Braxton Hicks contractions are characterized by:
Regular, painful contractions that cause cervical dilation
Irregular, often painless uterine contractions that do not cause cervical change
Contractions that worsen with hydration and rest
Contractions that are always a sign of true labor
The Correct Answer is B
Braxton Hicks contractions are irregular uterine contractions, generally painless, that do not cause cervical change. They begin as early as the second trimester but are most noticeable in the third trimester. Uterine tone normally increases with pregnancy due to rising estrogen and oxytocin receptor sensitivity, but Braxton Hicks contractions remain non-progressive. They are sometimes referred to as “false labor” because, unlike true labor contractions, they do not lead to cervical effacement or dilation.
Rationale for correct answers
2. Irregular, often painless uterine contractions without cervical dilation or effacement are the hallmark of Braxton Hicks. They usually resolve with rest, hydration, or position change and are not considered true labor.
Rationale for incorrect answers
1. Regular, painful contractions that cause cervical dilation define true labor, not Braxton Hicks. True labor contractions progressively intensify and shorten in interval.
3. Braxton Hicks contractions improve, not worsen, with hydration and rest. Worsening with activity and persistence despite rest indicates true labor.
4. Braxton Hicks are not a sign of true labor. They are preparatory contractions and do not indicate imminent delivery.
Take home points
- Braxton Hicks contractions are irregular, mild, and non-progressive.
- They do not cause cervical dilation or effacement.
- True labor is characterized by regular, painful contractions with progressive cervical change.
- Hydration, rest, or position change relieves Braxton Hicks but not true labor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Nausea and vomiting in early pregnancyare mainly due to elevated hCG, increased estrogen, and slowed gastrointestinal motility from progesterone. hCG peaks at 8–12 weeks (up to 100,000 mIU/mL, normal nonpregnant <5 mIU/mL), correlating with symptom severity. Estrogen contributes by delaying gastric emptying, while progesterone relaxes smooth muscle, reducing gastrointestinal peristalsis. Together, these changes cause queasiness, nausea, and occasional vomiting, known as morning sickness, which is physiological unless severe enough to cause dehydration or weight loss (hyperemesis gravidarum).
Rationale for correct answers
2.Elevated hCG, estrogen, and progesterone are the principal contributors to nausea and vomiting in the first trimester. Their hormonal effects explain the timing, severity, and natural improvement of symptoms after hCG levels plateau in the second trimester.
Rationale for incorrect answers
1.Decreased hCG does not cause nausea; rather, high circulating hCG correlates with symptom severity, especially in multiple gestation and molar pregnancy.
3.Gastrointestinal motility is not increased in pregnancy; progesterone actually decreases motility by relaxing smooth muscle, contributing to nausea, constipation, and bloating.
4.High maternal blood glucose is not a physiologic feature of early pregnancy and does not cause nausea. Gestational diabetes usually manifests later and presents differently (polyuria, polydipsia).
Take home points
- Nausea and vomiting in the first trimester are hormonally mediated by high hCG, estrogen, and progesterone.
- hCG peaks at 8–12 weeks, explaining timing of symptoms.
- Progesterone slows gastric emptying, adding to discomfort.
- Severe persistent vomiting suggests hyperemesis gravidarum, not normal morning sickness.
Correct Answer is B
Explanation
Backache in pregnancyis mainly due to relaxin-induced ligament laxity, lumbar lordosis, and increased mechanical strainfrom fetal growth. Relaxin peaks in the first trimester and remains elevated, softening the pubic symphysis and sacroiliac joints to prepare for childbirth. This increased joint mobility reduces pelvic and spinal stability, predisposing to lumbosacral pain. Additionally, weight gain (11.5–16 kg normal for BMI 18.5–24.9) and shift of the center of gravity increase lordotic curvature, straining paraspinal muscles.
Rationale for correct answers
2.Relaxation of pelvic ligaments and joints due to relaxin decreases pelvic stability, contributing to lumbosacral and back pain in pregnancy. This hormonal effect, combined with postural changes, explains the musculoskeletal discomfort commonly reported.
Rationale for incorrect answers
1.Lumbar lordosis actually increases, not decreases, in pregnancy due to the anterior shift in center of gravity. This worsens back strain but is not decreased as stated.
3.Reduced maternal weight gain would lessen, not worsen, back strain. It is excessive weight gain that increases musculoskeletal discomfort.
4.Abdominal muscle strength decreases as the uterus enlarges, further reducing core support. Increased strength would help prevent backache, not cause it.
Take home points
- Pregnancy backache results from relaxin-induced ligamentous laxity and increased lumbar lordosis.
- Mechanical load from fetal growth and maternal weight gain exacerbates pain.
- Reduced abdominal muscle tone worsens postural instability.
- Important differentials include urinary tract infection and preterm labor, which can also present with back pain.
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