MIDTERM CH 11 & 12: Antepartum

Question 1

__________ signs are those signs that the mother can perceive.

Answer 1

presumptive

Question 2

__________ signs of pregnancy are those that can be detected on physical examination by a HCP.

Answer 2

probable

Question 3

A 26-year-old woman presents to the clinic with amenorrhea for two months, nausea, fatigue, breast tenderness, and urinary frequency. Which of the following is the best explanation for these findings?

A. Definitive diagnosis of pregnancy
B. Probable signs of pregnancy
C. Presumptive signs of pregnancy
D. Positive signs of pregnancy

Answer 3

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.

Question 4

A patient reports missing her menstrual period for two months and experiencing breast tenderness and fatigue. She is concerned she may be pregnant. Which of the following should the nurse inform the patient about presumptive signs?

A. They conclusively confirm pregnancy.
B. They may indicate pregnancy but are not definitive.
C. They indicate hormonal imbalance.
D. They are signs of early menopause.

Answer 4

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.

Question 5

A nurse is educating a group of women on the signs of pregnancy. Which of the following is an example of a presumptive sign of pregnancy?

A. Positive pregnancy test
B. Bluish discoloration of the cervix and vagina (Chadwick’s sign)
C. Palpation of fetal movement by a healthcare provider
D. Nausea and vomiting

Answer 5

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.

Question 6

A patient presents with urinary frequency. Which of the following additional assessments would best help the nurse determine if this could be related to pregnancy?

A. History of recent sexual activity and missed periods
B. Positive laboratory test for urinary infection
C. Family history of urinary tract disorders
D. Recent changes in diet and fluid intake

Answer 6

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.

Question 7

A client with amenorrhea and fatigue expresses anxiety about possibly being pregnant. The nurse explains that presumptive signs of pregnancy are not definitive because:

A. Pregnancy tests have 100% accuracy in confirming pregnancy.

B. Many presumptive signs can be explained by other medical or physiological conditions.

C. Only probable signs of pregnancy are subjective.

D. Presumptive signs only occur in non-pregnant individuals.

Answer 7

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.

Question 8

A nurse is performing a pelvic examination on a client and notes softening of the cervix. Which of the following probable signs of pregnancy is this known as?

A. Chadwick sign
B. Hegar sign
C. Ballottement
D. Goodell sign

Answer 8

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.

Question 9

Which of the following statements is true regarding human chorionic gonadotropin (hCG) and pregnancy detection?

A. hCG levels decrease steadily after conception.

B. hCG levels lower than 25 mIU/mL are considered positive for pregnancy.

C. hCG levels double every 48 to 72 hours during early pregnancy.

D. hCG is detectable in the serum of less than 1% of clients by day 11 after conception.

Answer 9

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.

Question 10

During a prenatal visit, a healthcare provider notes a bluish-purple coloration of the vaginal mucosa and cervix. This is documented as which probable sign of pregnancy?

A. Goodell sign
B. Braxton Hicks contractions
C. Chadwick sign
D. Hegar sign

Answer 10

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.

Question 11

A nurse is educating a client on the reliability of home pregnancy tests. Which of the following statements by the client indicates a need for further teaching?

A. “These tests detect the presence of hCG to determine pregnancy.”

B. “The accuracy of the test can be influenced by how far along I am in the pregnancy.”

C. “A positive test result can be caused by conditions other than pregnancy.”

D. “Home pregnancy tests are always 100% accurate and reliable.”

Answer 11

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.

Question 12

A provider performs a pelvic examination and feels a rebound from the floating fetus when pushing against the cervix. This assessment finding is known as:

A. Ballottement
B. Hegar sign
C. Braxton Hicks contractions
D. Chadwick sign

Answer 12

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.

Question 13

A client with suspected pregnancy undergoes a blood test for hCG levels. The results show hCG levels of 30 mIU/mL. Which of the following statements by the nurse is appropriate?

A. “This level suggests you are not pregnant.”

B. “This level is considered negative for pregnancy.”

C. “Your hCG level suggests a positive pregnancy result.”

D. “The level of hCG does not matter for pregnancy detection.”

Answer 13

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.

Question 14

A nurse is assessing a pregnant client. Which of the following findings is considered a positive sign of pregnancy?

A. Nausea and vomiting
B. Positive urine pregnancy test
C. Softening of the cervix (Goodell sign)
D. Visualization of the fetus by ultrasound

Answer 14

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.

Question 15

The nurse hears a fetal heartbeat during a routine prenatal visit using a Doppler device. This is classified as which type of pregnancy sign?

A. Presumptive sign
B. Probable sign
C. Positive sign
D. Subjective sign

Answer 15

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.

Question 16

Which of the following is considered a positive sign of pregnancy that confirms fetal presence?

A. Abdominal enlargement
B. Braxton Hicks contractions
C. Palpation of fetal movements by a health care provider
D. A positive serum hCG test

Answer 16

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.

Question 17

A woman at 10 weeks gestation expresses concern that her pregnancy may not be viable. The nurse explains that which of the following findings confirms a viable intrauterine pregnancy?

A. Bluish coloration of the cervix and vaginal mucosa
B. Visualization of the fetus by ultrasound
C. Persistent nausea and vomiting
D. Softening of the lower uterine segment

Answer 17

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.

Question 18

The softening of the cervix between weeks 6 and 8 of pregnancy due to vasocongestion and hormonal influences is known as which sign?

A. Hegar sign
B. Chadwick sign
C. Goodell sign
D. Ballottement

Answer 18

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.

Question 19

Increased vascularization of the cervix during early pregnancy leads to a bluish-purple discoloration known as:

A. Chadwick sign
B. Goodell sign
C. Braxton Hicks contractions
D. Lightening

Answer 19

A. Chadwick sign

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

Question 20

A patient reports fatigue, nausea, and breast tenderness but is unsure if she is pregnant. Which of the following describes these symptoms?

a) Positive signs of pregnancy
b) Probable signs of pregnancy
c) Presumptive signs of pregnancy
d) Diagnostic signs of pregnancy

Answer 20

c) Presumptive signs of pregnancy

Rationale: Presumptive signs of pregnancy are subjective signs that a woman experiences, such as fatigue, nausea, and breast tenderness, but they are not definitive indicators of pregnancy.

Question 21

A nurse is assessing a woman who reports amenorrhea and urinary frequency. Which explanation should the nurse provide about these symptoms?

a) “These are probable signs of pregnancy and confirm you are pregnant.”
b) “These are presumptive signs of pregnancy and may suggest you are pregnant.”
c) “These are diagnostic signs of pregnancy and confirm fetal development.”
d) “These are related to an infection and are not pregnancy-related.”

Answer 21

b) “These are presumptive signs of pregnancy and may suggest you are pregnant.”

Rationale: Amenorrhea and urinary frequency are subjective symptoms that indicate a possibility of pregnancy, but they are not definitive proof.

Question 22

A pregnant patient at 12 weeks reports extreme fatigue. What is the nurse’s best response?

a) “Fatigue is uncommon in early pregnancy and should be evaluated further.”

b) “Fatigue is a probable sign of pregnancy and confirms fetal development.”

c) “Fatigue is a diagnostic sign and indicates pregnancy complications.”

d) “Fatigue is a presumptive sign of pregnancy and is expected around this time.”

Answer 22

d) “Fatigue is a presumptive sign of pregnancy and is expected around this time.”

Rationale: Fatigue is a common presumptive sign of pregnancy due to increased progesterone levels and higher metabolic demands, particularly by 12 weeks.

Question 23

A nurse is educating a patient about breast tenderness in pregnancy. When should the patient expect this symptom to occur?

a) Between 3–4 weeks
b) Between 8–10 weeks
c) After 12 weeks
d) After 20 weeks

Answer 23

a) Between 3–4 weeks

Rationale: Breast tenderness is one of the earliest presumptive signs of pregnancy, typically starting around 3–4 weeks due to hormonal changes.

Question 24

A woman reports feeling fetal movements at 18 weeks of gestation. How should the nurse document this finding?

a) Positive sign of pregnancy
b) Probable sign of pregnancy
c) Presumptive sign of pregnancy
d) Diagnostic sign of pregnancy

Answer 24

c) Presumptive sign of pregnancy

Rationale: Fetal movements, or quickening, are subjective sensations felt by the mother and are considered presumptive signs of pregnancy.

Question 25

During a prenatal exam, the nurse notes uterine enlargement at 10 weeks gestation. How should this finding be classified?

a) Positive sign of pregnancy
b) Probable sign of pregnancy
c) Presumptive sign of pregnancy
d) Diagnostic sign of pregnancy

Answer 25

c) Presumptive sign of pregnancy

Rationale: Uterine enlargement is a subjective observation made by the patient or provider, and it is considered a presumptive sign of pregnancy.

Question 26

What is the significance of a pregnancy test showing an hCG level higher than 25 mIU/mL?

a) It is considered positive for pregnancy.
b) It indicates an ectopic pregnancy.
c) It confirms multiple gestations.
d) It rules out other conditions like hydatidiform mole.

Answer 26

a) It is considered positive for pregnancy.

Rationale: An hCG level higher than 25 mIU/mL is considered a positive test for pregnancy, although further evaluation may be needed to confirm.

Question 27

What is the clinical relevance of hCG doubling every 48 to 72 hours in early pregnancy?

a) It indicates a molar pregnancy.

b) It suggests normal pregnancy development.

c) It confirms multiple gestations.

d) It diagnoses ectopic pregnancy.

Answer 27

b) It suggests normal pregnancy development.

Rationale: In early pregnancy, hCG levels that double every 48 to 72 hours are a sign of a normal, progressing pregnancy.

Question 28

What is one limitation of home pregnancy tests that nurses should communicate to patients?

a) They cannot detect hCG levels above 25 mIU/mL.

b) They are not affected by medications or blood contamination.

c) They have a high false-negative rate when performed early in pregnancy.

d) They are 100% reliable when instructions are followed.

Answer 28

c) They have a high false-negative rate when performed early in pregnancy.

Rationale: Home pregnancy tests may not detect early pregnancy due to low hCG levels, leading to false-negative results if performed too early.

Question 29

What is a key characteristic of Hegar sign as a probable sign of pregnancy?

a) Softening of the lower uterine segment
b) Bluish discoloration of the vaginal mucosa
c) Fetal rebound felt during examination
d) Increased uterine size and shape

Answer 29

a) Softening of the lower uterine segment

Rationale: Hegar sign refers to the softening of the lower uterine segment or isthmus, typically detected during a physical examination.

Question 30

Why is it important to begin prenatal care as soon as pregnancy is suspected?

a) To confirm a molar pregnancy early
b) To prevent pelvic congestion syndrome
c) To implement medication and lifestyle changes for a healthy pregnancy
d) To reduce the likelihood of Braxton Hicks contractions

Answer 30

c) To implement medication and lifestyle changes for a healthy pregnancy

Rationale: Early prenatal care ensures the implementation of necessary interventions to promote a healthy pregnancy, such as medication adjustments and lifestyle modifications.

Question 31

Which of the following are considered positive signs of pregnancy? (Select all that apply)

a) Visualization of the fetus by ultrasound
b) Palpation of fetal movements by a health care provider
c) Hearing a fetal heartbeat via Doppler
d) Presence of Braxton Hicks contractions
e) A positive home pregnancy test

Answer 31

a) Visualization of the fetus by ultrasound
b) Palpation of fetal movements by a health care provider
c) Hearing a fetal heartbeat via Doppler

Rationale: Positive signs of pregnancy are objective findings that directly confirm the presence of a fetus in the uterus. Visualization of the fetus, palpation of fetal movements by a trained provider, and hearing a fetal heartbeat are definitive indicators of pregnancy. Braxton Hicks contractions (d) and a positive pregnancy test (e) are probable signs but do not confirm a pregnancy.

Question 32

What is the earliest time that a positive sign of pregnancy, such as visualization of the fetus via ultrasound, can typically be observed?

a) 2 weeks after fertilization
b) 6 weeks’ gestation
c) 10 weeks’ gestation
d) 12 weeks’ gestation

Answer 32

b) 6 weeks’ gestation

Rationale: Visualization of the fetus by ultrasound can often confirm pregnancy as early as 6 weeks’ gestation. At this time, a gestational sac or fetal heartbeat may be detected, providing direct evidence of pregnancy.

Question 33

Why are positive signs of pregnancy critical for confirming a pregnancy?

a) They differentiate pregnancy from conditions like hydatidiform mole or uterine tumors.
b) They are required for health insurance coverage of prenatal care.
c) They occur earlier than probable and presumptive signs.
d) They help diagnose complications like ectopic pregnancy.

Answer 33

a) They differentiate pregnancy from conditions like hydatidiform mole or uterine tumors.

Rationale: Positive signs of pregnancy, such as fetal movement, visualization, and heartbeat, provide definitive evidence that a fetus is present in the uterus. This distinguishes pregnancy from other conditions, such as a hydatidiform mole, which can produce similar symptoms and hCG levels.

Question 34

During a prenatal visit, a health care provider confirms fetal movement through palpation. What should the nurse document?

a) Presumptive sign of pregnancy
b) Probable sign of pregnancy
c) Early pregnancy symptom
d) Positive sign of pregnancy

Answer 34

d) Positive sign of pregnancy

Rationale: Fetal movement palpated by an experienced health care provider is a positive sign of pregnancy, as it directly confirms the presence of a fetus.

Question 35

A client is 8 weeks pregnant and asks why an ultrasound is being performed so early. What is the best response by the nurse?

a) “An ultrasound at this stage is used to detect Braxton Hicks contractions.”

b) “Ultrasound allows visualization of the fetus to confirm the pregnancy and estimate gestational age.”

c) “Ultrasound at this stage ensures the placenta is fully formed.”

d) “Ultrasound is necessary to confirm ovulation.”

Answer 35

b) “Ultrasound allows visualization of the fetus to confirm the pregnancy and estimate gestational age.”

Rationale: Early ultrasounds are used to confirm pregnancy, detect a fetal heartbeat, and estimate gestational age, ensuring accurate counseling and prenatal care. The placenta does not fully form until later in pregnancy, and Braxton Hicks contractions are not visible on ultrasound.

Question 36

A client with a confirmed pregnancy via positive ultrasound asks about the purpose of early prenatal visits. Which of the following should the nurse include in her response? (Select all that apply)

a) Assessment of maternal and fetal health
b) Education on normal signs and symptoms of early pregnancy
c) Identification of gestational age for appropriate counseling
d) Initiation of fetal heart rate monitoring
e) Management of labor plans

Answer 36

a) Assessment of maternal and fetal health
b) Education on normal signs and symptoms of early pregnancy
c) Identification of gestational age for appropriate counseling

Rationale: Early prenatal visits focus on confirming pregnancy, assessing maternal and fetal health, providing education on pregnancy symptoms, and accurately determining gestational age. While fetal heart rate monitoring (d) is part of prenatal care, it is not typically initiated during early visits.

Question 37

How do you calculate the estimated date of birth?

Answer 37

add 7 days and 9 months from the LMP

Question 38

A woman at 10 weeks gestation reports feeling extremely fatigued. Which of the following is the most appropriate response by the nurse?

A) “Fatigue is usually a sign of anemia, so you should schedule an iron supplement.”

B) “Fatigue is a common symptom during the first trimester due to hormonal changes.”

C) “You may need to decrease your physical activity to avoid fatigue.”

D) “Fatigue should resolve once the placenta takes over progesterone production.”

Answer 38

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.

Question 39

A pregnant woman in her first trimester is experiencing nausea and vomiting. What is the nurse’s primary recommendation for managing these symptoms?

A) Avoiding eating at all to prevent triggering nausea.
B) Eating small, frequent meals and avoiding greasy foods.
C) Taking over-the-counter anti-nausea medications daily.
D) Lying down immediately after eating to avoid vomiting.

Answer 39

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.

Question 40

A 9-week pregnant woman is complaining of tender and swollen breasts. The nurse recognizes that this symptom is most likely due to:

A) Increased blood flow and hormonal changes preparing the breasts for lactation.

B) Excessive weight gain early in pregnancy.

C) A possible infection of the mammary glands.

D) A result of a high-fat diet causing hormonal fluctuations.

Answer 40

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.

Question 41

A pregnant woman at 12 weeks gestation asks the nurse about managing constipation, which she has been experiencing. The nurse’s best advice would be to:

A) Increase intake of fiber-rich foods and drink plenty of water.
B) Use over-the-counter laxatives regularly for relief.
C) Limit the intake of dairy products to prevent constipation.
D) Avoid exercise and rest to reduce pressure on the intestines.

Answer 41

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.

Question 42

A pregnant woman in her first trimester is experiencing nasal stuffiness, bleeding gums, and occasional nosebleeds. Which of the following would be the nurse’s most appropriate response?

A) “These symptoms are typical in pregnancy due to hormonal changes and increased blood flow.”

B) “You should see a dentist for the bleeding gums and start a nasal decongestant immediately.”

C) “These symptoms are a sign of an underlying infection that needs medical treatment.”

D) “Nosebleeds are abnormal in pregnancy, and you should report them to your healthcare provider.”

Answer 42

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.

Question 43

A 10-week pregnant woman reports experiencing cravings for certain foods. The nurse understands that cravings during pregnancy are most commonly caused by:

A) Nutritional deficiencies that the body tries to correct through cravings.
B) Emotional stress and anxiety during pregnancy.
C) Hormonal changes and the body’s need for additional calories.
D) Excessive weight gain causing an increased appetite for comfort foods.

Answer 43

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.

Question 44

Which strategies can help manage urinary frequency during the first trimester? (Select all that apply)

a) Decreasing fluid intake during the day
b) Limiting fluid intake 2–3 hours before bedtime
c) Performing Kegel exercises
d) Avoiding caffeinated beverages
e) Using a urinary catheter as needed

Answer 44

b) Limiting fluid intake 2–3 hours before bedtime
c) Performing Kegel exercises
d) Avoiding caffeinated beverages

Rationale: Urinary frequency in the first trimester is caused by the growing uterus compressing the bladder. Managing fluid intake near bedtime, avoiding caffeine, and strengthening pelvic muscles with Kegel exercises can help reduce this discomfort. Decreasing overall fluid intake (a) is not advised as hydration is essential during pregnancy, and urinary catheters (e) are not appropriate for routine management.

Question 45

What is the primary cause of fatigue during the first trimester of pregnancy?

a) Decreased progesterone levels
b) Increased oxygen consumption and metabolic demands
c) Compression of the bladder by the uterus
d) Reduced physical activity levels

Answer 45

b) Increased oxygen consumption and metabolic demands

Rationale: Fatigue in the first trimester results from increased oxygen consumption, metabolic demands, and hormonal changes such as elevated levels of progesterone and relaxin.

Question 46

What dietary changes can alleviate first-trimester nausea and vomiting? (Select all that apply)

a) Eating small, frequent meals throughout the day
b) Consuming high-fat foods
c) Eating dry crackers or cheese before getting out of bed
d) Avoiding strong food odors
e) Drinking liquids only during meals

Answer 46

a) Eating small, frequent meals throughout the day
c) Eating dry crackers or cheese before getting out of bed
d) Avoiding strong food odors

Rationale: Small, frequent meals prevent an empty stomach, while bland foods like crackers can help reduce nausea. Avoiding strong food odors minimizes triggers. High-fat foods (b) and drinking liquids during meals (e) may exacerbate symptoms.

Question 47

A pregnant woman reports persistent first-trimester nausea. Which FDA-approved medication should the nurse suggest?

a) Promethazine (Phenergan) and doxylamine (Diclegis)
b) Ondansetron (Zofran) and doxylamine (Diclegis)
c) Vitamin B6 and doxylamine (Diclegis)
d) Dimenhydrinate (Dramamine) and doxylamine (Diclegis)

Answer 47

c) Vitamin B6 and doxylamine (Diclegis)

Rationale: The FDA has approved vitamin B6 and doxylamine for treating nausea and vomiting during pregnancy. Other medications (a, b, d) may be used but are not the first line of treatment.

Question 48

What is the most common cause of constipation in pregnancy?

a) Increased iron in prenatal vitamins
b) Decreased physical activity
c) High levels of progesterone slowing gastrointestinal motility
d) Mechanical compression by the enlarging uterus

Answer 48

c) High levels of progesterone slowing gastrointestinal motility

Rationale: Progesterone causes decreased gastrointestinal contractility, slowing transit time and leading to constipation. Iron in prenatal vitamins (a) and uterine compression (d) may contribute, but hormonal changes are the primary cause.

Question 49

Which recommendations are most effective for relieving constipation during pregnancy? (Select all that apply)

a) Increasing fluid intake
b) Adding more fresh fruits and vegetables to the diet
c) Taking stimulant laxatives daily
d) Eating whole-grain cereals and breads
e) Engaging in regular physical activity

Answer 49

a) Increasing fluid intake
b) Adding more fresh fruits and vegetables to the diet
d) Eating whole-grain cereals and breads
e) Engaging in regular physical activity

Rationale: Hydration, fiber from fruits, vegetables, and whole grains, and physical activity all promote regular bowel movements. Stimulant laxatives (c) are not recommended unless prescribed by a provider.

Question 50

What causes nasal stuffiness and nosebleeds during the first trimester of pregnancy?

a) Low estrogen levels
b) High levels of vitamin B6
c) Reduced blood flow to the nasal passages
d) Edema of the mucous membranes due to increased estrogen

Answer 50

d) Edema of the mucous membranes due to increased estrogen

Rationale: Increased estrogen levels cause vascular changes, leading to swelling in the nasal mucosa and susceptibility to nosebleeds.

Question 51

A pregnant woman asks how to manage leukorrhea during the first trimester. Which advice should the nurse provide? (Select all that apply)

a) Use cotton underwear.
b) Avoid douching and tampon use.
c) Wear tight nylon clothing to control discharge.
d) Wash the perineal area with mild soap and water daily.
e) Use a deodorant spray to mask odors.

Answer 51

a) Use cotton underwear.
b) Avoid douching and tampon use.
d) Wash the perineal area with mild soap and water daily.

Rationale: Cotton underwear, avoiding irritants like douches, and practicing good hygiene help manage leukorrhea. Tight nylon clothing (c) and deodorants (e) can worsen symptoms.

Question 52

What does pica during pregnancy most commonly indicate?

a) A craving for salty foods
b) A dietary deficiency of vitamins or minerals
c) A hormonal imbalance
d) A sign of gestational diabetes

Answer 52

b) A dietary deficiency of vitamins or minerals

Rationale: Pica, the craving for non-food substances, may indicate deficiencies such as iron or zinc.

Question 53

A pregnant woman in her second trimester complains of lower back pain. Which of the following interventions is most appropriate for relieving her backache?

A) Encourage the woman to avoid lifting any objects to prevent straining her back.
B) Recommend wearing a back support belt and practicing good posture.
C) Advise strict bed rest to reduce pressure on the back.
D) Suggest taking hot baths and applying cold compresses to the back.

Answer 53

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.

Question 54

A woman in her second trimester reports developing varicosities in the vulva and legs. What should the nurse advise her to do to manage this discomfort?

A) Avoid prolonged standing and elevate the legs when sitting or lying down.
B) Wear tight-fitting stockings to prevent further varicosities.
C) Apply heat packs to the legs and vulva to promote blood circulation.
D) Increase physical activity and avoid sitting to prevent swelling.

Answer 54

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.

Question 55

A woman at 24 weeks gestation complains of hemorrhoids, which are causing pain and discomfort. Which of the following interventions should the nurse recommend to manage this discomfort?

A) Encourage the woman to perform deep breathing exercises to relax.
B) Suggest warm sitz baths and the use of hemorrhoid cream or witch hazel.
C) Recommend increasing physical activity to relieve constipation.
D) Advise using laxatives to soften stools and avoid further straining.

Answer 55

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.

Question 56

A pregnant woman in her second trimester reports flatulence and bloating. Which of the following is the most likely cause of these symptoms?

A) Hormonal changes causing gastrointestinal motility to slow down.
B) The uterus compressing the intestines and decreasing digestion.
C) A vitamin deficiency leading to an upset stomach and bloating.
D) Excessive intake of fiber-rich foods causing increased gas production.

Answer 56

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.

Question 57

A pregnant woman in her third trimester complains of experiencing the return of nausea and vomiting, similar to what she experienced during the first trimester. Which of the following is the most appropriate response by the nurse?

A) “This is a sign of a serious complication, and you should seek immediate medical care.”

B) “Morning sickness can return in the third trimester due to increased progesterone levels.”

C) “You are likely experiencing food poisoning, and it is best to avoid eating for 24 hours.”

D) “The return of nausea and vomiting in the third trimester is unusual and should be investigated further.”

Answer 57

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.

Question 58

A 34-week pregnant woman reports shortness of breath and dyspnea. Which of the following is the most likely cause of this symptom in the third trimester?

A) The growing uterus is putting pressure on the diaphragm, reducing lung expansion.
B) The increase in circulating blood volume is causing fluid accumulation in the lungs.
C) Decreased hemoglobin levels due to pregnancy are causing hypoxia.
D) Hormonal changes are leading to restricted airways and difficulty breathing.

Answer 58

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.

Question 59

A pregnant woman in her third trimester reports frequent heartburn and indigestion. Which of the following interventions should the nurse recommend?

A) Taking over-the-counter antacids as needed for relief.
B) Eating large meals throughout the day to ensure proper digestion.
C) Avoiding foods that are spicy, acidic, or fatty, and eating smaller meals.
D) Lying down immediately after meals to help with digestion.

Answer 59

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.

Question 60

A 36-week pregnant woman is experiencing dependent edema in her legs and feet. Which of the following interventions should the nurse recommend to alleviate this discomfort?

A) Keeping the legs elevated and avoiding prolonged standing or sitting.
B) Applying tight stockings to reduce swelling in the legs.
C) Increasing salt intake to reduce the fluid retention in the legs.
D) Engaging in intense exercise to increase circulation and reduce swelling.

Answer 60

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.

Question 61

A pregnant woman at 38 weeks gestation reports experiencing Braxton Hicks contractions. Which of the following is the most appropriate explanation the nurse should provide?

A) “These are early signs of labor, and you should go to the hospital immediately.”

B) “Braxton Hicks contractions are irregular and typically occur as the body prepares for labor.”

C) “You should monitor the contractions carefully, as they may indicate preterm labor.”

D) “These contractions are a result of too much physical activity, and you should rest more.”

Answer 61

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.

Question 62

a positive result on a pregnancy test is a __________ sign of pregnancy.

Presumptive
Probable
Positive
Negative

Answer 62

Probable

Question 63

Name the endocrine hormone that matches the correct description during pregnancy.

help to thin the cervix

a. thyroid gland
b. pituitary gland
c. pancreas
d. adrenal gland
e. prostaglandin secretion
f. placental secretion

Answer 63

e. prostaglandin secretion

Question 64

What is the role of prostaglandins in cervical ripening as labor approaches?

A. They inhibit cervical dilation
B. They induce uterine contractions
C. They promote softening and increased distensibility of the cervix
D. They decrease blood supply to the cervix

Answer 64

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.

Question 65

A nurse is educating a pregnant woman in her third trimester about the role of prostaglandins in labor. Which of the following statements by the nurse is most accurate regarding prostaglandins during labor?

A) Prostaglandins inhibit uterine contractions to prolong pregnancy.

B) Prostaglandins enhance the sensitivity of the uterus to oxytocin, promoting uterine contractions.

C) Prostaglandins decrease the secretion of progesterone, leading to early labor.

D) Prostaglandins are responsible for the softening and dilation of the cervix before labor.

Answer 65

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.

Question 66

A pregnant patient at 39 weeks gestation is receiving prostaglandin gel as part of her induction of labor. The nurse understands that prostaglandins in this context primarily function to:

A) Increase the production of estrogen to stimulate labor.

B) Stimulate uterine contractions by enhancing oxytocin activity.

C) Increase progesterone production to maintain pregnancy.

D) Relax the uterine muscles to prevent preterm labor.

Answer 66

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.

Question 67

What role do prostaglandins play during early pregnancy?

a) They inhibit uterine contractions to maintain pregnancy.

b) They promote uterine smooth muscle contractions to prepare for labor.

c) They aid in the implantation of the fertilized ovum.

d) They increase maternal blood flow to the uterus and placenta.

Answer 67

c) They aid in the implantation of the fertilized ovum.

Rationale: Prostaglandins are critical during early pregnancy to promote the successful implantation of the fertilized ovum into the uterine lining by increasing endometrial receptivity.

Question 68

How do prostaglandins contribute to maintaining pregnancy in the first trimester?

a) By inhibiting progesterone synthesis.

b) By increasing uterine blood flow and vascular tone.

c) By preventing luteolysis of the corpus luteum.

d) By stimulating uterine contractions to support placental attachment.

Answer 68

b) By increasing uterine blood flow and vascular tone.

Rationale: Prostaglandins help maintain pregnancy by regulating uterine blood flow and ensuring proper vascular tone to support the developing fetus and placenta during the first trimester.

Question 69

Which of the following describes a key function of prostaglandins in the placenta during pregnancy? (Select all that apply)

a) Regulating vascular tone to ensure adequate placental perfusion.

b) Stimulating the production of surfactant in the fetal lungs.

c) Contributing to the remodeling of uterine spiral arteries.

d) Promoting cervical dilation throughout the pregnancy.

e) Supporting the maintenance of the amniotic sac integrity.

Answer 69

a) Regulating vascular tone to ensure adequate placental perfusion.

c) Contributing to the remodeling of uterine spiral arteries.

Rationale: Prostaglandins play a key role in regulating vascular tone and remodeling the uterine spiral arteries to optimize placental perfusion. This ensures the fetus receives adequate oxygen and nutrients. They are not directly involved in fetal lung surfactant production (b) or cervical dilation during pregnancy (d).

Question 70

A gravida 2 para 1 client in the 10th week of her pregnancy says to the nurse, Ive never urinated as often as I have for the past three weeks. Which response would be most appropriate for the nurse to make?

A) Having to urinate so often is annoying. I suggest that you watch how much fluid you are drinking and limit it.

B) You shouldn’t be urinating this frequently now; it usually stops by the time youre eight weeks pregnant. Is there anything else bothering you?

C) By the time you are 12 weeks pregnant, this frequent urination should no longer be a problem, but it is likely to return toward the end of your pregnancy.

D) Women having their second child generally don’t have frequent urination. Are you experiencing any burning sensations?

Answer 70

C) By the time you are 12 weeks pregnant, this frequent urination should no longer be a problem, but it is likely to return toward the end of your pregnancy.

Question 71

In a clients seventh month of pregnancy, she reports feeling dizzy, like I’m going to pass out, when I lie down flat on my back. The nurse integrates which of the following in to the explanation?

A) Pressure of the gravid uterus on the vena cava

B) A 50% increase in blood volume

C) Physiologic anemia due to hemoglobin decrease

D) Pressure of the presenting fetal part on the diaphragm

Answer 71

A) Pressure of the gravid uterus on the vena cava

Question 72

A primiparous client is being seen in the clinic for her first prenatal visit. It is determined that she is 11 weeks pregnant. The nurse develops a teaching plan to educate the client about what she will most likely experience during this period. Which of the following would the nurse include?

A) Ankle edema

B) Urinary frequency

C) Backache

D) Hemorrhoids

Answer 72

B) Urinary frequency

Question 73

A woman comes to the prenatal clinic suspecting that she is pregnant, and assessment reveals probable signs of pregnancy. Which of the following would be included as part of this assessment? (Select all that apply.)

A) Positive pregnancy test

B) Ultrasound visualization of the fetus

C) Auscultation of a fetal heartbeat

D) Ballottement

E) Absence of menstruation

F) Softening of the cervix

Answer 73

A) Positive pregnancy test

D) Ballottement

F) Softening of the cervix

Question 74

A woman suspecting she is pregnant asks the nurse about which signs would confirm her pregnancy. The nurse would explain that which of the following would confirm the pregnancy?

A) Absence of menstrual period

B) Abdominal enlargement

C) Palpable fetal movement

D) Morning sickness

Answer 74

C) Palpable fetal movement

Question 75

A woman in her second trimester comes for a follow-up visit and says to the nurse, I feel like I’m on an emotional roller-coaster. Which response by the nurse would be most appropriate?

A) How often has this been happening to you?

B) Maybe you need some medication to level things out.

C) Mood swings are completely normal during pregnancy.

D) Have you been experiencing any thoughts of harming yourself?

Answer 75

C) Mood swings are completely normal during pregnancy.

Question 76

A group of students are reviewing the signs of pregnancy. The students demonstrate understanding of the information when they identify which as presumptive signs? (Select all that apply.)

A) Amenorrhea

B) Nausea

C) Abdominal enlargement

D) Braxton-Hicks contractions

E) Fetal heart sounds

Answer 76

A) Amenorrhea

B) Nausea