Appendicitis may be difficult to diagnose in pregnancy because the appendix is:

Correct Answer: D

Rationale: The correct answer is D because during pregnancy, the enlarging uterus pushes the appendix downward and laterally, making it low and to the right. This displacement can lead to atypical presentation of appendicitis symptoms. Choices A and B are incorrect as the appendix is not displaced high and to either side. Choice C is incorrect as the McBurney point is a specific location for appendicitis pain but does not describe the actual position of the appendix during pregnancy.

Correct Answer: B

Rationale: The correct answer is B. Increased urinary frequency in the first trimester is due to exaggerated uterine anteflexion caused by softening. This is because the growing uterus exerts pressure on the bladder, leading to the need for more frequent urination. This is a common physiological change in early pregnancy due to the hormonal effects on the pelvic floor muscles and bladder capacity. A: Lightening typically occurs near the end of the third trimester, not the second trimester, as the baby drops lower into the pelvis in preparation for birth. C: Braxton Hicks contractions are typically painless and irregular in the third trimester, not more painful. Pain with exercise could indicate preterm labor. D: Uterine souffle refers to the sound of blood flow through the uterine arteries, not movement of the fetus.

Correct Answer: A

Rationale: The correct answer is A: operculum. The mucous plug in the endocervical canal is called the operculum because it acts as a protective barrier to prevent pathogens from entering the uterus during pregnancy. This plug seals the cervix to protect the developing fetus. The other choices are incorrect because leukorrhea (choice B) refers to vaginal discharge, funic souffle (choice C) is a term related to fetal heart sounds, and ballottement (choice D) is a physical examination technique used to assess for floating objects in the uterus.

Correct Answer: D

Rationale: The correct answer is D because all the statements in choices A, B, and C are true regarding changes in the cardiovascular system during pregnancy. A: Pregnant women with disturbed cardiac rhythm, such as sinus arrhythmia, should be closely monitored as it can impact both the mother and the fetus, regardless of the mother's overall health status. B: Changes in heart size, position, and blood volume lead to auditory changes from 20 weeks to term, which is important for nurses to be aware of in order to monitor the cardiovascular health of pregnant patients. C: Palpitations are more likely to occur in twin gestations due to the increased demands on the cardiovascular system. In summary, all the changes mentioned in choices A, B, and C are common occurrences in pregnancy and it is crucial for maternity nurses to be aware of them in order to provide appropriate care and education to pregnant patients.

Correct Answer: C

Rationale: The correct answer is C because during pregnancy, hormonal changes can lead to congestion and swelling in the upper respiratory tract due to increased vascularity. This can result in changes in voice and impaired hearing. Estrogen levels (choice A) typically increase during pregnancy and do not directly cause these symptoms. Displacement of the diaphragm (choice B) may occur but is more related to breathing changes rather than voice and hearing issues. Increased blood volume (choice D) is a common physiological change in pregnancy but is not directly associated with voice and hearing changes.