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?
The client reports a decrease in nausea and vomiting.
The client gains 1 kg (2.2 lb) in 24 hr.
The client's urine specific gravity is 1.035
The client's hematocrit is 38%.
The Correct Answer is A
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.
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Correct Answer is C
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.
Correct Answer is B
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.
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