A patient relates a story of how her boyfriend is feeling her aches and pains associated with her pregnancy. She is concerned that her boyfriend is making fun of her concerns. How would you respond to this patient statement?

Correct Answer: C

Rationale: The correct answer is C because couvade syndrome is a real phenomenon where male partners experience similar symptoms to their pregnant partners. By explaining this to the patient, it validates her concerns and normalizes her boyfriend's behavior. Choice A is incorrect because it dismisses the patient's concerns and does not address the underlying issue. Choice B is incorrect because referring the patient to a psychologist may be premature without exploring the possibility of couvade syndrome first. Choice D is incorrect because it does not address the potential root cause of the boyfriend's behavior and may not provide a satisfactory resolution for the patient.

Correct Answer: B

Rationale: The correct answer is B: The relaxation of the lower esophageal ('cardiac') sphincter. During pregnancy, hormonal changes can cause the lower esophageal sphincter to relax, allowing stomach acid to flow back up into the esophagus, leading to heartburn. This is known as gastroesophageal reflux. The other choices are incorrect because heartburn in pregnancy is not caused by an increase in water reabsorption by the colon (A), a decrease in the capacity of the stomach (C), or an increase in stomach acid production (D). The key factor in pregnancy-related heartburn is the relaxation of the lower esophageal sphincter, which allows acid reflux into the esophagus.

Correct Answer: D

Rationale: The decrease in systemic vascular resistance leads to a decrease in blood pressure for the following reasons: 1. Vasodilation reduces resistance to blood flow in the blood vessels, lowering overall pressure. 2. As resistance decreases, the heart doesn't have to work as hard to pump blood, resulting in a decrease in blood pressure. 3. Lower resistance allows blood to flow more easily, reducing pressure on the arterial walls. The other choices are incorrect because: A: Decreasing systemic vascular resistance would typically increase cardiac output, not decrease it. B: Pulse rate is primarily affected by factors like sympathetic nervous system activity and not directly by changes in vascular resistance. C: Renal blood flow is more influenced by factors like renal artery pressure and hormonal regulation, rather than changes in systemic vascular resistance.

Correct Answer: D

Rationale: The correct answer is D: Progesterone relaxes smooth muscles. Progesterone is essential during pregnancy to maintain the uterine lining and prevent contractions that could lead to miscarriage. It also relaxes smooth muscles in the gastrointestinal tract to prevent premature labor. Choices A, B, and C are incorrect because progesterone's primary role is not to stimulate uterine development, relax pelvic ligaments and joints, or prepare breasts for lactation.

Correct Answer: C

Rationale: The correct answer is C: Enlargement of breasts and tenderness. This is because backache, flank pain, burning on urination, abdominal cramping, and vaginal bleeding are not typically associated with potential complications during pregnancy. Enlargement of breasts and tenderness could indicate conditions like preeclampsia or ectopic pregnancy, which require immediate medical attention to prevent serious complications. The other choices do not directly relate to pregnancy complications and may not be urgent concerns. It's crucial for the prenatal client to report any unusual or concerning symptoms to her healthcare provider promptly to ensure the safety of both her and the baby.