A nurse is reinforcing teaching with a client who is pregnant about expected changes related to pregnancy. Which of the following statements by the client indicates an understanding of the teaching?
It’s normal to have a white vaginal discharge.
I should recognize fetal movement by 12 weeks.
My nipples and areola will become pale as my breasts enlarge.
The fundus is responsible for the swelling in my ankles.
The Correct Answer is A
Choice A rationale:
It’s normal to have a white vaginal discharge during pregnancy. This is due to increased estrogen levels, which stimulate the production of cervical mucus. The mucus is typically white or clear, and has a mild odor. It helps to maintain a healthy vaginal environment and protect against infection.
Increased vaginal discharge is one of the earliest signs of pregnancy, and it typically continues throughout the pregnancy. While it may be bothersome at times, it is not a cause for concern unless it has a strong odor, is yellow or green in color, or is accompanied by itching or burning.
It is important for pregnant women to keep the vaginal area clean and dry to prevent infection. This can be done by wearing cotton underwear, avoiding tight-fitting clothing, and showering or bathing regularly.
Choice B rationale:
Most women do not recognize fetal movement until 16 to 22 weeks of pregnancy. This is because the fetus is still very small and its movements are not strong enough to be felt.
Some women may feel fluttering or "butterflies" in their abdomen as early as 12 weeks, but this is not always a reliable indication of fetal movement. It is more likely to be caused by gas or intestinal activity.
Choice C rationale:
The nipples and areola typically become darker, not paler, during pregnancy. This is due to increased levels of melanin, a pigment that is also responsible for skin color.
The darkening of the nipples and areola may be more pronounced in women with darker skin.
Choice D rationale:
The fundus is the top of the uterus. It does not cause swelling in the ankles.
Swelling in the ankles is a common symptom of pregnancy, especially in the third trimester. It is caused by a combination of factors, including increased blood volume, fluid retention, and pressure from the growing uterus on the veins in the legs.
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Related Questions
Correct Answer is D
Explanation
Rationale for Choice A:
A pelvic exam is required if you want birth control pills. This response is not therapeutic because it dismisses the client's feelings and does not address her concerns. It focuses on the policy or requirement rather than the client's emotional needs. It could make the client feel like her anxiety is not justified or that she has no choice in the matter.
Rationale for Choice B:
Don't worry, I will stay in there with you for the exam. While this response may be intended to provide reassurance, it does not fully address the client's underlying concerns. It offers a solution without first exploring the specific reasons for the client's anxiety. It could also make the client feel dependent on the nurse's presence for comfort, rather than empowering her to manage her own anxiety.
Rationale for Choice C:
All you need to do is relax during the exam. This response is not therapeutic because it minimizes the client's feelings and suggests that she can simply control her anxiety by relaxing. It does not acknowledge the validity of her concerns or provide any guidance on how to manage those concerns. It could make the client feel like her anxiety is her fault or that she is not coping well.
Rationale for Choice D:
Tell me more about your concerns. This is the most therapeutic response because it encourages the client to express her feelings and concerns openly. It validates the client's experience and demonstrates active listening and empathy. It provides an opportunity for the nurse to gather more information about the specific reasons for the client's anxiety and to tailor interventions accordingly. It also empowers the client by allowing her to share her thoughts and take control of the conversation.
Correct Answer is B
Explanation
Choice A:
Mood swings are a common and expected symptom of early pregnancy due to hormonal changes. They typically do not require medical attention unless they become severe or interfere with daily life.
While it's important to discuss mood swings with a healthcare provider, they are not considered a critical symptom that necessitates immediate action.
Choice C:
Urinary frequency, or the need to urinate more often, is also a common symptom of early pregnancy. It's caused by hormonal changes and the growing uterus putting pressure on the bladder.
While it can be inconvenient, it's typically not a cause for concern unless accompanied by other symptoms, such as pain or burning during urination.
Choice D:
Decreased energy, or fatigue, is another common and expected symptom of early pregnancy.
It's often caused by hormonal changes and the body's increased workload to support the growing fetus.
While it can be frustrating, it's typically not a cause for concern unless it becomes severe or interferes with daily life.
Choice B:
Facial edema, or swelling of the face, is not a common symptom of early pregnancy.
It can be a sign of preeclampsia, a serious pregnancy complication characterized by high blood pressure and protein in the urine.
Preeclampsia can develop suddenly and progress quickly, so it's important to seek medical attention right away if facial edema occurs.
Key Points:
Facial edema is a potential sign of preeclampsia, a serious pregnancy complication.
Mood swings, urinary frequency, and decreased energy are common and expected symptoms of early pregnancy that typically do not require immediate medical attention.
It's important for pregnant women to be aware of potential warning signs and to seek medical advice promptly if they experience any concerning symptoms.
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