What are presumptive signs of pregnancy that the nurse would expect when assessing a client at 10 weeks gestation.
Select all that apply.
Abdominal enlargement.
Breast changes.
Positive urine pregnancy test.
Goodell sign.
Fetal heart tones.
Urinary frequency.
Amenorrhea.
Correct Answer : B,F,G
Choice A rationale
Abdominal enlargement is considered a probable sign of pregnancy, not presumptive, because conditions other than pregnancy (e.g., tumors, ascites) can cause it. Presumptive signs are those experienced by the woman that are subjective and least indicative of pregnancy, typically beginning earlier than probable signs like abdominal enlargement.
Choice B rationale
Breast changes, such as tenderness, fullness, or darkening of the areolae, are presumptive signs. These changes are subjective and are primarily caused by the elevated levels of estrogen and progesterone, which stimulate the mammary glands and increase vascularity, although other hormonal conditions can also cause them.
Choice C rationale
A positive urine pregnancy test detecting human chorionic gonadotropin (hCG) is classified as a probable sign of pregnancy. While highly suggestive, it is not considered a positive sign because elevated hCG can rarely be caused by conditions like a hydatidiform mole or certain tumors, which are not a viable pregnancy.
Choice D rationale
Goodell sign (softening of the cervix) is a probable sign of pregnancy. It is an objective change noted upon examination, usually around the fifth week, caused by increased vascularity and edema. Probable signs are objective, yet not definite, as they can be caused by other physiological changes.
Choice E rationale
Hearing fetal heart tones with a Doppler (around 10-12 weeks) or a fetoscope (later) is considered a positive sign of pregnancy. Positive signs are those directly attributable only to the presence of a fetus and cannot be confused with any other condition.
Choice F rationale
Urinary frequency is a presumptive sign often seen early in the first trimester. It is caused by hormonal changes and pressure from the enlarging uterus on the bladder. This symptom is subjective and also occurs in non-pregnant states, such as with a urinary tract infection or increased fluid intake.
Choice G rationale
Amenorrhea (absence of menstruation) is a presumptive sign of pregnancy. It is often the first and most classic indicator, but it is subjective and can also be caused by conditions such as stress, hormonal imbalances, or extreme weight changes, making it not definitive on its own.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Genetic counseling is a non-directive process where the counselor provides comprehensive information about potential fetal conditions, including severity, inheritance patterns, and management options. Suggesting abortion, regardless of the defect's compatibility with life, is a directive approach that violates the core ethical principle of autonomy and the non-directive nature of genetic counseling. The couple makes the final informed decision, not the counselor.
Choice B rationale
Genetic counselors focus on providing accurate risk assessment, diagnostic information, and all available options, including continuation of pregnancy, adoption, or termination, but they do not make recommendations or push for any specific option. Non-directive counseling supports the client's autonomous decision-making; suggesting adoption as a primary course of action would constitute a violation of this ethical and professional standard.
Choice C rationale
Genetic counselors are experts who facilitate understanding of the medical and genetic implications. While they often coordinate care, the primary role is information provision and emotional support, not decision-making assistance from another provider. The counselor determines the probability and explains it, and then the client (the couple) makes the fully informed, autonomous decision based on their values, religious beliefs, and ethics.
Choice D rationale
This response accurately describes the core mission of non-directive genetic counseling, which is to provide education regarding the diagnosis, explore the etiology (probable cause), discuss the prognosis, and review all available management and reproductive options. This comprehensive approach empowers the clients to make an informed, autonomous decision that aligns with their personal and ethical framework.
Correct Answer is B
Explanation
Choice A rationale
G4 P1011 incorrectly indicates only one term delivery and one living child. Gravida (G) is the total number of pregnancies, including the current one, so 1 (current) + 3 (past) = 4. Term (T) deliveries are >37 weeks, so the child at 38 weeks is 1. Preterm (P) deliveries are 20-37 weeks, so the delivery at 26 weeks is 1. Abortions (A) are pregnancies lost before 20 weeks, so the miscarriage at 8 weeks is 1. Living children (L) is 1. The parity should be P1111.
Choice B rationale
G4 P1111 is the correct documentation. Gravida (G) represents 4 pregnancies (current + 3 past). Para (P) breakdown is: Term (T): one delivery at 38 weeks (1). Preterm (P): one delivery at 26 weeks (1). Abortions/Miscarriages (A): one loss at 8 weeks (1). Living Children (L): one child living (1). Thus, the notation is G4 P1111.
Choice C rationale
G5 P1211 incorrectly states the total number of pregnancies as 5 and the number of preterm deliveries as 2. The client has had only 4 total pregnancies (the current one, the 26-week delivery, the 8-week miscarriage, and the 38-week delivery). Also, there was only one preterm delivery (at 26 weeks), not two.
Choice D rationale
G4 P2112 incorrectly states the number of term deliveries as 2 and the number of living children as 2. The client had only one term delivery (at 38 weeks) and only one living child. The Gravida is correct as 4 (current + 3 past). The correct parity would be P1111 with one term, one preterm, one abortion, and one living child.
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