Conception & Development
Immediately before ovulation, a surge of which pituitary hormone stimulates release of the ovum?
Luteinizing hormone (LH).
On examination, the cervix feels softer than before pregnancy. What named pregnancy sign is this?
Goodell sign.
A patient early in pregnancy has markedly elevated hCG, uterine size larger than expected for dates, no fetal heart sounds, and may pass grapelike tissue. What complication fits best?
Gestational trophoblastic disease (molar pregnancy/hydatidiform mole).
A patient hospitalized with severe persistent vomiting has dehydration and ketonuria. Which problem should the nurse address first?
Restore/maintain hydration and correct fluid-electrolyte imbalance.
A term NST shows two fetal heart-rate accelerations of at least 15 bpm lasting at least 15 seconds within 20 minutes. How is the test interpreted?
Reactive/reassuring.
Before a sperm can complete the acrosomal reaction and penetrate the zona pellucida, what preparation process must it undergo?
Capacitation.
A pregnant patient has a lower hematocrit even though red-cell mass has increased. What normal pregnancy mechanism explains this?
Physiologic anemia/hemodilution from plasma volume increasing more than erythrocyte volume.
A patient has recurrent second-trimester pregnancy losses associated with a cervix that cannot remain closed in the absence of preterm labor. What condition is described?
Cervical insufficiency.
A stable patient is treated with methotrexate for an unruptured ectopic pregnancy. Which follow-up is essential to determine whether treatment is working?
Serial/follow-up hCG laboratory monitoring.
A BPP score is 8–10, amniotic fluid volume is normal, and the NST is reactive. What does this combination indicate?
Satisfactory fetal status.
During the first 6–7 weeks of pregnancy the corpus luteum supplies progesterone. What structure then takes over progesterone production?
The placenta.
Why is heartburn so common in pregnancy even when the patient has no gastrointestinal disease?
Progesterone relaxes smooth muscle, weakens the gastroesophageal sphincter, and slows GI movement, promoting reflux.
A pregnant patient without an earlier diabetes diagnosis reaches the routine screening window. At what gestational age does the chapter place routine GDM screening?
24–28 weeks’ gestation.
A patient with a cerclage asks why it was placed. What is the clearest explanation?
The cerclage mechanically helps keep the cervix closed to support the pregnancy.
At term, the amniotic fluid index is 4 cm. Which fluid-volume problem does this support?
Oligohydramnios.
Fetal arterial oxygen levels are much lower than maternal levels. What property of fetal hemoglobin helps compensate for this?
Fetal hemoglobin has a high affinity for oxygen at low oxygen tensions.
A patient’s LMP was June 8. Using Naegele rule, what is the estimated due date?
March 15 of the following year.
An Rh(D)-negative pregnant patient has a negative antibody screen at 28 weeks. What medication is used to help prevent sensitization?
Rho(D) immune globulin (RhoGAM).
A patient receiving magnesium sulfate develops absent patellar reflexes. What should the nurse do with the next magnesium dose?
Do not give additional magnesium until a positive reflex response returns; assess for toxicity and follow the ordered emergency plan.
A high-risk pregnancy has Doppler velocimetry ordered. What is this study evaluating rather than simply listening to the fetal heart rate?
Blood-flow velocity/patterns in fetal, placental, and/or uterine vessels.
A pregnancy is 9 weeks after fertilization. Which developmental period has begun?
The fetal period.
At a routine visit, fetal heart tones are heard with a Doppler. Why is this stronger evidence of pregnancy than nausea or amenorrhea?
Fetal heart tones heard by Doppler are a positive sign of pregnancy.
In a monochorionic twin pregnancy, abnormal shared placental circulation causes one fetus to become the donor and the other the recipient. What complication is this?
Twin-to-twin transfusion syndrome (TTTS).
A pregnant patient has bacteriuria but says, “I feel fine, so I don’t need treatment.” What is the nurse’s priority teaching point?
Untreated bacteriuria can progress to acute pyelonephritis and is associated with maternal/fetal complications.
During a contraction stress test, late decelerations occur with at least 50% of contractions. How is the CST interpreted?
Positive/abnormal CST.