Questions and Answers
At 20 weeks' gestation, where would the fundus be located?
What assessment finding might suggest vulvovaginal candidiasis in a pregnant woman with a whitish vaginal discharge?
What hormone acts against maternal insulin during the last half of pregnancy?
hPL
During a vaginal exam, the nurse notes that the cervix has a bluish color. The nurse documents this finding as:
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The nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. The mother will most likely experience which of the following at that time?
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A gravida 2 para 1 client in the 10th week of her pregnancy says to the nurse, 'I've never urinated as often as I have for the past three weeks.' Which response would be most appropriate for the nurse to make?
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In a client's 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 into the explanation?
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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?
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A pregnant client in her second trimester has a hemoglobin level of 11 g/dL. The nurse interprets this as indicating which of the following?
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The nurse is discussing the insulin needs of a primiparous client with diabetes. The nurse informs the client that her insulin needs will increase during pregnancy based on the nurse's understanding that the placenta produces:
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When teaching a pregnant client about the physiologic changes of pregnancy, the nurse reviews the effect of pregnancy on glucose metabolism. Which of the following would the nurse include as the underlying reason for the effect?
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When assessing a woman in her first trimester, which emotional response would the nurse most likely expect to find?
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The nurse is assessing a pregnant woman in the second trimester. Which of the following tasks would indicate to the nurse that the client is incorporating the maternal role into her personality?
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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)
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The nurse is teaching a pregnant woman about recommended weight gain. The woman has a prepregnancy body mass index of 26. The nurse determines that the teaching was successful when the woman states that she should gain no more than which amount during pregnancy?
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A nurse strongly encourages a pregnant client to avoid eating swordfish and tilefish because these fish contain which of the following?
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Which of the following changes in the musculoskeletal system would the nurse mention when teaching a group of pregnant women about the physiologic changes of pregnancy?
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Assessment of a pregnant woman reveals a pigmented line down the middle of her abdomen. The nurse documents this as which of the following?
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A nurse is assessing a pregnant woman on a routine checkup. When assessing the woman's gastrointestinal tract, which of the following would the nurse expect to find? (Select all that apply)
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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?
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A nurse is developing a teaching plan about nutrition for a group of pregnant women. Which of the following would the nurse include in the discussion? (Select all that apply)
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Assessment of a pregnant woman reveals that she compulsively craves ice. The nurse documents this finding as which of the following?
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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?
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While talking with a woman in her third trimester, which behavior indicates to the nurse that the woman is learning to give of oneself?
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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)
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A nursing instructor is teaching a class to a group of students about pregnancy, insulin, and glucose. Which of the following would the instructor least likely include as opposing insulin?
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Study Notes
Signs and Symptoms of Pregnancy
- Chadwick's sign: Bluish color of the cervix indicating pregnancy.
- Lightening: Fetal head descends into the pelvis about 2 weeks before labor, causing increased urinary frequency due to bladder pressure.
- Urinary frequency: Common in first trimester due to uterus pressure on the bladder; may return in third trimester as fetus descends.
- Supine hypotension syndrome: Dizziness when lying flat due to pressure on the vena cava from the gravid uterus.
- Probable signs of pregnancy: Include a positive pregnancy test, ballottement, and softening of the cervix, while absence of menstrual period is a presumptive sign.
Physiological Changes in Pregnancy
- Hemoglobin interpretation: A level of 11 g/dL in the second trimester indicates hemodilution due to increased plasma volume.
- Insulin resistance: In pregnancy, hPL hormone increases maternal insulin needs; hCG does not impact insulin directly.
- Maternal glucose metabolism: Glucose metered through the placenta to nourish the fetus increases the demand on maternal glucose stores.
Emotional Responses During Pregnancy
- First trimester emotions: Ambivalence often experienced; emotional lability may occur throughout the pregnancy.
- Acceptance of maternal role: Validated by acknowledging the fetus as a separate entity during the second trimester.
Nutritional Guidelines for Pregnancy
- Weight gain recommendations: A woman with a BMI of 26 should aim for a weight gain of 15 to 25 pounds.
- Avoidance of high-mercury fish: Swordfish and tilefish should be limited due to potential mercury exposure that harms fetal development.
- Dietary suggestions: Encourage three meals and snacks daily; avoid diuretics and engage in regular physical activity.
Musculoskeletal and Gastrointestinal Changes
- Increased lordosis: Pregnant women exhibit greater lumbar curvature and forward shift in center of gravity.
- Gastrointestinal effects: Common findings include hyperemic gums, nausea, bloating, and heartburn due to relaxed motility and hormonal changes.
Confirming Pregnancy
- Positive signs: Only palpating fetal movement, ultrasound visualization, and audible fetal heart sounds can confirm pregnancy.
- Distinction between signs: Presumptive signs (e.g., amenorrhea, nausea) may occur without pregnancy; probable signs include abdominal enlargement.
Special Considerations
- Pica: Refers to craving nonfood items; can indicate underlying nutritional deficiencies.
- Vulvovaginal candidiasis: Suspected alongside symptoms of vaginal itching and increased discharge during pregnancy.
- Emotional support: Common mood swings are normal and should be acknowledged to assist with emotional health during pregnancy.
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Description
Test your knowledge with these flashcards from Nursing Chapter 11. Explore key terms related to vaginal exams and signs of pregnancy. This quiz will help reinforce important concepts in obstetrical nursing.
