Chapter 31: The Pregnant Woman
Physical Examination and Health Assessment, 8th Edition by
Carolyn Jarvis
MULTIPLE CHOICE
1. Which of these statements best describes the action of the hormone progesterone during
pregnancy?
a. Progesterone produces the hormone human chorionic gonadotropin.
b. Duct formation in the breast is stimulated by progesterone.
c. Progesterone promotes sloughing of the endometrial wall.
d. Progesterone maintains the endometrium around the fetus.
ANS: D
Progesterone prevents the sloughing of the endometrial wall and maintains the
endometrium around the fetus. Progesterone increases the alveoli in the breast and
keeps the uterus in a quiescent state. The other options are not correct.
DIF: Cognitive Level: Remembering (Knowledge)
MSC: Client Needs: General
2. A female patient has nausea, breast tenderness, fatigue, and amenorrhea. Her last
menstrual period was 6 weeks ago. The nurse interprets that this patient is experiencing
signs of pregnancy.
a. Positive
b. Possible
c. Probable
d. Presumptive
ANS: D
Presumptive signs of pregnancy are those that the woman experiences and include
amenorrhea, breast tenderness, fatigue, nausea, and increased urinary frequency.
Probable signs are those that are detected by the examiner, such as an enlarged
uterus or changes in the cervix. Positive signs of pregnancy are those that
document direct evidence of the fetus such as fetal heart tones or positive cardiac
activity on ultrasound.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Health Promotion and Maintenance
3. A woman who is 8 weeks pregnant is visiting the clinic for a checkup. Her systolic blood
pressure is 30 mm Hg higher than her prepregnancy systolic blood pressure. The nurse
should:
, a. Consider this a normal finding.
b. Expect the blood pressure to decrease as the estrogen levels increase throughout
the pregnancy.
c. Consider this an abnormal finding because blood pressure is typically lower at this
point in the pregnancy.
d. Recommend that she decrease her salt intake in an attempt to decrease her
peripheral vascular resistance.
ANS: C
During the seventh gestational week, blood pressure begins to drop as a result of
falling peripheral vascular resistance. Early in the first trimester, blood pressure
values are similar to those of prepregnancy measurements. In this case, the
womans blood pressure is higher than it should be.
DIF: Cognitive Level: Analyzing (Analysis)
MSC: Client Needs: Health Promotion and Maintenance
4. A patient is being seen at the clinic for her 10-week prenatal visit. She asks when she will
be able to hear the babys heartbeat. The nurse should reply:
a. The babys heartbeat is not usually heard until the second trimester.
b. The babys heartbeat may be heard anywhere from the ninth to the twelfth week.
c. It is often difficult to hear the heartbeat at this point, but we can try.
d. It is normal to hear the heartbeat at 6 weeks. We may be able to hear it today.
ANS: B
Fetal heart tones can be heard with the use of the Doppler device between 9 and
12 weeks. The other responses are incorrect.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Health Promotion and Maintenance
5. A patient who is in her first trimester of pregnancy tells the nurse that she is
experiencing significant nausea and vomiting and asks when it will improve. The nurse
should reply:
a. Did your mother have significant nausea and vomiting?
b. Many women experience nausea and vomiting until the third trimester.
c. Usually, by the beginning of the second trimester, the nausea and vomiting
improve.
d. At approximately the time you begin to feel the baby move, the nausea and
vomiting will subside.
ANS: C
The nausea, vomiting, and fatigue of pregnancy improve by the 12th week.
Quickening, when the mother recognizes fetal movement, occurs at approximately
18 to 20 weeks.
DIF: Cognitive Level: Analyzing (Analysis)
Physical Examination and Health Assessment, 8th Edition by
Carolyn Jarvis
MULTIPLE CHOICE
1. Which of these statements best describes the action of the hormone progesterone during
pregnancy?
a. Progesterone produces the hormone human chorionic gonadotropin.
b. Duct formation in the breast is stimulated by progesterone.
c. Progesterone promotes sloughing of the endometrial wall.
d. Progesterone maintains the endometrium around the fetus.
ANS: D
Progesterone prevents the sloughing of the endometrial wall and maintains the
endometrium around the fetus. Progesterone increases the alveoli in the breast and
keeps the uterus in a quiescent state. The other options are not correct.
DIF: Cognitive Level: Remembering (Knowledge)
MSC: Client Needs: General
2. A female patient has nausea, breast tenderness, fatigue, and amenorrhea. Her last
menstrual period was 6 weeks ago. The nurse interprets that this patient is experiencing
signs of pregnancy.
a. Positive
b. Possible
c. Probable
d. Presumptive
ANS: D
Presumptive signs of pregnancy are those that the woman experiences and include
amenorrhea, breast tenderness, fatigue, nausea, and increased urinary frequency.
Probable signs are those that are detected by the examiner, such as an enlarged
uterus or changes in the cervix. Positive signs of pregnancy are those that
document direct evidence of the fetus such as fetal heart tones or positive cardiac
activity on ultrasound.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Health Promotion and Maintenance
3. A woman who is 8 weeks pregnant is visiting the clinic for a checkup. Her systolic blood
pressure is 30 mm Hg higher than her prepregnancy systolic blood pressure. The nurse
should:
, a. Consider this a normal finding.
b. Expect the blood pressure to decrease as the estrogen levels increase throughout
the pregnancy.
c. Consider this an abnormal finding because blood pressure is typically lower at this
point in the pregnancy.
d. Recommend that she decrease her salt intake in an attempt to decrease her
peripheral vascular resistance.
ANS: C
During the seventh gestational week, blood pressure begins to drop as a result of
falling peripheral vascular resistance. Early in the first trimester, blood pressure
values are similar to those of prepregnancy measurements. In this case, the
womans blood pressure is higher than it should be.
DIF: Cognitive Level: Analyzing (Analysis)
MSC: Client Needs: Health Promotion and Maintenance
4. A patient is being seen at the clinic for her 10-week prenatal visit. She asks when she will
be able to hear the babys heartbeat. The nurse should reply:
a. The babys heartbeat is not usually heard until the second trimester.
b. The babys heartbeat may be heard anywhere from the ninth to the twelfth week.
c. It is often difficult to hear the heartbeat at this point, but we can try.
d. It is normal to hear the heartbeat at 6 weeks. We may be able to hear it today.
ANS: B
Fetal heart tones can be heard with the use of the Doppler device between 9 and
12 weeks. The other responses are incorrect.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Health Promotion and Maintenance
5. A patient who is in her first trimester of pregnancy tells the nurse that she is
experiencing significant nausea and vomiting and asks when it will improve. The nurse
should reply:
a. Did your mother have significant nausea and vomiting?
b. Many women experience nausea and vomiting until the third trimester.
c. Usually, by the beginning of the second trimester, the nausea and vomiting
improve.
d. At approximately the time you begin to feel the baby move, the nausea and
vomiting will subside.
ANS: C
The nausea, vomiting, and fatigue of pregnancy improve by the 12th week.
Quickening, when the mother recognizes fetal movement, occurs at approximately
18 to 20 weeks.
DIF: Cognitive Level: Analyzing (Analysis)
