Chapter 6: Maternal Adaptation during Pregnancy
1. A pregnant mother may experience constipation and the increased pressure in the veins
below the uterus can lead to development of what problem?
Correct response:
Hemorrhoids
2. The nurse instructs a pregnant client on the need to increase foods containing folic acid.
Which client statement indicates that teaching has been effective?
Correct response:
“I will add spinach to my salad every evening.”
Explanation:
The client should be instructed to eat foods that are high in folic acid such as spinach,
asparagus, and legumes.
3. The nurse is preparing to teach a community class to a group of first-time parents.
Which information should the nurse include concerning what the pregnant woman's
partner may experience as a normal response?
Correct response:
physical symptoms similar to the mother
Explanation:
Couvade syndrome is the occurrence of physical symptoms by the partner, similar to
the physical symptoms of the mother.
4. A pregnant client at 33 weeks' gestation is in the office for a routine visit. She lies down
on her back and while the nurse is listening for fetal heart tones, the client tells the nurse
that she feels lightheaded; her blood pressure is 82/58 mm Hg. What is the most likely
explanation for this problem?
Correct response:
She is experiencing supine hypotension syndrome
Explanation:
As the uterus gets larger toward the end of the pregnancy, it presses the aorta and vena
cava against the spine, causing decreased blood return to the heart. This reduces
,cardiac output and the woman may feel lightheaded and dizzy and her blood pressure
will drop.
5. A 22-year-old client comes to the walk-in clinic complaining of fatigue, breast heaviness
and extreme tenderness, and a clear vaginal discharge. What question would the nurse
ask this client?
Correct response:
Have you been sexually active in the past 2 months?
Explanation:
The client is presenting with presumptive or subjective symptoms of pregnancy. Given
her symptoms and age, asking about sexual activity is the most appropriate question.
6. During a vaginal exam, the nurse notes that the lower uterine segment is softened. How
should the nurse document this finding?
correct response:
Hegar sign
Explanation:
Hegar sign refers to the softening of the lower uterine segment or isthmus. Bluish
coloration of the cervix is termed Chadwick sign. Goodell sign refers to the softening of
the cervix.
7. 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?
Correct response:
urinary frequency
Explanation:
Lightening refers to the descent of the fetal head into the pelvis and engagement. With
this descent, pressure on the diaphragm decreases, easing breathing, but pressure on
the bladder increases, leading to urinary frequency.
8. A client comes to the clinic and tells the nurse, "I think I might be pregnant." After
completing the history and physical examination, the nurse obtains a blood
, specimen for pregnancy testing. When explaining this test to the client, which
hormone will the nurse identify as being measured by this test?
Correct response:
human chorionic gonadotropin
Explanation:
The commonly used laboratory tests for pregnancy are based on the use of a
venipuncture or a urine specimen to detect the presence of human chorionic
gonadotropin (hCG), a hormone created by the chorionic villi of the placenta, in the
urine or blood serum of the pregnant client.
9. Which assessment finding in the pregnant woman at 12 weeks' gestation should
the nurse find most concerning? The inability to:
Correct response:
detect fetal heart sounds with a Doppler.
Explanation:
Fetal heart sounds are audible with a Doppler at 10 to 12 weeks' gestation but cannot
be heard through a stethoscope until 18 to 20 weeks' gestation.
10. After a routine examination, a client tells the nurse that she plans to use a home
pregnancy test to determine if she is pregnant. What should the nurse's response
be to this client's plan?
Correct response:
Arrange for prenatal care if the test is positive.
Explanation:
After a positive pregnancy test, the first step should be to arrange for prenatal care. This
is the response that the nurse should make to the client.
11. Which information provided by a client would be considered a presumptive sign
of pregnancy?
Correct response:
Breast tenderness
Explanation:
1. A pregnant mother may experience constipation and the increased pressure in the veins
below the uterus can lead to development of what problem?
Correct response:
Hemorrhoids
2. The nurse instructs a pregnant client on the need to increase foods containing folic acid.
Which client statement indicates that teaching has been effective?
Correct response:
“I will add spinach to my salad every evening.”
Explanation:
The client should be instructed to eat foods that are high in folic acid such as spinach,
asparagus, and legumes.
3. The nurse is preparing to teach a community class to a group of first-time parents.
Which information should the nurse include concerning what the pregnant woman's
partner may experience as a normal response?
Correct response:
physical symptoms similar to the mother
Explanation:
Couvade syndrome is the occurrence of physical symptoms by the partner, similar to
the physical symptoms of the mother.
4. A pregnant client at 33 weeks' gestation is in the office for a routine visit. She lies down
on her back and while the nurse is listening for fetal heart tones, the client tells the nurse
that she feels lightheaded; her blood pressure is 82/58 mm Hg. What is the most likely
explanation for this problem?
Correct response:
She is experiencing supine hypotension syndrome
Explanation:
As the uterus gets larger toward the end of the pregnancy, it presses the aorta and vena
cava against the spine, causing decreased blood return to the heart. This reduces
,cardiac output and the woman may feel lightheaded and dizzy and her blood pressure
will drop.
5. A 22-year-old client comes to the walk-in clinic complaining of fatigue, breast heaviness
and extreme tenderness, and a clear vaginal discharge. What question would the nurse
ask this client?
Correct response:
Have you been sexually active in the past 2 months?
Explanation:
The client is presenting with presumptive or subjective symptoms of pregnancy. Given
her symptoms and age, asking about sexual activity is the most appropriate question.
6. During a vaginal exam, the nurse notes that the lower uterine segment is softened. How
should the nurse document this finding?
correct response:
Hegar sign
Explanation:
Hegar sign refers to the softening of the lower uterine segment or isthmus. Bluish
coloration of the cervix is termed Chadwick sign. Goodell sign refers to the softening of
the cervix.
7. 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?
Correct response:
urinary frequency
Explanation:
Lightening refers to the descent of the fetal head into the pelvis and engagement. With
this descent, pressure on the diaphragm decreases, easing breathing, but pressure on
the bladder increases, leading to urinary frequency.
8. A client comes to the clinic and tells the nurse, "I think I might be pregnant." After
completing the history and physical examination, the nurse obtains a blood
, specimen for pregnancy testing. When explaining this test to the client, which
hormone will the nurse identify as being measured by this test?
Correct response:
human chorionic gonadotropin
Explanation:
The commonly used laboratory tests for pregnancy are based on the use of a
venipuncture or a urine specimen to detect the presence of human chorionic
gonadotropin (hCG), a hormone created by the chorionic villi of the placenta, in the
urine or blood serum of the pregnant client.
9. Which assessment finding in the pregnant woman at 12 weeks' gestation should
the nurse find most concerning? The inability to:
Correct response:
detect fetal heart sounds with a Doppler.
Explanation:
Fetal heart sounds are audible with a Doppler at 10 to 12 weeks' gestation but cannot
be heard through a stethoscope until 18 to 20 weeks' gestation.
10. After a routine examination, a client tells the nurse that she plans to use a home
pregnancy test to determine if she is pregnant. What should the nurse's response
be to this client's plan?
Correct response:
Arrange for prenatal care if the test is positive.
Explanation:
After a positive pregnancy test, the first step should be to arrange for prenatal care. This
is the response that the nurse should make to the client.
11. Which information provided by a client would be considered a presumptive sign
of pregnancy?
Correct response:
Breast tenderness
Explanation:
