Chapter 07: Physiologic Adaptations to Pregnancy

Chapter 07: Physiologic Adaptations to Pregnancy

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A pregnant client’s mother is worried that her daughter is not “big enough” at 20 weeks of gestation. The nurse palpates and measures the fundal height at 20 cm, which is even with the woman’s umbilicus. Which should the nurse report to the client and her mother?

ANS:  C

At 20 weeks, the fundus is usually located at the umbilical level. Because the uterus grows in a predictable pattern, obstetric nurses should know that the uterus of 20 weeks’ gestation is located at the level of the umbilicus. Lightening has not yet occurred. At 20 weeks, the uterus should be at the umbilical level. The descent of the fetal head (lightening) occurs in late pregnancy. Waiting until the next appointment avoids the direct question and might increase the anxiety of the mother and grandmother.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   94

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Health Promotion and Maintenance

2. While the vital signs of a pregnant client in her third trimester are being assessed, the client complains of feeling faint, dizzy, and agitated. Which nursing intervention is appropriate?

ANS:  C

Blood pressure is affected by positions during pregnancy. The supine position may cause occlusion of the vena cava and descending aorta. Turning the pregnant woman to a lateral recumbent position alleviates pressure on the blood vessels and quickly corrects supine hypotension. Pressures are significantly higher when the patient is standing. This would cause an increase in systolic and diastolic pressures. The arm should be supported at the same level of the heart. The supine position may cause occlusion of the vena cava and descending aorta, creating hypotension.

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   96

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Physiologic Integrity

3. A pregnant client has come to the emergency department with complaints of nasal congestion and epistaxis. Which is the correct interpretation of these symptoms by the health care provider?

ANS:  D

As capillaries become engorged, the upper respiratory tract is affected by the subsequent edema and hyperemia, which causes these conditions, seen commonly during pregnancy. Progesterone is responsible for the heightened awareness of the need to breathe in pregnancy. Progesterone levels increase during pregnancy. The client should be reassured that these symptoms are within normal limits. No referral is needed at this time. Relaxation of the smooth muscles in the respiratory tract is affected by progesterone.

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   97

OBJ:   Nursing Process Step: Planning        MSC:  Client Needs: Physiologic Integrity

4. Which suggestion is appropriate for the pregnant client who is experiencing heartburn?

ANS:  D

Antacids high in calcium (e.g., Tums, Alkamints) can provide temporary relief. Fluids overstretch the stomach and may precipitate reflux when lying down. Instruct the woman to eat five or six small meals per day rather than three full meals. Coffee and orange juice stimulate acid formation in the stomach.

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   114

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Physiologic Integrity

5. While providing education to a primiparous client regarding the normal changes of pregnancy, what is important for the nurse to explain about Braxton Hicks contractions?

ANS:  D

Throughout pregnancy, the uterus undergoes irregular contractions called Braxton Hicks contractions. During the first two trimesters, the contractions are infrequent and usually not felt by the woman until the third trimester. Braxton Hicks contractions do not indicate preterm labor. Braxton Hicks contractions can cause some discomfort, especially in the third trimester. Braxton Hicks contractions occur throughout the whole pregnancy.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   94

OBJ:    Nursing Process Step: Implementation