Nokea
A patient in her first trimester complains of nausea and vomiting. She asks, "Why does this happen?” The nurse's best response is:
- A. "It is due to an increase in gastric motility.”
- B. "It may be due to changes in hormones.”
- C. "It is related to an increase in glucose levels.”
- D. "It is caused by a decrease in gastric secretions.”
Correct Answer: B
Rationale: The correct answer is B: "It may be due to changes in hormones." During the first trimester of pregnancy, hormonal changes, particularly an increase in human chorionic gonadotropin (hCG) and estrogen levels, can trigger nausea and vomiting, commonly known as morning sickness. These hormonal fluctuations can affect the gastrointestinal system, leading to symptoms of nausea and vomiting. The other choices are incorrect because: A) an increase in gastric motility typically occurs in later stages of pregnancy, not the first trimester; C) an increase in glucose levels is not directly linked to nausea and vomiting in early pregnancy; D) a decrease in gastric secretions is unlikely to be the primary cause of nausea and vomiting in the first trimester.
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What is the physiologic reason for vascular volume increasing by 40% to 60% during pregnancy?
- A. Prevents maternal and fetal dehydration
- B. Eliminates metabolic wastes of the mother
- C. Provides adequate perfusion of the placenta
- D. Compensates for decreased renal plasma flow
Correct Answer: C
Rationale: The correct answer is C: Provides adequate perfusion of the placenta. During pregnancy, the increased vascular volume ensures sufficient blood flow to the placenta, supplying oxygen and nutrients to the developing fetus. This is crucial for fetal growth and development. The other choices are incorrect because:
A: Preventing maternal and fetal dehydration is not the main reason for the significant increase in vascular volume during pregnancy.
B: Eliminating metabolic wastes of the mother does not require such a substantial increase in vascular volume.
D: Compensating for decreased renal plasma flow is not the primary physiologic reason for the vascular volume expansion during pregnancy.
Which of these findings would indicate a potential complication related to renal function during pregnancy?
- A. Increase in glomerular filtration rate (GFR)
- B. Increase in serum creatinine level
- C. Decrease in blood urea nitrogen (BUN)
- D. Mild proteinuria
Correct Answer: B
Rationale: Step-by-step rationale:
1. In a healthy pregnancy, GFR increases to accommodate the increased metabolic demands.
2. An increase in serum creatinine level indicates impaired renal function, as creatinine clearance decreases during pregnancy.
3. Decrease in BUN is normal due to increased GFR.
4. Mild proteinuria can be common in pregnancy without indicating a complication.
Therefore, an increase in serum creatinine level (Choice B) suggests a potential renal complication during pregnancy.
A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a:
- A. primipara.
- B. primigravida.
- C. multipara.
- D. nulligravida.
Correct Answer: A
Rationale: A primipara is a woman who has completed one pregnancy with a viable fetus.
Which comment made by a new mother to her own mother is most likely to encourage the grandmother's participation in the infant's care?
- A. "Could you help me with the housework today?"
- B. "The baby is spitting up a lot. What should I do?"
- C. "I know you are busy, so I'll get John's mother to help me
- D. “The baby has a stomachache. I’ll call the nurse to find out what to do.
Correct Answer: B
Rationale: The correct answer is B because it directly involves the grandmother in the baby's care by seeking advice and guidance. Asking for help with a specific issue shows trust and respect for the grandmother's experience. Choice A is about housework, not infant care. Choice C suggests seeking help elsewhere. Choice D involves a healthcare professional, not the grandmother.
The maternity nurse understands that vascular volume increases 40% to 45% during pregnancy to:
- A. compensate for decreased renal plasma flow.
- B. provide adequate perfusion of the placenta
- C. eliminate metabolic wastes of the mother.
- D. prevent maternal and fetal dehydration.
Correct Answer: B
Rationale: The correct answer is B because the increased vascular volume during pregnancy is essential to provide adequate perfusion of the placenta, ensuring proper nutrient and oxygen exchange between the mother and fetus. This is crucial for the optimal growth and development of the fetus.
A: The increased vascular volume during pregnancy does not compensate for decreased renal plasma flow but rather supports the increased metabolic demands of pregnancy.
C: The elimination of metabolic wastes of the mother is primarily carried out by the kidneys and liver, not solely through increased vascular volume.
D: Preventing maternal and fetal dehydration is more related to adequate fluid intake and retention, rather than the increase in vascular volume during pregnancy.