Review Practice Exercise 2

Discomforts of Pregnancy > Maternal Newborn

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Practice Exercise 2

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Total Questions : 6

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Question 1:

Which physiological change contributes to heartburn in pregnancy?

A. Increased lower esophageal sphincter tone B. Decreased intra-abdominal pressure C. Relaxation of the lower esophageal sphincter D. Accelerated gastric emptying

Answer and Explanation

Choice A:

Increased lower esophageal sphincter tone does not occur in pregnancy. Instead, LES tone decreases, making reflux more likely. Increased tone would actually protect against heartburn.

Choice B:

Decreased intra-abdominal pressure is incorrect, as intra-abdominal pressure increases due to uterine expansion. This mechanical effect worsens reflux but is not the primary hormonal mechanism.

Choice C:

Relaxation of the lower esophageal sphincter is the main cause of heartburn in pregnancy. Progesterone reduces LES tone, impairing the barrier between stomach and esophagus, which allows acid reflux and produces the burning sensation.

Choice D:

Accelerated gastric emptying does not occur; in fact, gastric emptying is slowed in pregnancy due to progesterone effects, further promoting reflux. Faster emptying would reduce reflux risk rather than increase it.

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Question 2:

A client with heartburn in the second trimester should be advised to:

A. Eat large meals right before bedtime B. Avoid lying down immediately after eating C. Increase intake of spicy and fatty foods D. Drink carbonated beverages with meals

Answer and Explanation

Choice A:

Eating large meals before bedtime worsens reflux by increasing gastric distension and acid production at a time when recumbency promotes reflux. Small, frequent meals are recommended instead.

Choice B:

Avoiding lying down immediately after eating reduces reflux because gravity helps maintain gastric contents in the stomach. A minimum delay of 2–3 hours before reclining or sleeping is recommended to reduce heartburn episodes.

Choice C:

Increasing intake of spicy and fatty foods aggravates reflux symptoms by further lowering LES tone and delaying gastric emptying, making this an inappropriate intervention.

Choice D:

Drinking carbonated beverages with meals increases gastric distension, promotes transient LES relaxations, and elevates reflux risk, worsening heartburn symptoms.

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Question 3:

Which dietary recommendation is most effective for managing constipation?

A. Reducing fiber intake B. Increasing consumption of high-fiber foods C. Avoiding hydration D. Limiting fruit intake

Answer and Explanation

Choice A:

Reducing fiber intake worsens constipation, as low-fiber diets decrease stool bulk and prolong colonic transit. This is the opposite of what is needed in management.

Choice B:

Increasing consumption of high-fiber foods such as fruits, vegetables, legumes, and whole grains improves constipation by enhancing stool bulk, stimulating peristalsis, and reducing colonic transit time. This is the most effective dietary recommendation.

Choice C:

Avoiding hydration is harmful because dehydration leads to excessive water reabsorption from the colon, resulting in harder stools. Adequate hydration is essential for fiber to function effectively.

Choice D:

Limiting fruit intake removes an important source of soluble and insoluble fiber as well as natural sorbitol, which helps soften stools. Restricting fruits worsens constipation instead of improving it.

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Question 4:

What is a recommended intervention for managing back pain in pregnancy?

A. Prolonged standing B. Use of a maternity belt C. High-impact exercise D. Avoiding all physical activity

Answer and Explanation

Choice A:

Prolonged standing worsens venous stasis, increases lumbar strain, and aggravates musculoskeletal pain. It should be avoided in women with pregnancy-associated back pain.

Choice B:

Use of a maternity belt provides external support to the lower back and abdomen, reducing lumbar strain, improving posture, and alleviating discomfort caused by ligament laxity and increased abdominal weight.

Choice C:

High-impact exercise, such as running or jumping, increases mechanical load on joints loosened by relaxin and worsens back pain. Safer alternatives include swimming, yoga, and walking.

Choice D:

Avoiding all physical activity is not recommended, as moderate exercise improves posture, strengthens core muscles, and relieves pain. Inactivity increases stiffness and worsens musculoskeletal discomfort.

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Question 5:

Which of the following factors contribute to heartburn in pregnancy? Select all that apply.

A. Relaxation of the lower esophageal sphincter B. Increased intra-abdominal pressure C. Accelerated gastric emptying D. Consumption of spicy foods E. Elevated head position during sleep

Answer and Explanation

Choice A:

Relaxation of the lower esophageal sphincter is the primary physiological change due to progesterone, leading to decreased barrier pressure and increased reflux.

Choice B:

Increased intra-abdominal pressure from the enlarging uterus contributes mechanically to reflux, especially in the 2nd and 3rd trimesters.

Choice C:

Accelerated gastric emptying does not occur; instead, gastric emptying is delayed in pregnancy due to progesterone, which increases reflux risk. Faster emptying would decrease reflux.

Choice D:

Consumption of spicy foods worsens reflux by irritating the esophageal mucosa and stimulating gastric acid secretion, aggravating heartburn.

Choice E:

Elevated head position during sleep reduces nocturnal reflux by using gravity to keep gastric contents in the stomach, making it a management strategy rather than a contributing factor.

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Question 6:

Which of the following factors contribute to heartburn in pregnancy? Select all that apply.

A. Relaxation of the lower esophageal sphincter B. Increased intra-abdominal pressure C. Accelerated gastric emptying D. Consumption of spicy foods E. Elevated head position during sleep

Answer and Explanation

Choice A:

Relaxation of the lower esophageal sphincter is the primary physiological change due to progesterone, leading to decreased barrier pressure and increased reflux.

Choice B:

Increased intra-abdominal pressure from the enlarging uterus contributes mechanically to reflux, especially in the 2nd and 3rd trimesters.

Choice C:

Accelerated gastric emptying does not occur; instead, gastric emptying is delayed in pregnancy due to progesterone, which increases reflux risk. Faster emptying would decrease reflux.

Choice D:

Consumption of spicy foods worsens reflux by irritating the esophageal mucosa and stimulating gastric acid secretion, aggravating heartburn.

Choice E:

Elevated head position during sleep reduces nocturnal reflux by using gravity to keep gastric contents in the stomach, making it a management strategy rather than a contributing factor.

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Total Questions : 6

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Practice Exercise 2

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