Nokea
A pregnant patient tells the nurse that she has been nauseated and vomiting. How will the nurse explain that hyperemesis gravidarum is distinguished from morning sickness?
- A. Hyperemesis gravidarum usually lasts for the duration of the pregnancy.
- B. Hyperemesis gravidarum causes dehydration and electrolyte imbalances.
- C. Sensitivity to smells is usually the cause of vomiting in hyperemesis gravidarum.
- D. The woman with hyperemesis gravidarum will have persistent vomiting without weight loss.
Correct Answer: B
Rationale: Dehydration and electrolyte imbalances result from persistent nausea and vomiting associated with hyperemesis gravidarum. Dehydration impairs the perfusion to the placenta.
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What situation would concern the nurse about the presence of Rh incompatibility?
- A. Rh-negative mother, Rh-positive fetus
- B. Rh-positive mother, Rh-negative fetus
- C. Rh-negative mother, Rh-negative fetus
- D. Rh-positive mother, Rh-positive fetus
Correct Answer: A
Rationale: Rh incompatibility can occur only if the mother is Rh negative and the fetus is Rh positive.
What will the nurse begin with when asking a patient about drug use during a prenatal history?
- A. Do you smoke, drink alcohol, or use drugs?'
- B. Do you ever use prescription or street drugs?'
- C. What over-the-counter and prescription drugs have you taken in the past 3 months?'
- D. We need to know if you take drugs so we can help your baby.'
Correct Answer: C
Rationale: Screening for drug use should begin in a nonthreatening way by asking about prescription and OTC medications and how the information can help provide safe and appropriate prenatal care.
The nurse is obtaining history and physical information on a new patient attending her first prenatal visit. After recording current height, weight, and BMI, it is determined that the patient is obese. What complications related to obesity will the nurse assess for during pregnancy? (Select all that apply.)
- A. Gestational diabetes
- B. RH incompatibility
- C. Hypertension
- D. Pre-eclampsia
- E. Infection
Correct Answer: A,C,D
Rationale: The obese woman who is pregnant has a high risk for developing complications during pregnancy such as gestational diabetes, hypertension, cardiac problems, pre-eclampsia, and respiratory problems.
The nurse finds a woman crying after she has undergone a dilation and evacuation (D&E) for a missed abortion. What is the most appropriate statement by the nurse?
- A. There is usually something wrong with the fetus when this happens early in pregnancy.'
- B. Now there. You can try to conceive on your next cycle.'
- C. I'm here if you need to talk.'
- D. You are young and strong. I know you can have a healthy pregnancy.'
Correct Answer: C
Rationale: An effective technique when communicating with a woman experiencing pregnancy loss is to say, 'I'm here if you need to talk.' The nurse listens and acknowledges the woman's grief.
The nurse is caring for a prenatal patient diagnosed with a placenta previa. What is the best position for this patient?
- A. Flat on her back with knees flexed to help prevent hemorrhage
- B. On her side to prevent supine hypotension
- C. In the semi-Fowler's position to prevent supine hypotension
- D. In the knee-chest position to reduce pressure on the placenta
Correct Answer: B
Rationale: The prenatal patient with placenta previa is best placed on her side with a pillow for support. This position not only reduces stress on the placenta but also reduces the possibility of supine hypotension.