Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition)

9. When assessing a woman in her first trimester, which emotional response would the nurse most likely expect to find? A) Ambivalence B) Introversion C) Acceptance D) Emotional lability Answer: A Explanation: Ambivalence, or having conflicting feelings at the same time, is a universal feeling and is considered normal when preparing for a lifestyle change and new role. Pregnant women commonly experience ambivalence during the first trimester. Introversion, or focusing on oneself, is common during the early part of pregnancy. The woman may withdraw and become increasingly preoccupied with herself and her fetus. As a result, she may participate less with the outside world, and she may appear passive to her family and friends. This introspective behavior is a normal psychological adaptation to motherhood for most women. Introversion seems to heighten during the first and third trimesters, when the woman’s focus is on behaviors that will ensure a safe and health pregnancy outcome. During the second trimester, the physical changes of the growing fetus, including an enlarging abdomen and fetal movement, bring reality and validity to the pregnancy. 10. The nurse is assessing a pregnant woman in the second trimester. Which of the following tasks would indicate to the nurse that the client is incorporating the maternal role into her personality? A) The woman demonstrates concern for herself and her fetus as a unit. B) The client identifies what she must give up to assume her new role. C) The woman acknowledges the fetus as a separate entity within her. D) The client demonstrates unconditional acceptance without rejection. Answer: C Explanation: At second trimester, woman develops attachment of great value to her fetus, with sensation of fetal movement (quickening), mother acknowledges fetus as a separate entity within her, and identifies with infant, learns how to delay own desires. The woman demonstrates concern for herself and her fetus as a unit, and demonstrates unconditional acceptance without rejection take place during third trimester while identifying what she must give up to assume her new role happens in first trimester. 11. A woman comes to the prenatal clinic suspecting that she is pregnant, and assessment reveals probable signs of pregnancy. Which of the following would be included as part of this assessment? (Select all that apply.) A) Positive pregnancy test B) Ultrasound visualization of the fetus C) Auscultation of a fetal heart beat D) Ballottement E) Absence of menstruation F) Softening of the cervix Answer: A, D, F Explanation: Probable signs of pregnancy are: Braxton Hicks contractions (16–28 wks); Positive pregnancy test (4–12 wks); Abdominal enlargement (14 wks); Ballottement (16–28 wks); Goodell’s sign (5 wks); Chadwick’s sign (6–8 wks); Hegar’s sign (6–12 wks). Absence of menstruation is a presumptive sign while ultrasound visualization of the fetus is a positive sign of pregnancy. 12. The nurse is teaching a pregnant woman about recommended weight gain. The woman has a prepregnancy body mass index of 26. The nurse determines that the teaching was successful when the woman states that she should gain no more than which amount during pregnancy? A) 35 to 40 pounds B) 25 to 35 pounds C) 28 to 40 pounds D) 15 to 25 pounds Answer: D Explanation: Underweight (BMI 18.5) total weight gain range = 28–40 lb; Normal weight (BMI = 18.5–24.9) total weight gain range = 25–35 lb.; Overweight (BMI = 25–29.9) total weight gain range = 15–25 lb.; Obese (BMI = 30 or higher) total weight gain range = 11–20 lb. 13. A nurse strongly encourages a pregnant client to avoid eating swordfish and tilefish because these fish contain which of the following? A) Excess folic acid, which could increase the risk for neural tube defects B) Mercury, which could harm the developing fetus if eaten in large amounts C) Lactose, which leads to abdominal discomfort, gas, and diarrhea D) Low-quality protein that does not meet the woman's requirements Answer: B Explanation: 14. Which of the following changes in the musculoskeletal system would the nurse mention when teaching a group of pregnant women about the physiologic changes of pregnancy? A) Ligament tightening B) Decreased swayback C) Increased lordosis D) Joint contraction Answer: C Explanation: By the 10th to 12th week of pregnancy, the ligaments that hold the sacroiliac joints and the pubis symphysis in place begin to soften and stretch, and the articulations between the joints widen and become more movable. The postural changes of pregnancy—an increased swayback and an upper spine extension to compensate for the enlarging abdomen—coupled with the loosening of the sacroiliac joints may result in lower back pain. The woman’s center of gravity shifts forward, requiring a realignment of the spinal curvatures. An increase in the normal lumbosacral curve (lordosis) occurs and a compensatory curvature in the cervicodorsal area develops to assist her in maintaining her balance. In addition, relaxation and increased mobility of joints occur because of the hormones progesterone and relaxin, which lead to the characteristic “waddle” gait that pregnant women demonstrate toward term. 15. Assessment of a pregnant woman reveals a pigmented line down the middle of her abdomen. The nurse documents this as which of the following? A) Linea nigra B) Striae gravidarum C) Melasma D) Vascular spiders Answer: A Explanation: The skin in the middle of the abdomen may develop a pigmented line called linea nigra, which extends from the umbilicus to the pubic area. Striae gravidarum, or stretch marks, are irregular reddish streaks that appear on the abdomen, breasts, and buttocks in up to 90% of pregnant women. Striae are most prominent by 6 to 7 months. 16. A nurse is assessing a pregnant woman on a routine checkup. When assessing the woman's gastrointestinal tract, which of the following would the nurse expect to find? (Select all that apply.) A) Hyperemic gums B) Increased peristalsis C) Complaints of bloating D) Heartburn E) Nausea Answer: A, C, D, E Explanation: During pregnancy, the gums become hyperemic, swollen, and friable and tend to bleed easily. This change is influenced by estrogen and increased proliferation of blood vessels and circulation to the mouth. Smooth muscle relaxation and decreased peristalsis occur related to the influence of progesterone. Elevated progesterone levels cause smooth muscle relaxation, which results in delayed gastric emptying and decreased peristalsis. Transition time of food throughout the gastrointestinal tract may be so much slower that more water than normal is reabsorbed, leading to bloating and constipation. The slowed gastric emptying combined with relaxation of the cardiac sphincter allows reflux, which causes heartburn. Acid indigestion or heartburn (pyrosis) seems to be a universal problem for pregnant women. Nausea and vomiting, better known as morning sickness, plague about 80% of pregnant women. This condition is usually self-limiting, but the symptoms can be distressing and interfere with work, social activities, and interrupt sleep. 17. A woman suspecting she is pregnant asks the nurse about which signs would confirm her pregnancy. The nurse would explain that which of the following would confirm the pregnancy? A) Absence of menstrual p