Chapter 4: Physiological Aspects of Antepartum Care Answer Section
MULTIPLE CHOICE
1. ANS: 2
Chapter: Chapter 4 Physiological Aspects of Antepartum Care
Chapter Learning Objective: 3. Identify the anatomical and physiological changes over the course
of pregnancy.
Page: 58
Heading: Table 4-1: Physiological Changes in Pregnancy
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Analyzing [Analysis]
Concept: Ante/Intra/Post-partum
Difficulty: Moderate
Feedback
1 This is incorrect. There is no need to cover signs of infection because of the
patient’s concern.
2 This is correct. The leakage of yellow fluid from the patient’s breasts is a
normal change during pregnancy. The patient is experiencing a leakage of
colostrum, which is rich in antibodies for the neonate. This manifestation can
begin as early as 16 weeks.
3 This is incorrect. The presentation of colostrum does not affect the EDD.
4 This is incorrect. The topic of support bras should take place early in the first
trimester due to expected breast enlargement. Covering this topic does not
address the patient’s concern.
PTS: 1 CON: Ante/Intra/Post-partum
2. ANS: 1
Chapter: Chapter 4 Physiological Aspects of Antepartum Care
Chapter Learning Objective: 3. Identify the anatomical and physiological changes over the course
of pregnancy.
Page: 58
Heading: Table 4-1: Physiological Changes in Pregnancy
Integrated Processes: Nursing Process
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Feedback
1 This is correct. The patient’s hemoglobin and hematocrit are below normal for
the patient. This finding causes the nurse concern because the increased demand
of iron for fetal development results in maternal iron deficiency anemia.
2 This is incorrect. The patient’s PT is indicative of hypercoagulability, which is
an expected physiological response to pregnancy in anticipation of blood loss
during delivery. Normal PT is in the range of 11 to 13.5 seconds. This finding
does not cause the nurse concern.
3 This is incorrect. WBC count of 16,000 mm3 is not abnormal in a patient who is
at 30 weeks gestation, especially if there are no other indications of infection.
The scenario does not indicate manifestations of infection.
4 This is incorrect. A 15 to 20 bpm increase in heart rate is expected due to a 40%
increase in cardiac output. This finding does not cause the nurse concern.
PTS: 1 CON: Ante/Intra/Post-partum
3. ANS: 1
Chapter: Chapter 4 Physiological Aspects of Antepartum Care
Chapter Learning Objective: 7. Describe the elements of patient education and anticipatory
guidance appropriate for each trimester of pregnancy.
Page: 58
Heading: Table 4-1: Physiological Changes in Pregnancy
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Analysis [Analyzing]
Concept: Ante/Intra/Post-partum
Difficulty: Difficult
Feedback
1 This is correct. The information that specifically addresses the patient’s
comment about how her uterus will accommodate a term baby is clarified with
the fact that the uterus increases in size 20 times over the non-pregnant size.
2 This is incorrect. The weight of the uterus does increase from 7 g to 1,100 g;
however, this fact does not specifically address the patient’s comment.
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