Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) Chapter 11: Maternal Adaptation during Pregnancy

Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) Chapter 11: Maternal Adaptation during Pregnancy 1. During a vaginal exam, the nurse notes that the cervix has a bluish color. The nurse documents this finding as: A) Hegars sign B) Goodells sign C) Chadwicks sign D) Ortolanis sign Answer: C Explanation: Common probable signs of pregnancy include softening of the lower uterine segment or isthmus (Hegar’s sign), softening of the cervix (Goodell’s sign), and a bluish- purple coloration of the vaginal mucosa and cervix (Chadwick’s sign) 2. 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? A) Dysuria B) Dyspnea C) Constipation D) Urinary frequency Answer: D Explanation: The uterus remains in the pelvic cavity for the first 3 months of pregnancy, after which it progressively ascends into the abdomen. As the uterus grows, it presses on the urinary bladder and causes the increased frequency of urination experienced during early pregnancy. 3. 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? 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 you’re 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: C Explanation: Lying on either side relieves the pressure that the enlarged uterus puts on the vena cava carrying blood from the legs. Subsequently, venous return to the heart increases, leading to increased cardiac output. Increased cardiac output results in increased renal perfusion and glomerular filtration. As a rule, all the physiologic changes maximize by the end of the second trimester and then start to return to the prepregnant level. However, changes in the anatomy take up to 3 months postpartum to subside. 4. 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 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