At a maternity clinic, a woman who is 32 weeks pregnant is being taught by the nurse about the danger signs of pregnancy.
Which among the choices below would the nurse include?
Alteration in the pattern of fetal movement.
Edema in the ankles and feet at the end of the day.
Constipation.
Hair loss.
The Correct Answer is A
Choice A rationale
Fetal movement is a primary indicator of fetal well-being and placental function. A significant decrease or sudden change in the frequency and intensity of movements can signal fetal distress, hypoxia, or placental insufficiency. Nurses teach women to perform kick counts, typically expecting at least 10 movements within a 2-hour period. Any deviation from the established baseline for that specific fetus requires immediate medical evaluation via a non-stress test or biophysical profile to assess the intrauterine environment.
Choice B rationale
Dependent edema in the lower extremities is a common physiological finding in late pregnancy due to increased hydrostatic pressure in the legs and compression of the inferior vena cava by the uterus. While uncomfortable, it is usually not a danger sign if it resolves with elevation and is not accompanied by hypertension or proteinuria. Normal salt and water retention during the third trimester contributes to this. However, sudden edema of the face or hands would be a concerning sign.
Choice C rationale
Constipation is a frequent complaint during the third trimester resulting from high progesterone levels, which relax smooth muscles and slow intestinal peristalsis. The mechanical pressure of the enlarging uterus on the rectum also contributes to delayed transit time. While it can lead to discomfort and hemorrhoids, it is considered a common discomfort of pregnancy rather than a danger sign. It is managed with increased fluid intake, fiber-rich diets, and moderate physical activity to stimulate bowel movements.
Choice D rationale
Changes in hair growth cycles are common during and after pregnancy due to shifts in estrogen levels. During pregnancy, the high estrogen levels typically keep hair in the growing phase, leading to thicker hair, though some women may experience thinning due to stress or nutritional deficiencies. Significant hair loss is generally not classified as an acute danger sign of pregnancy complications like preeclampsia or preterm labor. It is usually a benign cosmetic concern that stabilizes after the postpartum period ends.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While infant falls are a significant safety concern in the postpartum period and early childhood, the Period of PURPLE Crying program is not specifically focused on mechanical safety or physical handling techniques. Falls are usually addressed through general safety teaching regarding furniture, stairs, and carrying techniques. This specific educational program targets the psychological and behavioral aspects of responding to a crying infant rather than the physical prevention of accidental falls or drops in the home environment.
Choice B rationale
Hypoglycemia prevention is a critical aspect of early neonatal care, but it is managed through feeding education and monitoring of glucose levels rather than through a video about crying patterns. The physiology of blood sugar regulation is unrelated to the behavioral education provided in the PURPLE Crying curriculum. Feeding schedules are discussed in the context of nutrition and growth, whereas this video focuses on the emotional and developmental challenges parents face when an infant cries excessively.
Choice C rationale
Sudden Infant Death Syndrome (SIDS) prevention is addressed through the Safe to Sleep campaign, which emphasizes supine positioning, firm sleep surfaces, and the avoidance of loose bedding. While both programs are essential for newborn safety, they target different risks. The PURPLE Crying program does not provide instruction on sleep environments or SIDS risk factors, as its primary goal is to educate parents on the developmental phase of increased crying to prevent caregiver frustration and potential abuse.
Choice D rationale
The Period of PURPLE Crying is a specialized evidence-based program designed to prevent Shaken Baby Syndrome and abusive head trauma. It educates parents that crying is a normal developmental phase that often increases at 2 weeks of age and peaks at 2 months. By explaining that crying can be inconsolable and is not a reflection of poor parenting, the program helps reduce the frustration and anger that can lead a caregiver to shake or harm an infant.
Correct Answer is B
Explanation
Choice A rationale
Placental abruption occurs when the placenta detaches prematurely from the uterine wall, typically due to hypertension, trauma, or cocaine use. Side-lying does not physically anchor the placenta or prevent this mechanical separation. The primary concern during a nonstress test is ensuring adequate fetal oxygenation through optimal perfusion rather than preventing structural detachment of the placenta, which is governed by different physiological and pathological triggers during the third trimester.
Choice B rationale
The gravid uterus can compress the inferior vena cava and aorta when the mother is supine, leading to decreased venous return and maternal hypotension. This reduces uterine blood flow and placental perfusion. Side-lying, especially on the left, relieves this pressure, maximizing blood flow through the spiral arteries into the intervillous space. This ensures a steady delivery of oxygenated blood to the fetus, which is critical for an accurate and reactive nonstress test result.
Choice C rationale
The placenta functions as a semi-permeable membrane using passive diffusion, facilitated diffusion, and active transport to move nutrients and waste. While it acts as a barrier to some pathogens and large molecules, its filtering efficiency is determined by the health of the syncytiotrophoblast and molecular size, not maternal positioning. Side-lying optimizes the volume of blood reaching the placenta but does not change the inherent biochemical or cellular mechanism used to filter harmful substances.
Choice D rationale
The placenta does not facilitate the passage of air or gaseous oxygen in a literal sense like the lungs. Instead, oxygen is dissolved in the maternal blood and transferred to fetal hemoglobin across the placental membrane via a partial pressure gradient. Side-lying improves the delivery of the medium carrying the oxygen, which is the blood, but it does not facilitate the movement of air, as the fetal environment remains entirely fluid-filled and aquatic.
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