Health Assessment For Nursing Practice 5th Edition by Wilson
Health Assessment For Nursing Practice 5th Edition by Wilson
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Chapter 20: Assessment of the Pregnant Patient
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | “A woman’s blood pressure usually drops several points during pregnancy, but yours hasn’t.” |
| b. | “The blood pressure increases because your blood volume increases to supply you and the baby with enough blood.” |
| c. | “Yes, this is a significant change from your baseline, and I advise you to see your obstetrician at your earliest convenience.” |
| d. | “If you spend more time lying down, I think your blood pressure should return to normal in a few days.” |
ANS: B
| Feedback | |
| A | The blood pressure may decrease slightly in the second trimester and then return to the usual level during the third trimester. With an increase in blood volume, the patient may experience an increase in blood pressure above baseline. |
| B | Blood volume increases by 1500 mL to meet the needs of an enlarged uterus and fetal tissue, causing increased cardiac workload (increased heart rate and blood pressure). |
| C | This referral is unnecessary. |
| D | With an increase in blood volume, the patient may experience an increase in blood pressure above baseline. |
DIF: Cognitive Level: Apply REF: 496
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Reduction of Risk Potential: System Specific Assessments
| a. | Nipples becoming thicker |
| b. | Hands and feet becoming pale and cool |
| c. | Blotchy, brown pigmentation of the abdomen |
| d. | Stretch marks on the expanding abdomen |
ANS: D
| Feedback | |
| A | Nipples and areolae become more prominent and deeply pigmented. |
| B | Blood volume increases and edema often develops in the feet. |
| C | The blotchy, brown pigmentation occurs on the face and is called chloasma, or the mask of pregnancy. |
| D | The increasing size of the abdomen contributes to striae gravidarum (stretch marks) over the abdomen. |
DIF: Cognitive Level: Understand REF: 496| 505
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alterations in Body Systems
| a. | Assesses the softening of the lower uterine segment |
| b. | Palpates for softening of the cervix |
| c. | Assesses the breasts for fullness and tenderness |
| d. | Inspects the cervix for a bluish coloration |
ANS: B
| Feedback | |
| A | Assesses the softening of the lower uterine segment is a description of Hegar sign. |
| B | Palpates for softening of the cervix is a description of Goodell sign. |
| C | Assesses the breasts for fullness and tenderness is a presumptive sign of pregnancy rather than a probable sign. |
| D | Inspects the cervix for a bluish coloration is a description of Chadwick sign. |
DIF: Cognitive Level: Understand REF: 496, Table 20-1
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care
| a. | Cessation of menstruation |
| b. | Visualization of the fetus by ultrasound |
| c. | Nausea and increased abdominal girth |
| d. | Positive pregnancy test (hCG) |
ANS: B
| Feedback | |
| A | Cessation of menstruation is a presumptive sign of pregnancy. |
| B | This is a positive sign of pregnancy. |
| C | Nausea and increased abdominal girth are presumptive signs of pregnancy. |
| D | Positive pregnancy test (hCG) is a probable sign of pregnancy. |
DIF: Cognitive Level: Understand REF: 496, Table 20-1
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care
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