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Showing 14 questions, Sign in for moreA nurse is calculating the partial pressure of oxygen (PaO2) in the arterial blood of a pregnant client who is in her second trimester.
The nurse should use which of the following values as the normal range for PaO2 in pregnancy?
Explanation
95 to 105 mmHg.
This is the normal range for PaO2 in pregnancy according to several sources.
PaO2 is the partial pressure of oxygen in arterial blood and reflects the oxygenation of the blood.
It is influenced by factors such as ventilation, perfusion, diffusion, and hemoglobin affinity.
Choice A is wrong because 27 to 32 mmHg is too low for PaO2 and would indicate severe hypoxemia or low oxygen levels in the blood.
Choice C is wrong because 500 to 700 mL is a measure of tidal volume, not PaO.
Tidal volume is the amount of air that moves in and out of the lungs with each breath.
Choice D is wrong because 7 to 10 L/min is a measure of oxygen flow rate, not PaO.
Oxygen flow rate is the amount of oxygen delivered to a patient through a device such as a nasal cannula or a mask.
Which factors would change during pregnancy if the hormone progesterone were withdrawn or reduced?
Explanation
Peristalsis and uterine contractility would increase.
This is because progesterone is a hormone that relaxes the smooth muscles of the uterus and the gastrointestinal tract during pregnancy.
If progesterone were reduced or withdrawn, the uterus would contract more and peristalsis would increase, leading to possible preterm labor and digestive problems.
Choice A is wrong because insulin resistance would be decreased, not increased, by lower progesterone levels.
Progesterone increases insulin resistance during pregnancy to ensure adequate glucose supply for the fetus.
Choice B is wrong because sweat and sebaceous glands would decrease production, not increase, by lower progesterone levels.
Progesterone stimulates the activity of these glands during pregnancy to regulate body temperature and protect the skin from infections.
Choice C is wrong because pyrosis (heartburn) would decrease in frequency, not increase, by lower progesterone levels.
Progesterone relaxes the lower esophageal sphincter during pregnancy, allowing gastric acid to reflux into the esophagus and cause pyrosis.
A nurse is caring for a pregnant client who has hyperemesis gravidarum and is receiving IV fluids and antiemetics in an acute care facility.
Which of the following outcomes indicates that treatment has been effective?
Explanation
The correct answer is choice A. The client reports a decrease in nausea and vomiting.
This indicates that the treatment has been effective in reducing the symptoms of hyperemesis gravidarum and improving the quality of life of the client.
Choice B is wrong because weight gain alone is not a reliable indicator of treatment effectiveness.
Weight gain may be due to fluid retention or other factors unrelated to nausea and vomiting.
Choice C is wrong because urine specific gravity of 1.035 is high and indicates dehydration, which is a complication of hyperemesis gravidarum.
The normal range of urine specific gravity is 1.005 to 1.0302.
Choice D is wrong because hematocrit of 38% is within the normal range for pregnant women (33 to 39%) and does not reflect the severity or improvement of hyperemesis gravidarum.
A nurse is providing education to a pregnant client about the hormonal changes during pregnancy.
Which hormone is responsible for maintaining the corpus luteum and stimulating fetal growth ?
Explanation
Progesterone is responsible for maintaining the corpus luteum and stimulating fetal growth.
Progesterone also prevents miscarriage by relaxing the uterus and maintaining the endometrium.
Choice B is wrong because estrogen is not responsible for maintaining the corpus luteum or stimulating fetal growth.
Estrogen helps develop the female sexual traits and supports the growth of the uterus and placenta.
Choice C is wrong because thyroid hormones are not responsible for maintaining the corpus luteum or stimulating fetal growth.
Thyroid hormones regulate the metabolism and energy levels of the mother and the fetus.
Choice D is wrong because prolactin is not responsible for maintaining the corpus luteum or stimulating fetal growth.
Prolactin stimulates milk production in the breasts after delivery.
A nurse is caring for a pregnant client who is experiencing increased urinary protein levels.
What is the primary cause of this change?
Explanation
Increased glomerular filtration rate.
This is because during pregnancy, the renal blood flow and glomerular filtration rate increase to meet the increased metabolic demands of the mother and fetus.
This can result in increased urinary protein excretion, which is usually mild and does not indicate renal damage.
Choice A is wrong because decreased glomerular permeability would reduce the amount of protein that can pass through the glomerulus and into the urine.
Choice B is wrong because decreased protein intake would not affect the urinary protein levels, unless the intake is severely deficient.
Choice D is wrong because increased tubular reabsorption would decrease the amount of protein that is excreted in the urine, as the tubules would reabsorb more protein from the filtrate and return it to the blood.
A nurse is explaining the musculoskeletal changes during pregnancy to a group of expectant mothers.
Which change alters the center of gravity and posture of the body?
Explanation
This change alters the center of gravity and posture of the body because the uterus expands and shifts higher as the fetus grows during pregnancy.
This causes an increased strain on the muscles and ligaments supporting the vertebral column and leads to lower back pain.
Choice A is wrong because increased joint laxity does not alter the center of gravity and posture of the body.
It is caused by hormonal changes that loosen the ligaments throughout the body, resulting in decreased stability of the joints.
Choice C is wrong because increased muscle strain does not alter the center of gravity and posture of the body.
It is a consequence of the shift in the center of gravity and the weight gain during pregnancy, which put more pressure on the back muscles.
Choice D is wrong because decreased muscle strength does not alter the center of gravity and posture of the body.
It is not a common musculoskeletal change during pregnancy, although some women may experience fatigue or weakness due to hormonal changes or anemia.
A nurse is educating a pregnant client about the renal changes during pregnancy.
Which change is responsible for the increased urinary output?
Explanation
Increased renal blood flow is responsible for the increased urinary output during pregnancy.
This is because the renal plasma flow and glomerular filtration rate increase by 50% to 80% during pregnancy, resulting in more urine production.
Choice A is wrong because the glomerular filtration rate increases, not decreases, during pregnancy.
Choice B is wrong because the tubular reabsorption decreases, not increases, during pregnancy.
This is due to the increased levels of progesterone, which inhibit sodium reabsorption and cause diuresis.
Choice D is wrong because the increased plasma volume is a consequence, not a cause, of the increased renal blood flow.
The plasma volume expands by 30% to 50% during pregnancy to meet the increased metabolic demands of the mother and fetus.
A nurse is reviewing the laboratory results of a pregnant client.
Which finding is expected regarding serum creatinine and urea levels?
Explanation
Serum creatinine and urea are waste products of protein metabolism that are normally filtered by the kidneys and excreted in urine.
In pregnancy, the glomerular filtration rate (GFR) increases by about 50%, which means more creatinine and urea are cleared from the blood.Therefore, serum creatinine and urea levels decrease in pregnancy compared to nonpregnant women.
A. Increased serum creatinine and urea levels are wrong because they indicate impaired kidney function or dehydration, which are not normal in pregnancy.
C. Unchanged serum creatinine and urea levels are wrong because they do not reflect the increased GFR in pregnancy.
D. Increased glomerular filtration rate is correct but it is not a finding regarding serum creatinine and urea levels, which are the focus of the question.
Normal ranges for serum creatinine and urea vary depending on the laboratory and the units used, but based on a nonpregnant reference interval of 45-90 μmol/l (0.51-1.02 mg/dl) for creatinine and 2.5-6.4 mmol/l (7-18 mg/dl) for urea, a serum creatinine of >77 μmol/l (0.87 mg/dl) and a blood urea of >8.5 mmol/l (24 mg/dl) should be considered outside the normal range for pregnancy.
A nurse is providing education to a pregnant client about the symptoms associated with musculoskeletal changes.
Which symptom is commonly experienced due to increased muscle strain during pregnancy?
Explanation
Back pain is a common symptom experienced due to increased muscle strain during pregnancy.
As the uterus grows and the center of gravity shifts, there is more pressure on the lower back muscles and ligaments.
This can cause pain, difficulty with balance, and reduced activity.
Choice A is wrong because leg cramps are not caused by muscle strain, but by other factors such as dehydration, electrolyte imbalance, or compression of blood vessels.
Choice C is wrong because pelvic pain is not a typical symptom of musculoskeletal changes during pregnancy.
Pelvic pain can be caused by other conditions such as urinary tract infection, preterm labor, or pelvic girdle pain.
Choice D is wrong because carpal tunnel syndrome is not a result of muscle strain, but of fluid retention and swelling that compresses the median nerve in the wrist.
This can cause numbness, tingling, or pain in the hand and fingers.
A pregnant client reports experiencing frequent urination at night.
The nurse explains that this symptom is primarily caused by:.
Explanation
This is because a pregnant client may experience frequent urination at night due to increased urinary output caused by the increased blood volume and renal function during pregnancy.
This symptom is more common in the first and third trimesters.
Choice A is wrong because increased glomerular permeability does not cause nocturia, but it may cause proteinuria, which is the presence of protein in the urine.
Choice B is wrong because decreased renal blood flow does not cause nocturia, but it may cause renal ischemia, which is a condition where the kidneys do not receive enough blood supply.
Choice C is wrong because increased tubular reabsorption does not cause nocturia, but it may cause water retention and edema, which are swelling of the body tissues due to fluid accumulation.
A nurse is educating a pregnant client about the endocrine changes during pregnancy.
Which hormone is responsible for inhibiting ovulation and stimulating milk production?
Explanation
Prolactin is a hormone that is responsible for inhibiting ovulation and stimulating milk production during pregnancy.
It is produced by the anterior pituitary gland and increases throughout pregnancy.
Choice A is wrong because hCG (human chorionic gonadotropin) is a hormone that is produced by the placenta and maintains the corpus luteum, which secretes progesterone and estrogen.
hCG does not inhibit ovulation or stimulate milk production.
Choice B is wrong because progesterone is a hormone that is produced by the corpus luteum and the placenta and supports the endometrium, prevents uterine contractions, and prepares the breasts for lactation.
Progesterone does not inhibit ovulation or stimulate milk production.
Choice C is wrong because estrogen is a hormone that is produced by the corpus luteum and the placenta and stimulates uterine growth, blood flow, and breast duct development.
Estrogen does not inhibit ovulation or stimulate milk production.
A nurse is educating a pregnant client about the changes in her posture during pregnancy.
Which factor contributes to increased spinal curvature?
Explanation
The correct answer is choice A. Increased joint laxity contributes to increased spinal curvature in pregnant women.
Joint laxity is caused by the hormone relaxin, which loosens the ligaments and joints of the pelvis and spine to prepare for childbirth.
This can result in increased lordosis (inward curvature) of the lumbar spine and increased kyphosis (outward curvature) of the thoracic spine.
Choice B is wrong because increased weight gain does not directly affect spinal curvature, but it can cause postural changes such as anterior pelvic tilt and forward trunk lean.
Choice C is wrong because increased muscle strain is a consequence, not a cause, of spinal curvature changes.
Muscle strain can occur due to the altered biomechanics and balance of the spine and pelvis during pregnancy.
Choice D is wrong because decreased muscle strength is also a consequence, not a cause, of spinal curvature changes.
Muscle strength can decrease due to reduced physical activity, hormonal changes, or pain during pregnancy.
Normal ranges for spinal curvature vary depending on age, sex, and measurement method, but generally they are:
Sacral inclination: 30-50 degrees
Lumbar curvature: 20-45 degrees
Thoracic curvature: 20-40 degrees
Cervical curvature: 20-35 degrees
A nurse is caring for a pregnant client who is experiencing leg cramps.
These cramps are primarily caused by:.
Explanation
Leg cramps are painful muscle contractions that typically affect the calf, foot or both.
They are common during pregnancy, often happening at night during the second and third trimesters.
While the exact cause of leg cramps during pregnancy isn’t clear, various theories point to the following causes of leg cramps during pregnancy: 2
Pregnancy fatigue from carrying the extra baby weight
Compression of the blood vessels in the legs
Diet (an excess of phosphorus and a shortage of calcium or magnesium)
Pregnancy hormones since they seem to cause so many pregnancy aches and pains
Choice A is wrong because increased joint laxity is not a cause of leg cramps, but rather a result of hormonal changes that relax the ligaments and joints in preparation for childbirth.
Choice B is wrong because increased spinal curvature is not a cause of leg cramps, but rather a result of the changing center of gravity and posture during pregnancy.
Choice D is wrong because decreased muscle strength is not a cause of leg cramps, but rather a consequence of muscle fatigue and weight gain during pregnancy.
Normal ranges for calcium are 8.5 to 10.2 mg/dL, for magnesium are 1.7 to 2.2 mg/dL, and for phosphorus are 2.5 to 4.5 mg/dL.
A nurse is caring for a patient who had an amniocentesis performed at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.
Which action should be taken first?
Explanation
This is because cramping and vaginal bleeding 24 hours after amniocentesis are signs of possible complications, such as injury to the baby or mother, leaking of amniotic fluid, infection, Rh sensitization, preterm labor, or miscarriage.
These complications are rare, but they can be serious and require immediate medical attention.
Choice B is wrong because administering pain medication to the patient does not address the underlying cause of the cramping and bleeding, and may delay seeking help.
Choice C is wrong because encouraging the patient to rest and elevate her legs may not prevent further complications, and may also delay seeking help.
Choice D is wrong because offering emotional support and reassurance to the patient is not enough to ensure the safety of the baby and the mother, and may give a false sense of security.
Normal ranges for amniocentesis are:
No chromosomal defects detected in the fetus and no abnormal proteins present in amniotic fluid
No signs of infection or other illness in the baby
Fetal lungs mature enough for birth if delivery is planned sooner than 39 weeks
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