To reassure and educate pregnant patients about changes in their cardiovascular system, maternity nurses should be aware that:

Correct Answer: B

Rationale: The correct answer is B: changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term. This answer is correct because during pregnancy, the heart enlarges and rotates slightly to the left due to the growing uterus pushing against it. This anatomical change can cause a shift in the heart sounds that can be auscultated by healthcare providers. Additionally, the increase in blood volume during pregnancy puts more demand on the heart, leading to changes in cardiac output and heart rate. Option A is incorrect because while disturbed cardiac rhythm may warrant medical attention, not all cases of sinus arrhythmia in pregnant women require close medical and obstetric observation. It is essential to assess the severity and impact on maternal and fetal well-being before determining the level of intervention needed. Option C is incorrect because palpitations are not necessarily more likely to occur in twin gestations. Palpitations can occur in any pregnancy due to the physiological changes in the cardiovascular system, but it is not specifically linked to twin pregnancies. Understanding the cardiovascular changes in pregnancy is crucial for maternity nurses to provide comprehensive care to pregnant patients. By recognizing these normal physiological adaptations, nurses can differentiate between expected changes and potential complications, ensuring the well-being of both the mother and the baby. It is essential for nurses to educate pregnant patients about these changes to alleviate any concerns and promote a positive pregnancy experience.

Correct Answer: D

Rationale: The correct answer is D: Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial. During pregnancy, it is common for women to experience nausea and vomiting, known as morning sickness. While this can be uncomfortable for the mother, it is generally not harmful to the fetus and can actually be a positive sign of a healthy pregnancy. Option A is incorrect because insufficient salivation (ptyalism) is actually caused by increases in progesterone, not estrogen. Option B is incorrect because acid indigestion (pyrosis) typically worsens as pregnancy progresses due to the growing uterus putting pressure on the stomach. Option C is incorrect because hyperthyroidism is not a common condition in pregnancy; instead, hypothyroidism is more prevalent due to the increased demand for thyroid hormones. Understanding the physiological changes that occur during pregnancy is crucial for healthcare professionals working with pregnant individuals. It is important to be able to differentiate between normal discomforts of pregnancy, like nausea and vomiting, and conditions that may require medical intervention to ensure the health and well-being of both the mother and the fetus.

Correct Answer: B

Rationale: In the context of pregnancy, glycosuria, the presence of glucose in the urine, is considered a variation of normal. During pregnancy, hormonal changes can lead to increased glucose levels in the urine, even when blood glucose levels are within normal limits. This is due to the kidneys working harder to filter the increased blood volume during pregnancy. Glycosuria is commonly observed in pregnant women and is usually not a cause for concern unless accompanied by high blood glucose levels indicative of gestational diabetes. Proteinuria (option A) in pregnancy can indicate potential kidney issues or preeclampsia, a serious condition characterized by high blood pressure and organ damage. Bacteria in the urine (option C) can be a sign of urinary tract infection, which needs prompt treatment to prevent complications during pregnancy. Ketones in the urine (option D) can indicate inadequate carbohydrate intake or potential issues with diabetes management, which can have negative implications for both the mother and the developing fetus. Understanding the variations in normal findings during pregnancy is crucial for healthcare providers to monitor and manage maternal health effectively. Educating pregnant women about these nuances can empower them to recognize when to seek medical attention for any concerning symptoms or test results during their pregnancy.

Correct Answer: B

Rationale: Physiologic anemia during pregnancy occurs because of the dilution of hemoglobin concentration in the blood due to an increase in plasma volume that is greater than the increase in red blood cell mass. This is a normal adaptation to support the increased demands of the developing fetus and placenta. Option B is correct because it directly addresses this physiological process. Option A, inadequate intake of iron, is incorrect because although iron deficiency can contribute to anemia, physiologic anemia in pregnancy is primarily due to hemodilution rather than inadequate iron intake. Option C, the fetus establishing iron stores, is incorrect because fetal iron stores do not directly cause the physiologic anemia in the mother. Option D, decreased production of erythrocytes, is incorrect because while there is an increase in red blood cell production during pregnancy, it is not sufficient to compensate for the expanded plasma volume, resulting in relative anemia. Understanding the mechanisms of physiologic changes in pregnancy is crucial for healthcare professionals to provide appropriate care and support to pregnant individuals. It also highlights the importance of monitoring and managing maternal health to ensure the well-being of both the mother and the developing fetus.

Correct Answer: B

Rationale: The correct answer is B) Situation, background, assessment, and recommendation. This method, known as SBAR (Situation, Background, Assessment, Recommendation), is a widely recognized communication tool in healthcare settings to ensure effective and structured information sharing. In this context, Situation refers to the current status of the patient, Background provides relevant information about the patient's history or condition, Assessment includes the nurse's analysis of the situation, and Recommendation suggests the action to be taken or the next steps required. Option A is incorrect as it includes "Shift-end report" instead of "Situation" and lacks "Recommendation." Option C also includes "Shift-end report" and "Recommendation," but it lacks the crucial "Situation" element. Option D is incorrect as it introduces "actual nursing diagnoses" and "remedy," which are not part of the standard SBAR communication framework. Understanding and utilizing the SBAR method is crucial for effective communication in healthcare, ensuring that critical information is conveyed accurately, concisely, and consistently among healthcare professionals, ultimately leading to improved patient outcomes and safety.