Chapter 13: Anatomy and Physiology of Pregnancy
MULTIPLE CHOICE
1. Which presumptive sign or symptom of pregnancy would a client experience who is
approximately 10 weeks of gestation?
a. Amenorrhea
b. Positive pregnancy test
c. Chadwick sign
d. Hegar sign
ANS: A
Amenorrhea is a presumptive sign of pregnancy. Presumptive signs of pregnancy are those
felt by the woman. A positive pregnancy test and the presence of the Chadwick and Hegar
signs are all probable signs of pregnancy.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
2. A client is seen at the clinic at 14 weeks of gestation for a follow-up appointment. At which
level does the nurse expect to palpate the fundus?
a. Nonpalpable above the symphysis at 14 weeks of gestation
b. Slightly above the symphysis pubis
c. At the level of the umbN cuRs SINGTB.COM
iliU
d. Slightly above the umbilicus
ANS: B
In normal pregnancies, the uterus grows at a predictable rate. It may be palpated above the
symphysis pubis sometime between the 12th and 14th weeks of pregnancy. As the uterus
grows, it may be palpated above the symphysis pubis sometime between the 12th and 14th
weeks of pregnancy. At 14 weeks, the uterus is not yet at the level of the umbilicus. The
fundus is not palpable above the umbilicus until 22 to 24 weeks of gestation.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
3. The musculoskeletal system adapts to the changes that occur throughout the pregnancy.
Which musculoskeletal alteration should the client expect?
a. Her center of gravity will shift backward.
b. She will have increased lordosis.
c. She will have increased abdominal muscle tone.
d. She will notice decreased mobility of her pelvic joints.
ANS: B
, An increase in the normal lumbosacral curve (lordosis) develops, and a compensatory
curvature in the cervicodorsal region develops to help her maintain balance. The center of
gravity shifts forward. She will have decreased abdominal muscle tone and will notice
increased mobility of her pelvic joints.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
4. A 31-year-old woman believes that she may be pregnant. She took an over-the-counter
(OTC) pregnancy test 1 week ago after missing her period; the test was positive. During her
assessment interview, the nurse asks about the woman’s last menstrual period and whether
she is taking any medications. The client states that she takes medicine for epilepsy. She has
been under considerable stress lately at work and has not been sleeping well. Her physical
examination does not indicate that she is pregnant. She has an ultrasound scan, which
confirms that she is not pregnant. What is the most likely cause of the false-positive
pregnancy test result?
a. The pregnancy test was taken too early.
b. Anticonvulsant medications may cause the false-positive test result.
c. The woman has a fibroid tumor.
d. She has been under considerable stress and has a hormone imbalance.
ANS: B
Anticonvulsants may cause false-positive pregnancy test results. OTC pregnancy tests use
enzyme-linked immunosorbent assay (ELISA) technology, which can yield positive results
as soon as 4 days after implantation. Implantation occurs 6 to 10 days after conception. If
the woman were pregnant, then she would be into her third week at this point (having
missed her period 1 week aNgoU)R
. FS
ibIroNidGtT
umorC
B. s doMnot produce hormones and have no
bearing on human chorionic gonadotropin (hCG) pregnancy tests. Although stress may
interrupt normal hormone cycles (menstrual cycles), it does not affect hCG levels or
produce positive pregnancy test results.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
5. A woman is in her seventh month of pregnancy. She reports episodes of nasal congestion
and occasional epistaxis. Which statement best describes why this may be happening to this
client?
a. This respiratory change is normal in pregnancy and caused by an elevated level of
estrogen.
b. This cardiovascular change is abnormal, and the nosebleeds are an ominous sign.
c. The woman is a victim of domestic violence and is being hit in the face by her
partner.
d. The woman has been likely intranasally using cocaine for several months.
ANS: A
, Elevated levels of estrogen cause capillaries to become engorged in the respiratory tract,
which may result in edema in the nose, larynx, trachea, and bronchi. This congestion may
cause nasal stuffiness and epistaxis. Cardiovascular changes in pregnancy may cause edema
in the lower extremities. Domestic violence cannot be determined on the basis on the sparse
facts provided. If the woman had been hit in the face, then she most likely would have
additional physical findings. Cocaine use cannot be determined on the basis on the sparse
facts provided.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
6. The nurse is providing education to a client regarding the normal changes of the breasts
during pregnancy. Which statement regarding these changes is correct?
a. The visibility of blood vessels that form an intertwining blue network indicates a
possible infection of the tubercles.
b. The mammary glands do not develop until 2 weeks before labor.
c. Lactation is inhibited until the progesterone level declines after birth.
d. Colostrum is the yellowish oily substance used to lubricate the nipples for
breastfeeding.
ANS: C
Lactation is inhibited until after birth due to progesterone levels. The visible blue network of
blood vessels is a normal outgrowth of a richer blood supply. The mammary glands are
functionally complete by mid-pregnancy. Colostrum is a creamy white-to-yellow pre-milk
fluid that can be expressed from the nipples before birth.
NURSINGTB.COM
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
7. Which hormone is essential for maintaining pregnancy?
a. Estrogen
b. hCG
c. Oxytocin
d. Progesterone
ANS: D
Progesterone is essential for maintaining pregnancy; it does so by relaxing smooth muscles,
which reduces uterine activity and prevents miscarriage. Estrogen plays a vital role in
pregnancy, but it is not the primary hormone for maintaining pregnancy. hCG levels rise at
implantation but decline after 60 to 70 days. Oxytocin stimulates uterine contractions.
PTS: 1 DIF: Cognitive Level: Remember
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
8. Which clinical finding in a primiparous client at 32 weeks of gestation might be an
indication of anemia?
a. Ptyalism
MULTIPLE CHOICE
1. Which presumptive sign or symptom of pregnancy would a client experience who is
approximately 10 weeks of gestation?
a. Amenorrhea
b. Positive pregnancy test
c. Chadwick sign
d. Hegar sign
ANS: A
Amenorrhea is a presumptive sign of pregnancy. Presumptive signs of pregnancy are those
felt by the woman. A positive pregnancy test and the presence of the Chadwick and Hegar
signs are all probable signs of pregnancy.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
2. A client is seen at the clinic at 14 weeks of gestation for a follow-up appointment. At which
level does the nurse expect to palpate the fundus?
a. Nonpalpable above the symphysis at 14 weeks of gestation
b. Slightly above the symphysis pubis
c. At the level of the umbN cuRs SINGTB.COM
iliU
d. Slightly above the umbilicus
ANS: B
In normal pregnancies, the uterus grows at a predictable rate. It may be palpated above the
symphysis pubis sometime between the 12th and 14th weeks of pregnancy. As the uterus
grows, it may be palpated above the symphysis pubis sometime between the 12th and 14th
weeks of pregnancy. At 14 weeks, the uterus is not yet at the level of the umbilicus. The
fundus is not palpable above the umbilicus until 22 to 24 weeks of gestation.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
3. The musculoskeletal system adapts to the changes that occur throughout the pregnancy.
Which musculoskeletal alteration should the client expect?
a. Her center of gravity will shift backward.
b. She will have increased lordosis.
c. She will have increased abdominal muscle tone.
d. She will notice decreased mobility of her pelvic joints.
ANS: B
, An increase in the normal lumbosacral curve (lordosis) develops, and a compensatory
curvature in the cervicodorsal region develops to help her maintain balance. The center of
gravity shifts forward. She will have decreased abdominal muscle tone and will notice
increased mobility of her pelvic joints.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
4. A 31-year-old woman believes that she may be pregnant. She took an over-the-counter
(OTC) pregnancy test 1 week ago after missing her period; the test was positive. During her
assessment interview, the nurse asks about the woman’s last menstrual period and whether
she is taking any medications. The client states that she takes medicine for epilepsy. She has
been under considerable stress lately at work and has not been sleeping well. Her physical
examination does not indicate that she is pregnant. She has an ultrasound scan, which
confirms that she is not pregnant. What is the most likely cause of the false-positive
pregnancy test result?
a. The pregnancy test was taken too early.
b. Anticonvulsant medications may cause the false-positive test result.
c. The woman has a fibroid tumor.
d. She has been under considerable stress and has a hormone imbalance.
ANS: B
Anticonvulsants may cause false-positive pregnancy test results. OTC pregnancy tests use
enzyme-linked immunosorbent assay (ELISA) technology, which can yield positive results
as soon as 4 days after implantation. Implantation occurs 6 to 10 days after conception. If
the woman were pregnant, then she would be into her third week at this point (having
missed her period 1 week aNgoU)R
. FS
ibIroNidGtT
umorC
B. s doMnot produce hormones and have no
bearing on human chorionic gonadotropin (hCG) pregnancy tests. Although stress may
interrupt normal hormone cycles (menstrual cycles), it does not affect hCG levels or
produce positive pregnancy test results.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
5. A woman is in her seventh month of pregnancy. She reports episodes of nasal congestion
and occasional epistaxis. Which statement best describes why this may be happening to this
client?
a. This respiratory change is normal in pregnancy and caused by an elevated level of
estrogen.
b. This cardiovascular change is abnormal, and the nosebleeds are an ominous sign.
c. The woman is a victim of domestic violence and is being hit in the face by her
partner.
d. The woman has been likely intranasally using cocaine for several months.
ANS: A
, Elevated levels of estrogen cause capillaries to become engorged in the respiratory tract,
which may result in edema in the nose, larynx, trachea, and bronchi. This congestion may
cause nasal stuffiness and epistaxis. Cardiovascular changes in pregnancy may cause edema
in the lower extremities. Domestic violence cannot be determined on the basis on the sparse
facts provided. If the woman had been hit in the face, then she most likely would have
additional physical findings. Cocaine use cannot be determined on the basis on the sparse
facts provided.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
6. The nurse is providing education to a client regarding the normal changes of the breasts
during pregnancy. Which statement regarding these changes is correct?
a. The visibility of blood vessels that form an intertwining blue network indicates a
possible infection of the tubercles.
b. The mammary glands do not develop until 2 weeks before labor.
c. Lactation is inhibited until the progesterone level declines after birth.
d. Colostrum is the yellowish oily substance used to lubricate the nipples for
breastfeeding.
ANS: C
Lactation is inhibited until after birth due to progesterone levels. The visible blue network of
blood vessels is a normal outgrowth of a richer blood supply. The mammary glands are
functionally complete by mid-pregnancy. Colostrum is a creamy white-to-yellow pre-milk
fluid that can be expressed from the nipples before birth.
NURSINGTB.COM
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
7. Which hormone is essential for maintaining pregnancy?
a. Estrogen
b. hCG
c. Oxytocin
d. Progesterone
ANS: D
Progesterone is essential for maintaining pregnancy; it does so by relaxing smooth muscles,
which reduces uterine activity and prevents miscarriage. Estrogen plays a vital role in
pregnancy, but it is not the primary hormone for maintaining pregnancy. hCG levels rise at
implantation but decline after 60 to 70 days. Oxytocin stimulates uterine contractions.
PTS: 1 DIF: Cognitive Level: Remember
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
8. Which clinical finding in a primiparous client at 32 weeks of gestation might be an
indication of anemia?
a. Ptyalism
