows gastrointestinal motility and leads to more gas buildup. The growing uterus can also contribute to these symptoms by putting pressure on the intestines.

Answer 324

B) "Morning sickness can return in the third trimester due to increased progesterone levels." Rationale: Although nausea and vomiting are most common in the first trimester, some women experience a return of symptoms in the third trimester due to increased progesterone levels and the pressure of the growing uterus on the stomach.

Answer 325

A) The growing uterus is putting pressure on the diaphragm, reducing lung expansion. Rationale: Shortness of breath and dyspnea in the third trimester are commonly caused by the growing uterus pressing against the diaphragm, which limits lung expansion and decreases respiratory capacity.

Answer 326

C) Avoiding foods that are spicy, acidic, or fatty, and eating smaller meals. Rationale: Heartburn and indigestion are common in the third trimester due to the growing uterus pressing on the stomach and slowing digestion. Eating smaller meals, avoiding trigger foods (such as spicy, acidic, or fatty foods), and not lying down immediately after eating can help alleviate these symptoms.

Answer 327

A) Keeping the legs elevated and avoiding prolonged standing or sitting. Rationale: Dependent edema in pregnancy is caused by increased blood volume and pressure from the growing uterus. Elevating the legs and avoiding prolonged standing or sitting helps reduce swelling by promoting better circulation and reducing fluid retention.

Answer 328

B) "Braxton Hicks contractions are irregular and typically occur as the body prepares for labor." Rationale: Braxton Hicks contractions, also known as "practice contractions," are irregular and painless contractions that occur in the third trimester. They are a normal part of pregnancy and help the body prepare for labor. They do not indicate true labor or preterm labor unless they become regular and painful.

Answer 329

cranial nerve VII

Answer 330

Can be caused by HSV or other viral infections, varicella, Epstein-barr