Nursing 317: Maternal Adaptation During
Pregnancy (NCLEX Questions and
Review)
____ supplementation is recommended for all pregnant women because it is almost
impossible for the pregnant woman to get what is required from diet alone, especially after
20 weeks' gestation when the requirements of the fetus increase. - ANS--Iron
\_______ increases during the second half of pregnancy, and it helps in the preparation of
mammary glands for lactation and is involved in the process of making glucose available for
fetal growth by altering maternal carbohydrate, fat, and protein metabolism. - ANS--hPL
\_______ signs affirm that proof exists that there is a developing fetus in any trimester and
are objective criteria seen by a trained observer or diagnostic study - ANS--Positive
(e.g., ultrasound.)
\_________ signs are signs that appear in the first and early second trimesters, seen via
objective criteria, but can also be indicators of other conditions... - ANS--Probable signs
(e.g., hydatidiform mole).
\A 24-week pregnant client calls the clinic crying after a prenatal visit, where she had a pelvic
exam. She states that she noticed blood on the tissue when she wiped after voiding. What
initial statement by the nurse would explain this finding?
-The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual.
-She may have a bleeding disorder so she needs to come back to the clinic for blood work.
-It is possible she is losing her mucous plug, which can cause bloody show.
-Some bleeding during pregnancy is not uncommon and this finding is expected. - ANS--The
cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual.
\A 33-week pregnant client 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 is
lightheaded and her blood pressure is 82/58. What is the most likely explanation for this
problem?
-She is experiencing supine hypotension syndrome
-She did not drink enough fluids prior to coming to the office.
-Her hematocrit is low and she needs additional iron supplements.
-The baby is kicking her spinal column, causing a pinched nerve. - ANS--She is experiencing
supine hypotension syndrome
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.
\A client at 39 weeks' gestation calls the OB triage and questions the nurse concerning a
bloody mucous discharge noted in the toilet after an OB office visit several hours earlier.
What is the best response from the triage nurse?
-"It might be nothing. If it happens again call your provider who is on-call."
-"If the provider did an exam, it might be just normal vaginal secretions, so don't worry about
it."
, -"A one time discharge of bloody mucus in the toilet might have been your mucous plug."
-"Bloody mucus is a sign you are in labor. Please come to the hospital." - ANS--"A one time
discharge of bloody mucus in the toilet might have been your mucous plug."
Bloody mucus can either be a mucous plug or bloody show. The one time occurrence would
be more likely to be the mucous plug. A bloody show would continue if her cervix was
changing, but this usually does not occur until after contractions start. It is a sign that
something is happening and should be reported to the health care provider. The bloody
mucus is not a sign of labor, but it can be an early sign that labor is coming soon.
\A client in her 10th week of gestation arrives at the maternity clinic reporting morning
sickness. The nurse needs to inform the client about the body system adaptations during
pregnancy. Which factors correspond to the morning sickness period during pregnancy?
Select all that apply.
-Reduced stomach acidity
-Elevated human chorionic gonadotropin (hCG)
-Increased red blood cell (RBC) production -Increased estrogen level elevated human
placental lactogen (hPL) - ANS--Reduced stomach acidity
-Elevated human chorionic gonadotropin (hCG)
-Increased estrogen level
\A client who is entering her third trimester comes to the prenatal clinic for a follow-up
examination. When assessing the breasts, which findings would the nurse expect? Select all
that apply.
-Pallor of the areolae
-Prominent veins
-Hyperpigmentation of the nipple
-Warmth increased sensitivity - ANS--Prominent veins
-Hyperpigmentation of the nipple
-Increased sensitivity
Normal breast findings include prominent veins, nodular breasts, increased sensitivity to
touch, and hyperpigmentation of the nipples and areolae. Warmth would suggest possible
infection.
\A client who is in her sixth week of gestation is being seen for a routine prenatal care visit.
The client asks the nurse about changes in her eating habits that she should make during
her pregnancy. The client informs the nurse that she is a vegetarian. The nurse knows that
she has to monitor the client for which risks arising from her vegetarian diet? Select all that
apply.
-epistaxis
-iron-deficiency anemia
-decreased mineral absorption
-constipation
-low gestational weight gain - ANS--Iron-deficiency anemia
-Decreased mineral absorption
-Low gestational weight gain
\A client who suspects she is pregnant asks the nurse about the accuracy of home
pregnancy tests. The nurse would tell the client that:
-Home pregnancy tests often give a false positive result.
-Their reliability is only about 90%.
Pregnancy (NCLEX Questions and
Review)
____ supplementation is recommended for all pregnant women because it is almost
impossible for the pregnant woman to get what is required from diet alone, especially after
20 weeks' gestation when the requirements of the fetus increase. - ANS--Iron
\_______ increases during the second half of pregnancy, and it helps in the preparation of
mammary glands for lactation and is involved in the process of making glucose available for
fetal growth by altering maternal carbohydrate, fat, and protein metabolism. - ANS--hPL
\_______ signs affirm that proof exists that there is a developing fetus in any trimester and
are objective criteria seen by a trained observer or diagnostic study - ANS--Positive
(e.g., ultrasound.)
\_________ signs are signs that appear in the first and early second trimesters, seen via
objective criteria, but can also be indicators of other conditions... - ANS--Probable signs
(e.g., hydatidiform mole).
\A 24-week pregnant client calls the clinic crying after a prenatal visit, where she had a pelvic
exam. She states that she noticed blood on the tissue when she wiped after voiding. What
initial statement by the nurse would explain this finding?
-The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual.
-She may have a bleeding disorder so she needs to come back to the clinic for blood work.
-It is possible she is losing her mucous plug, which can cause bloody show.
-Some bleeding during pregnancy is not uncommon and this finding is expected. - ANS--The
cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual.
\A 33-week pregnant client 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 is
lightheaded and her blood pressure is 82/58. What is the most likely explanation for this
problem?
-She is experiencing supine hypotension syndrome
-She did not drink enough fluids prior to coming to the office.
-Her hematocrit is low and she needs additional iron supplements.
-The baby is kicking her spinal column, causing a pinched nerve. - ANS--She is experiencing
supine hypotension syndrome
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.
\A client at 39 weeks' gestation calls the OB triage and questions the nurse concerning a
bloody mucous discharge noted in the toilet after an OB office visit several hours earlier.
What is the best response from the triage nurse?
-"It might be nothing. If it happens again call your provider who is on-call."
-"If the provider did an exam, it might be just normal vaginal secretions, so don't worry about
it."
, -"A one time discharge of bloody mucus in the toilet might have been your mucous plug."
-"Bloody mucus is a sign you are in labor. Please come to the hospital." - ANS--"A one time
discharge of bloody mucus in the toilet might have been your mucous plug."
Bloody mucus can either be a mucous plug or bloody show. The one time occurrence would
be more likely to be the mucous plug. A bloody show would continue if her cervix was
changing, but this usually does not occur until after contractions start. It is a sign that
something is happening and should be reported to the health care provider. The bloody
mucus is not a sign of labor, but it can be an early sign that labor is coming soon.
\A client in her 10th week of gestation arrives at the maternity clinic reporting morning
sickness. The nurse needs to inform the client about the body system adaptations during
pregnancy. Which factors correspond to the morning sickness period during pregnancy?
Select all that apply.
-Reduced stomach acidity
-Elevated human chorionic gonadotropin (hCG)
-Increased red blood cell (RBC) production -Increased estrogen level elevated human
placental lactogen (hPL) - ANS--Reduced stomach acidity
-Elevated human chorionic gonadotropin (hCG)
-Increased estrogen level
\A client who is entering her third trimester comes to the prenatal clinic for a follow-up
examination. When assessing the breasts, which findings would the nurse expect? Select all
that apply.
-Pallor of the areolae
-Prominent veins
-Hyperpigmentation of the nipple
-Warmth increased sensitivity - ANS--Prominent veins
-Hyperpigmentation of the nipple
-Increased sensitivity
Normal breast findings include prominent veins, nodular breasts, increased sensitivity to
touch, and hyperpigmentation of the nipples and areolae. Warmth would suggest possible
infection.
\A client who is in her sixth week of gestation is being seen for a routine prenatal care visit.
The client asks the nurse about changes in her eating habits that she should make during
her pregnancy. The client informs the nurse that she is a vegetarian. The nurse knows that
she has to monitor the client for which risks arising from her vegetarian diet? Select all that
apply.
-epistaxis
-iron-deficiency anemia
-decreased mineral absorption
-constipation
-low gestational weight gain - ANS--Iron-deficiency anemia
-Decreased mineral absorption
-Low gestational weight gain
\A client who suspects she is pregnant asks the nurse about the accuracy of home
pregnancy tests. The nurse would tell the client that:
-Home pregnancy tests often give a false positive result.
-Their reliability is only about 90%.
