NUR 160
NURS 434 Exam 3 Study Questions and Answers 2026
What is GTPAL?
G: # of pregnancies including present T: # of pregnancies that ended at or
after 37 weeks P: number of pregnancies ending preterm A: # of abortions L:
# of living children
What is given to mothers once at 24-27 weeks and then 72 hours after birth if
rH negative?
Rhogam
What are presumptive signs of pregnancy?
subjective things the pt reports, amenorrhea, fatigue, breast enlargement,
nausea, darkening pigment of skin
What are probable signs of pregnancy?
things you can see, goodells sign, braxton hicks, abdominal enlargement,
chadwicks sign, hegars sign
What is goodells sign?
cervical softening as early as 5 weeks
What is hegars sign?
softening of lower portion of uterus, 6-12 weeks
What is chadwicks sign?
slight blueing of the female genitatia
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,NUR 160
What are positive signs of pregnancy?
visualization of the fetus by ultrasound, fetal movement, fetal heart tones
What changes occur in the integumentary system during pregnancy?
stretch marks on breasts, abdomen, and thighs, linea nigra development,
chloasma, may have palmar erythema, hair and nails may be more abundant
then after birth go back to normal.
What are changes in the endocrine system during pregnancy?
thyroid glad produces more hormones for mom and baby, pancreas produces
more insulin b/c the placenta causes insulin resistance, the adrenals produce
more cortisol to help with fetal lung development and more aldosterone to
increase blood volume, the pituitary gland produces prolactin and oxytocin
which help in breast development and uterine contractions
What are changes that occur in the respiratory system during pregnancy?
O2 consumption increases by 15-20%, tidal volume increases, blows of more
CO2, may have more dyspnea or SOB, thoracic cavity will enlarge to assist
in lung expansion, increases estrogen can cause congestion
What cardiovascular changes occur in pregnancy?
Cardiac output increases 50%, total blood volume increases 40-50%, WBC
count may be elevated but does not indicate infection, blood pressure may be
lower because vasodilation occurs, may hear heart murmurs because of
cardiac output increase, may have physiologic anemia due to blood dilution
What changes occur in the urinary system during pregnancy?
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,NUR 160
the increased blood volume causes increased GFR, hydration is key to
prevent water retention, may have increased urination
What changes occur in the reproductive system during pregnancy?
estrogen and progesterone cause breast growth, HCG inhibits ovulation,
hypertrophy and hyperplasia of the uterus occurs, cervical enlargement and
mucus plug development, vaginal and vulva experience chadwicks sign,
edema, and discharge
What changes occur in the musculoskeletal system during pregnancy?
lordosis may occur due to change in center of gravity, ligaments and joints
become more lax, diastasis recti may occur, calcium stores in bones go to the
fetus so it is important to educate on nutritional supplements
What changes occur in the GI system during pregnancy?
decrease in peristalsis causing heart burn, constipation, metabolic rate
increases so pt should eat 350 more calories during the 1st and 2nd trimester
and 450 extra during the 3rd
What are normal discomforts in pregnancy?
fatigue, SOB, postural hypotension, varicosities, edema around joints,
headaches, vision changes, braxton hicks, vaginal discomfort, breast
tenderness, nausea and vomiting, food cravings, heart burn, low back pain,
leg cramps, acne, dry skin, pigmentation changes
What is the schedule of prenatal care?
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, NUR 160
1st visit in 1st trimester and then monthly visits after until week 28 then
every two weeks till 36 then every week until end of pregnancy
What will happen in the first trimester visit?
interview the patient, assess their physiological responses, educate on
nutrition and substance use, exercise and work, exposure to hazards and
bathing, physical examination and lab testing and imaging
What lab tests are done at the first trimester appointment?
HCG levels, blood type and screen, CBC, rubella, HBV, syphilis, gonorrhea
and chlamydia, HIV, and urine dip
What happens at second trimester visits?
review of hx, interval hx, VS and weight, fundal height and measurement, pt
assessment and fetal activity, routine lab tests, fetal anomaly screening,
diagnostic tests, physiologic responses
What happens at the third trimester visits?
Same as the second trimester but more frequent
What are the types of spontaneous abortions?
complete, missed, inevitable, threatened, recurrent
What is a complete spontaneous abortion?
pt reports passing clots and tissue with heavy cramping and bleeding, cervix
is closed upon exam, medical intervention is required
What is a missed spontaneous abortion?
NUR 160
NURS 434 Exam 3 Study Questions and Answers 2026
What is GTPAL?
G: # of pregnancies including present T: # of pregnancies that ended at or
after 37 weeks P: number of pregnancies ending preterm A: # of abortions L:
# of living children
What is given to mothers once at 24-27 weeks and then 72 hours after birth if
rH negative?
Rhogam
What are presumptive signs of pregnancy?
subjective things the pt reports, amenorrhea, fatigue, breast enlargement,
nausea, darkening pigment of skin
What are probable signs of pregnancy?
things you can see, goodells sign, braxton hicks, abdominal enlargement,
chadwicks sign, hegars sign
What is goodells sign?
cervical softening as early as 5 weeks
What is hegars sign?
softening of lower portion of uterus, 6-12 weeks
What is chadwicks sign?
slight blueing of the female genitatia
NUR 160
,NUR 160
What are positive signs of pregnancy?
visualization of the fetus by ultrasound, fetal movement, fetal heart tones
What changes occur in the integumentary system during pregnancy?
stretch marks on breasts, abdomen, and thighs, linea nigra development,
chloasma, may have palmar erythema, hair and nails may be more abundant
then after birth go back to normal.
What are changes in the endocrine system during pregnancy?
thyroid glad produces more hormones for mom and baby, pancreas produces
more insulin b/c the placenta causes insulin resistance, the adrenals produce
more cortisol to help with fetal lung development and more aldosterone to
increase blood volume, the pituitary gland produces prolactin and oxytocin
which help in breast development and uterine contractions
What are changes that occur in the respiratory system during pregnancy?
O2 consumption increases by 15-20%, tidal volume increases, blows of more
CO2, may have more dyspnea or SOB, thoracic cavity will enlarge to assist
in lung expansion, increases estrogen can cause congestion
What cardiovascular changes occur in pregnancy?
Cardiac output increases 50%, total blood volume increases 40-50%, WBC
count may be elevated but does not indicate infection, blood pressure may be
lower because vasodilation occurs, may hear heart murmurs because of
cardiac output increase, may have physiologic anemia due to blood dilution
What changes occur in the urinary system during pregnancy?
NUR 160
,NUR 160
the increased blood volume causes increased GFR, hydration is key to
prevent water retention, may have increased urination
What changes occur in the reproductive system during pregnancy?
estrogen and progesterone cause breast growth, HCG inhibits ovulation,
hypertrophy and hyperplasia of the uterus occurs, cervical enlargement and
mucus plug development, vaginal and vulva experience chadwicks sign,
edema, and discharge
What changes occur in the musculoskeletal system during pregnancy?
lordosis may occur due to change in center of gravity, ligaments and joints
become more lax, diastasis recti may occur, calcium stores in bones go to the
fetus so it is important to educate on nutritional supplements
What changes occur in the GI system during pregnancy?
decrease in peristalsis causing heart burn, constipation, metabolic rate
increases so pt should eat 350 more calories during the 1st and 2nd trimester
and 450 extra during the 3rd
What are normal discomforts in pregnancy?
fatigue, SOB, postural hypotension, varicosities, edema around joints,
headaches, vision changes, braxton hicks, vaginal discomfort, breast
tenderness, nausea and vomiting, food cravings, heart burn, low back pain,
leg cramps, acne, dry skin, pigmentation changes
What is the schedule of prenatal care?
NUR 160
, NUR 160
1st visit in 1st trimester and then monthly visits after until week 28 then
every two weeks till 36 then every week until end of pregnancy
What will happen in the first trimester visit?
interview the patient, assess their physiological responses, educate on
nutrition and substance use, exercise and work, exposure to hazards and
bathing, physical examination and lab testing and imaging
What lab tests are done at the first trimester appointment?
HCG levels, blood type and screen, CBC, rubella, HBV, syphilis, gonorrhea
and chlamydia, HIV, and urine dip
What happens at second trimester visits?
review of hx, interval hx, VS and weight, fundal height and measurement, pt
assessment and fetal activity, routine lab tests, fetal anomaly screening,
diagnostic tests, physiologic responses
What happens at the third trimester visits?
Same as the second trimester but more frequent
What are the types of spontaneous abortions?
complete, missed, inevitable, threatened, recurrent
What is a complete spontaneous abortion?
pt reports passing clots and tissue with heavy cramping and bleeding, cervix
is closed upon exam, medical intervention is required
What is a missed spontaneous abortion?
NUR 160
