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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.
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A woman is at 14 weeks of gestation. The nurse would expect to palpate the fundus at which level?
- A. Not palpable above the symphysis at this time
- B. Slightly above the symphysis pubis
- C. At the level of the umbilicus
- D. Slightly above the umbilicus
Correct Answer: B
Rationale: At 14 weeks of gestation, the fundus should be palpable slightly above the symphysis pubis. This is because the fundus gradually rises with the progression of pregnancy. At this stage, the uterus is still within the pelvis and hasn't yet reached the level of the umbilicus or above it. Choice A is incorrect as some level of fundal height should be palpable by this time. Choice C is incorrect as the fundus is not expected to be at the level of the umbilicus until around 20 weeks. Choice D is also incorrect as the fundus would not typically be palpable slightly above the umbilicus until later in the pregnancy.
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.
Human chorionic gonadotropin (hCG) is an important biochemical marker for pregnancy and the basis for many tests. A maternity nurse should be aware that:
- A. hCG can be detected 2.5 weeks after conception.
- B. the hCG level increases gradually and uniformly throughout pregnancy.
- C. much lower than normal increases in the level of hCG may indicate a postdate pregnancy.
- D. a higher than normal level of hCG may indicate an ectopic pregnancy or Down
Correct Answer: A
Rationale: The correct answer is A because hCG can be detected in the blood as early as 2.5 weeks after conception. This is because hCG is produced by the placenta shortly after implantation of the fertilized egg in the uterus. The other choices are incorrect. B is incorrect because hCG levels do not increase gradually and uniformly; they rise rapidly in early pregnancy and peak around 8-11 weeks before stabilizing. C is incorrect because lower than normal increases in hCG may indicate a potential issue with the pregnancy, such as a possible miscarriage, rather than a postdate pregnancy. D is incorrect because a higher than normal level of hCG may indicate conditions such as a molar pregnancy or twins, not necessarily ectopic pregnancy or Down syndrome.
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: Nausea and vomiting are believed to be caused by increased levels of hormones, decreased gastric motility, and hypoglycemia.
is a treatment used to relieve symptoms of the menopause:
- A. Dialysis
- B. Chemotherapy
- C. Laser therapy
- D. Hormone replacement therapy (HRT)
Correct Answer: D
Rationale: Hormone replacement therapy (HRT) alleviates menopausal symptoms by replenishing declining hormone levels.