Chapter 12 Physical and Psychologic Changes of Pregnancy

Chapter 12   Physical and Psychologic Changes of Pregnancy

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

1) A client with a normal prepregnancy weight asks why she has been told to gain 25-35 pounds during her pregnancy while her underweight friend was told to gain more weight. What should the nurse tell the client the recommended weight gain is during pregnancy?

1. 25-35 pounds, regardless of a client’s prepregnant weight
2. More than 25-35 pounds for an overweight woman
3. Up to 40 pounds for an underweight woman
4. The same for a normal weight woman as for an overweight woman

Answer:  3

Explanation:  3. Prepregnant weight determines the recommended weight gain during pregnancy. Underweight women are advised to gain 28-40 pounds.

Page Ref: 229

Cognitive Level:  Applying

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, cultural, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  1 Identify the anatomic and physiologic changes that occur during pregnancy.

MNL LO:  2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

2) The nurse understands that a client’s pregnancy is progressing normally when what physiologic changes are documented on the prenatal record of a woman at 36 weeks’ gestation?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. The joints of the pelvis have relaxed, causing a waddling gait.
2. The cervix is firm and blue-purple in color.
3. The uterus vasculature contains one sixth of the total maternal blood volume.
4. Gastric emptying time is delayed, and the client complains of constipation and bloating.
5. Supine hypotension occurs when the client lies on her back.

Answer:  1, 3, 4, 5

Explanation:  1. The sacroiliac, sacrococcygeal, and pubic joints of the pelvis relax in the later part of the pregnancy, presumably as a result of hormonal changes. This often causes a waddling gait.

3. By the end of pregnancy, one sixth of the total maternal blood volume is contained within the vascular system of the uterus.
4. Gastric emptying time and intestinal motility are delayed, leading to frequent complaints of bloating and constipation, which can be aggravated by the smooth muscle relaxation and increased electrolyte and water reabsorption in the large intestine.
5. The enlarging uterus may exert pressure on the vena cava when the woman lies supine, causing a drop in blood pressure. This is called the vena caval syndrome, or supine hypotension.

Page Ref: 225, 226, 227, 228

Cognitive Level:  Understanding

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome:  2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO:  2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

3) A client who is in the second trimester of pregnancy tells the nurse that she has developed a darkening of the line in the midline of her abdomen from the symphysis pubis to the umbilicus. What other expected changes during pregnancy might she also notice?

1. Lightening of the nipples and areolas
2. Reddish streaks called striae on her abdomen
3. A decrease in hair thickness
4. Small purplish dots on her face and arms

Answer:  2

Explanation:  2. Striae, or stretch marks, are reddish, wavy, depressed streaks that may occur over the abdomen, breasts, and thighs as pregnancy progresses.

Page Ref: 228

Cognitive Level:  Understanding

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:  2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO:  2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

4) The nurse is listening to the fetal heart tones of a client at 37 weeks’ gestation while the client is in a supine position. The client states, “I’m getting lightheaded and dizzy.” What is the nurse’s best action?

1. Assist the client to sit up.
2. Remind the client that she needs to lie still to hear the baby.
3. Help the client turn onto her left side.
4. Check the client’s blood pressure.

Answer:  3

Explanation:  3. During pregnancy the enlarging uterus may put pressure on the vena cava when the woman is supine, resulting in supine hypotensive syndrome. This pressure interferes with returning blood flow and produces a marked decrease in blood pressure with accompanying dizziness, pallor, and clamminess, which can be corrected by having the woman lie on her left side.

Page Ref: 226

Cognitive Level:  Analyzing

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: III. B. 3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Respect the patient’s dignity, uniqueness, integrity, and self-determination and his or her own power and self-healing process. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO:  2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

5) What is the increased vascularization causing the softening of the cervix known as?

1. Hegar sign
2. Chadwick sign
3. Goodell sign
4. McDonald sign

Answer:  3

Explanation:  3. Increased vascularization causes the softening of the cervix known as Goodell sign.

Page Ref: 231

Cognitive Level:  Remembering

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: III. B. 3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Respect the patient’s dignity, uniqueness, integrity, and self-determination, and his or her own power and self-healing process. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:  1 Identify the anatomic and physiologic changes that occur during pregnancy.

MNL LO:  2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.