A nurse is reinforcing teaching with a group of adolescent females who are pregnant about expected changes related to pregnancy.Which of the following client statements indicates understanding of the teaching?
“If I develop striae gravidarum, I need to call my provider immediately.”.
“My nipples and areola will become pale as my breasts enlarge.”.
“I should begin to recognize fetal movement by 10 weeks gestation.”.
“Some nausea and vomiting is normal, but I should call my provider if I am unable to keep food or water down.”.
The Correct Answer is D
Choice A rationale
Striae gravidarum, or stretch marks, are a common occurrence during pregnancy due to the rapid stretching of the skin. They are not a medical emergency and do not require immediate attention from a healthcare provider.
Choice B rationale
During pregnancy, the nipples and areola typically become darker, not paler, as the breasts enlarge. This change is due to hormonal influences and increased blood flow to the area.
Choice C rationale
Fetal movement, also known as quickening, is usually felt by the mother between 18 to 25 weeks of gestation, not as early as 10 weeks. At 10 weeks, the fetus is still too small for its movements to be felt by the mother.
Choice D rationale
Some nausea and vomiting, known as morning sickness, is normal during pregnancy. However, if a pregnant woman is unable to keep food or water down, it is important to contact a healthcare provider to ensure she and the baby are receiving adequate nutrition and hydration.
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Correct Answer is A
Explanation
Choice A rationale
The uterus can indeed increase in size by 20 times its non-pregnant size. This significant expansion is necessary to accommodate the growing fetus and the increased blood supply required during pregnancy.
Choice B rationale
While the weight of the uterus does increase significantly during pregnancy, from about 100 grams to approximately 1,000 grams, this statement does not directly address the client’s concern about the uterus’s ability to stretch.
Choice C rationale
About 25% of the increased capacity of the uterus is related to uteroplacental content, but this does not fully explain the uterus’s ability to stretch to accommodate a full-term baby.
Choice D rationale
The increase in uterus size during pregnancy is not solely related to amniotic fluid volume. The uterus itself grows and stretches significantly to accommodate the developing fetus.
Correct Answer is A
Explanation
Choice A rationale
The ductus venosus, foramen ovale, and ductus arteriosus are shunts in fetal circulation that bypass the lungs and liver, directing oxygenated blood to the brain and body. The foramen ovale allows blood to flow from the right atrium to the left atrium, bypassing the lungs. The ductus arteriosus connects the pulmonary artery to the aorta, allowing blood to bypass the lungs. The ductus venosus shunts blood from the umbilical vein to the inferior vena cava, bypassing the liver.
Choice B rationale
This choice is incorrect because the primary purpose of these shunts is not to ensure proper development of the fetal heart. While they do play a role in directing blood flow, their main function is to bypass the non-functional fetal lungs and liver.
Choice C rationale
This choice is incorrect because the shunts are not primarily involved in regulating blood pressure in the fetus. Their main function is to direct oxygenated blood to vital organs like the brain and heart.
Choice D rationale
This choice is incorrect because the shunts bypass the lungs, which are not yet functional in the fetus. Gas exchange occurs in the placenta, not the fetal lungs.