A pregnant client at 28 weeks gestation reports experiencing leg discomfort and noticing bulging veins in her legs. The nurse explains that varicose veins are common during pregnancy. What is the primary physiological change during pregnancy that contributes to the development of varicose veins?

Reduced cardiac output

Dehydration leading to poor circulation

Decreased progesterone levels

Increased blood volume

Answer and Explanation

The Correct Answer is D

A. Reduced cardiac output: Cardiac output actually increases during pregnancy to meet the demands of the growing fetus. A reduction in cardiac output would not be typical in a healthy pregnancy and is not a contributing factor to varicose veins.

B. Dehydration leading to poor circulation: Dehydration may affect overall vascular health but is not a primary cause of varicose veins in pregnancy. Varicosities are more directly related to mechanical and volume changes rather than fluid intake status.

C. Decreased progesterone levels: Progesterone levels rise during pregnancy and contribute to venous dilation by relaxing vessel walls. A decrease in progesterone would not support the formation of varicosities and is not physiologically consistent with pregnancy.

D. Increased blood volume: Pregnancy causes a 40–50% increase in blood volume, which raises venous pressure, especially in the lower extremities. Combined with uterine pressure on pelvic veins, this leads to vein distension and varicose vein formation.

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Correct Answer is C

Explanation

A. I should report any pain, burning, or itching associated with the vaginal discharge: Pain, itching, or burning are signs of possible infection and should be reported promptly. These symptoms are not typical of normal pregnancy changes. Reporting them helps prevent complications. This statement reflects appropriate understanding.

B. I understand that an increase in vaginal discharge is normal during pregnancy: Hormonal changes during pregnancy lead to increased vaginal secretions. This discharge, known as leukorrhea, is usually clear or white and non-irritating. Recognizing this as normal indicates correct learning.

C. I should be concerned if I experience a white, odorless vaginal discharge: White, odorless discharge is considered normal in pregnancy and does not require concern. Thinking it is abnormal shows a misunderstanding of physiological changes. This indicates a need for further education about normal discharge patterns.

D. My vaginal walls may appear bluish due to increased blood flow: Increased vascularization causes a bluish discoloration of the vaginal mucosa, known as Chadwick’s sign. It is a normal early sign of pregnancy. The client’s awareness of this change reflects accurate knowledge.

A. Insert an indwelling urinary catheter. B. Witness the signature for informed consent for surgery. C. Prepare the abdominal and perineal areas. D. Initiate IV access.

Correct Answer is D

Explanation

A. Insert an indwelling urinary catheter: While a catheter may be necessary later for monitoring output or surgical prep, it is not the most urgent need. Ensuring circulatory access to manage potential hemorrhage takes priority over urinary concerns.

B. Witness the signature for informed consent for surgery: Although consent is important if an emergency cesarean becomes necessary, stabilizing the client’s condition first is critical. Legal paperwork should not delay immediate life-saving interventions.

C. Prepare the abdominal and perineal areas: Preparation for surgery may be required, but it is secondary to stabilizing the client. Without IV access, essential fluids, medications, or blood products cannot be administered during active bleeding.

D. Initiate IV access: The client shows signs of possible hypovolemia from bleeding, with tachycardia and low blood pressure. Rapid IV access is the top priority to administer fluids or blood products and support maternal and fetal well-being.

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A pregnant client at 28 weeks gestation reports experiencing leg discomfort and noticing bulging veins in her legs. The nurse explains that varicose veins are common during pregnancy. What is the primary physiological change during pregnancy that contributes to the development of varicose veins?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is educating a pregnant client about normal vaginal changes during pregnancy. Which statement by the client indicates a need for further teaching?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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