A nurse is teaching a client who is at 14 weeks of gestation about expected body changes during pregnancy.
Which of the following manifestations should the nurse include in the teaching?

Skin mottling.

Thinning hair.

Nipple inversion.

Breast enlargement.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Skin mottling, characterized by a patchy, net-like, reddish-blue discoloration of the skin, is typically caused by vasoconstriction in response to cold exposure or by circulatory changes in individuals with poor peripheral perfusion. This is not a typical, expected body change during a normal pregnancy; expected skin changes relate more to hyperpigmentation (e.g., chloasma, linea nigra).

Choice B rationale

During pregnancy, hormonal changes, particularly the increase in estrogen, shift a greater proportion of hair follicles into the anagen (growth) phase, leading to thicker, fuller hair. Hair thinning (telogen effluvium) is commonly experienced postpartum when hormone levels drop and the hair follicles shift rapidly back into the telogen (resting) phase, thus it is not expected at 14 weeks gestation.

Choice C rationale

Nipple inversion is a structural variation where the nipple is retracted into the areola; it is not a change that typically develops during pregnancy. Expected breast changes include areolar darkening (hyperpigmentation), prominent Montgomery's tubercles, and nipple erection. Nipple inversion is a pre-existing condition that may present challenges for breastfeeding.

Choice D rationale

Breast enlargement (hypertrophy) is an expected and early body change during pregnancy, beginning in the first trimester (around 6 weeks). This growth is driven by elevated estrogen and progesterone levels, stimulating the development of the mammary glands in preparation for lactation, and is often accompanied by tenderness and increased vascularity.

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Correct Answer is ["A","E","F"]

Explanation

Body System	Finding	Interpretation	Report to Provider?
Neurologic	Irritability	Can be normal if mild, but persistent irritability may indicate hypoglycemia, hypocalcemia, withdrawal, or infection → concerning	✅ Yes
	Pupil response (brisk, equal)	Normal neuro finding	❌ No
Integumentary	Milia on nose/cheeks	Benign, normal newborn finding	❌ No
	Lanugo on shoulders	Normal in preterm/term newborns	❌ No
Cardiopulmonary	Axillary temperature 36.2°C (97.2°F)	Low temp (normal 36.5–37.5°C). Hypothermia can indicate infection, poor thermoregulation	✅ Yes
	Respiratory rate 80/min	Tachypnea (normal 30–60/min). May indicate respiratory distress, sepsis, metabolic issue	✅ Yes
	Apical heart rate 158/min	Normal (110–160/min)	❌ No
	Lung findings (clear)	Normal	❌ No
Gastrointestinal	Stool characteristics (meconium, normal)	Normal	❌ No
	Abdomen findings (not abnormal)	Normal	❌ No

🧾 Explanation

Irritability: While some fussiness is expected, persistent irritability is a red flag for metabolic or infectious causes.
Temperature 36.2°C: Below normal → newborn hypothermia, which can worsen quickly.
Respiratory rate 80/min: Markedly elevated → tachypnea, possible respiratory distress or sepsis.
Other findings (milia, lanugo, brisk pupils, HR 158, clear lungs, normal stool) are expected newborn variations and do not require reporting.

✅ Final Answer: The nurse should report:

Neurologic: Irritability
Cardiopulmonary: Axillary temperature 36.2°C
Cardiopulmonary: Respiratory rate 80/min

A. Consistent crying. B. Rooting reflex. C. Sucking motions. D. Hand-to-mouth movements. E. Babinski reflex.

Correct Answer is ["B","C","D"]

Explanation

Choice A rationale

Consistent crying is considered a late cue of hunger in a newborn. Crying, a complex physiological and behavioral response, requires a high expenditure of energy and is an indication that the newborn is already significantly distressed by hunger and needs to be fed immediately to avoid excessive agitation and difficulty latching.

Choice B rationale

The rooting reflex involves the newborn turning their head toward any stimulation of their cheek or mouth and opening their mouth, which is an innate physiological response critical for locating the nipple. This is a primary early hunger cue, indicating the newborn is ready and searching for a food source, initiating feeding efforts.

Choice C rationale

Sucking motions, such as rapid, repetitive sucking on the lips, tongue, or anything near the mouth, are direct early behavioral manifestations of the newborn's innate physiological need for nourishment. This action is a preparatory step for feeding, indicating readiness for oral intake and satiation of hunger.

Choice D rationale

Hand-to-mouth movements are a key early hunger cue, demonstrating the newborn's increasing drive to seek oral stimulation and food. This behavior is part of the newborn's reflexive self-soothing and exploratory repertoire, signaling a rising level of hunger before the onset of overt distress or crying.

Choice E rationale

The Babinski reflex is a normal neurological response in infants where the great toe extends upward and the other toes fan out when the sole of the foot is firmly stroked. It is a primitive reflex related to neurological development and is not an indicator of hunger or feeding readiness.

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A nurse is teaching a client who is at 14 weeks of gestation about expected body changes during pregnancy. Which of the following manifestations should the nurse include in the teaching?

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Correct Answer is ["A","E","F"]

Explanation

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Correct Answer is ["B","C","D"]

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A nurse is teaching a client who is at 14 weeks of gestation about expected body changes during pregnancy.
Which of the following manifestations should the nurse include in the teaching?