Chapter 11 Physical and Psychologic Changes of Pregnancy
1) A client with a normal prepregnancy weight asks why she has been told to
gain 25-35 pounds during her pregnancy while her underweight friend was told
to gain more weight. What should the nurse tell the client the recommended
weight gain is during pregnancy?
1. 25-35 pounds, regardless of a clients prepregnant weight
2. More than 25-35 pounds for an overweight woman
3. Up to 40 pounds for an underweight woman
4. The same for a normal weight woman as for an overweight woman
Answer: 3
Explanation: 3. Prepregnant weight determines the recommended weight gain
during pregnancy. Underweight women are advised to gain 28-40 pounds.
Page Ref: 229
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. B. 10. Engage patients or designated
surrogates in active partnerships that promote health, safety and well-being, and
self-care management. | AACN Essentials Competencies: IX. 7. Provide
appropriate patient teaching that reflects developmental stage, age, cultural,
spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-
Centered Care: Communicate information effectively; listen openly and
cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1 Identify the anatomic and physiologic changes that occur
during pregnancy.
MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to
pregnancy.
1
Copyright 2016 Pearson Education, Inc.
2) The nurse understands that a clients pregnancy is progressing normally when
what physiologic changes are documented on the prenatal record of a woman
at 36 weeks gestation?
,Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. The joints of the pelvis have relaxed, causing a waddling gait.
2. The cervix is firm and blue-purple in color.
3. The uterus vasculature contains one sixth of the total maternal blood volume.
4. Gastric emptying time is delayed, and the client complains of constipation
and bloating.
5. Supine hypotension occurs when the client lies on her back.
Answer: 1, 3, 4, 5
Explanation: 1. The sacroiliac, sacrococcygeal, and pubic joints of the pelvis
relax in the later part of the pregnancy, presumably as a result of hormonal
changes. This often causes a waddling gait.
3. By the end of pregnancy, one sixth of the total maternal blood volume is
contained within the vascular system of the uterus.
4. Gastric emptying time and intestinal motility are delayed, leading to frequent
complaints of bloating and constipation, which can be aggravated by the smooth
muscle relaxation and increased electrolyte and water reabsorption
in the large intestine.
,5. The enlarging uterus may exert pressure on the vena cava when the woman
lies supine, causing a drop in blood pressure. This is called the vena caval
syndrome, or supine hypotension.
Page Ref: 225, 226, 227, 228
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences,
and expressed needs as part of clinical interview, implementation of care
plan, and evaluation of care. | AACN Essentials Competencies: IX. 1.
Conduct comprehensive and focused physical, behavioral, psychological,
spiritual, socioeconomic, and environmental assessments of health and illness
parameters in patients, using developmentally and culturally appropriate
approaches. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 2 Relate the physiologic and anatomic changes that occur
in the body systems during pregnancy to the signs and symptoms that
develop in the woman.
MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to
pregnancy.
2
Copyright 2016 Pearson Education, Inc.
3) A client who is in the second trimester of pregnancy tells the nurse that she
has developed a darkening of the line in the midline of her abdomen from the
symphysis pubis to the umbilicus. What other expected changes during
pregnancy might she also notice?
1. Lightening of the nipples and areolas
2. Reddish streaks called striae on her abdomen
3. A decrease in hair thickness
4. Small purplish dots on her face and arms
Answer: 2
, Explanation: 2. Striae, or stretch marks, are reddish, wavy, depressed streaks
that may occur over the abdomen, breasts, and thighs as pregnancy
progresses.
Page Ref: 228
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences,
and expressed needs as part of clinical interview, implementation of care
plan, and evaluation of care. | AACN Essentials Competencies: IX. 1.
Conduct comprehensive and focused physical, behavioral, psychological,
spiritual, socioeconomic, and environmental assessments of health and illness
parameters in patients, using developmentally and culturally appropriate
approaches. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2 Relate the physiologic and anatomic changes that occur
in the body systems during pregnancy to the signs and symptoms that
develop in the woman.
MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to
pregnancy.
3
Copyright 2016 Pearson Education, Inc.
4) The nurse is listening to the fetal heart tones of a client at 37 weeks gestation
while the client is in a supine position. The client states, Im getting lightheaded
and dizzy. What is the nurses best action?
1. Assist the client to sit up.
2. Remind the client that she needs to lie still to hear the baby.
3. Help the client turn onto her left side.
4. Check the clients blood pressure.
Answer: 3
Explanation: 3. During pregnancy the enlarging uterus may put pressure on
1) A client with a normal prepregnancy weight asks why she has been told to
gain 25-35 pounds during her pregnancy while her underweight friend was told
to gain more weight. What should the nurse tell the client the recommended
weight gain is during pregnancy?
1. 25-35 pounds, regardless of a clients prepregnant weight
2. More than 25-35 pounds for an overweight woman
3. Up to 40 pounds for an underweight woman
4. The same for a normal weight woman as for an overweight woman
Answer: 3
Explanation: 3. Prepregnant weight determines the recommended weight gain
during pregnancy. Underweight women are advised to gain 28-40 pounds.
Page Ref: 229
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. B. 10. Engage patients or designated
surrogates in active partnerships that promote health, safety and well-being, and
self-care management. | AACN Essentials Competencies: IX. 7. Provide
appropriate patient teaching that reflects developmental stage, age, cultural,
spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-
Centered Care: Communicate information effectively; listen openly and
cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1 Identify the anatomic and physiologic changes that occur
during pregnancy.
MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to
pregnancy.
1
Copyright 2016 Pearson Education, Inc.
2) The nurse understands that a clients pregnancy is progressing normally when
what physiologic changes are documented on the prenatal record of a woman
at 36 weeks gestation?
,Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. The joints of the pelvis have relaxed, causing a waddling gait.
2. The cervix is firm and blue-purple in color.
3. The uterus vasculature contains one sixth of the total maternal blood volume.
4. Gastric emptying time is delayed, and the client complains of constipation
and bloating.
5. Supine hypotension occurs when the client lies on her back.
Answer: 1, 3, 4, 5
Explanation: 1. The sacroiliac, sacrococcygeal, and pubic joints of the pelvis
relax in the later part of the pregnancy, presumably as a result of hormonal
changes. This often causes a waddling gait.
3. By the end of pregnancy, one sixth of the total maternal blood volume is
contained within the vascular system of the uterus.
4. Gastric emptying time and intestinal motility are delayed, leading to frequent
complaints of bloating and constipation, which can be aggravated by the smooth
muscle relaxation and increased electrolyte and water reabsorption
in the large intestine.
,5. The enlarging uterus may exert pressure on the vena cava when the woman
lies supine, causing a drop in blood pressure. This is called the vena caval
syndrome, or supine hypotension.
Page Ref: 225, 226, 227, 228
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences,
and expressed needs as part of clinical interview, implementation of care
plan, and evaluation of care. | AACN Essentials Competencies: IX. 1.
Conduct comprehensive and focused physical, behavioral, psychological,
spiritual, socioeconomic, and environmental assessments of health and illness
parameters in patients, using developmentally and culturally appropriate
approaches. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 2 Relate the physiologic and anatomic changes that occur
in the body systems during pregnancy to the signs and symptoms that
develop in the woman.
MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to
pregnancy.
2
Copyright 2016 Pearson Education, Inc.
3) A client who is in the second trimester of pregnancy tells the nurse that she
has developed a darkening of the line in the midline of her abdomen from the
symphysis pubis to the umbilicus. What other expected changes during
pregnancy might she also notice?
1. Lightening of the nipples and areolas
2. Reddish streaks called striae on her abdomen
3. A decrease in hair thickness
4. Small purplish dots on her face and arms
Answer: 2
, Explanation: 2. Striae, or stretch marks, are reddish, wavy, depressed streaks
that may occur over the abdomen, breasts, and thighs as pregnancy
progresses.
Page Ref: 228
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences,
and expressed needs as part of clinical interview, implementation of care
plan, and evaluation of care. | AACN Essentials Competencies: IX. 1.
Conduct comprehensive and focused physical, behavioral, psychological,
spiritual, socioeconomic, and environmental assessments of health and illness
parameters in patients, using developmentally and culturally appropriate
approaches. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2 Relate the physiologic and anatomic changes that occur
in the body systems during pregnancy to the signs and symptoms that
develop in the woman.
MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to
pregnancy.
3
Copyright 2016 Pearson Education, Inc.
4) The nurse is listening to the fetal heart tones of a client at 37 weeks gestation
while the client is in a supine position. The client states, Im getting lightheaded
and dizzy. What is the nurses best action?
1. Assist the client to sit up.
2. Remind the client that she needs to lie still to hear the baby.
3. Help the client turn onto her left side.
4. Check the clients blood pressure.
Answer: 3
Explanation: 3. During pregnancy the enlarging uterus may put pressure on
