To reassure and educate pregnant patients about changes in the uterus, nurses should be aware that:

Correct Answer: B

Rationale: The correct answer, option B, is that the woman's increased urinary frequency in the first trimester is the result of exaggerated uterine anteflexion caused by softening. This is the correct answer because during early pregnancy, the uterus undergoes changes such as softening and anteflexion, which can put pressure on the bladder and lead to increased urinary frequency. Option A is incorrect because lightening actually occurs near the end of the third trimester, not the second, as the baby descends into the pelvis in preparation for birth. Option C is incorrect because Braxton Hicks contractions are typically mild and irregular throughout pregnancy, not necessarily more painful in the third trimester with exercise. Option D is incorrect because the uterine souffle refers to a soft blowing sound heard over the uterus, not the movement of the fetus. Educationally, understanding these physiological changes in the uterus during pregnancy is crucial for nurses to provide accurate information and reassurance to pregnant patients. By knowing these details, nurses can better address common concerns and help pregnant individuals navigate their pregnancy with confidence and understanding.

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: C

Rationale: The correct answer is C) congestion and swelling, which occur because the upper respiratory tract has become more vascular. During pregnancy, hormonal changes lead to increased blood flow to mucous membranes, including those in the upper respiratory tract. This increased vascularity can result in congestion and swelling, leading to symptoms like changes in voice and impaired hearing. The physiological changes in pregnancy can affect various body systems, including the respiratory system. Option A is incorrect because decreased estrogen levels are not typically associated with changes in voice or impaired hearing during pregnancy. Option B is incorrect as displacement of the diaphragm primarily affects breathing patterns and may not directly cause changes in voice or hearing. Option D is also incorrect as increased blood volume in pregnancy is more closely related to cardiovascular changes and would not directly cause the symptoms described. Understanding the anatomical and physiological changes that occur during pregnancy is crucial for healthcare providers to effectively care for pregnant patients. Educating patients about these normal changes can help alleviate anxiety and ensure appropriate management of symptoms.

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.