In a client's seventh month of pregnancy, she reports feeling "dizzy, like I'm going to pass out, when I lie down ﬂat on my back". The nurse explains that this is due to:
Select one:

Physiologic anemia due to maternal increased plasma volume.

Pressure of the gravid uterus on the maternal inferior vena cava and aorta.

Pressure of the presenting fetal part on the maternal diaphragm.

A 50% increase in maternal blood volume during pregnancy.

Answer and Explanation

The Correct Answer is B

Choice A Reason: Physiologic anemia due to maternal increased plasma volume. This is an incorrect answer that refers to a diﬀerent condition that aﬀects hemoglobin levels, not blood pressure. Physiologic anemia is a condition where the maternal plasma volume increases more than the red blood cell mass during pregnancy, which dilutes the hemoglobin concentration and lowers the hematocrit value. Physiologic anemia does not cause significant symptoms or complications in pregnant women, as it is an adaptive mechanism that enhances oxygen delivery and prevents ﬂuid overload.

Choice B Reason: Pressure of the gravid uterus on the maternal inferior vena cava and aorta. This is because this statement explains the cause of supine hypotensive syndrome, which is a condition where lying ﬂat on the back causes compression of the major blood vessels by the gravid uterus, which reduces venous return and cardiac output, which lowers blood pressure and perfusion to vital organs. Supine hypotensive syndrome can cause symptoms such as dizziness, lightheadedness, nausea, pallor, or syncope in pregnant women, especially in the third trimester.

Choice C Reason: Pressure of the presenting fetal part on the maternal diaphragm. This is an incorrect answer that indicates a diﬀerent condition that aﬀects respiratory function, not blood pressure. Pressure of the presenting fetal part on the maternal diaphragm is a result of cephalic engagement or lightening, which occurs when the fetal head descends into the pelvis and occupies more space in the abdominal cavity. Pressure of the presenting fetal part on the maternal diaphragm can cause symptoms such as dyspnea, heartburn, or rib pain in pregnant women.

Choice D Reason: A 50% increase in maternal blood volume during pregnancy. This is an incorrect answer that describes a normal physiological change that occurs during pregnancy, not a cause of supine hypotensive syndrome. A 50% increase in maternal blood volume during pregnancy is due to increased production of plasma and red blood cells, which helps meet the increased oxygen and nutrient demands of the fetus and placenta, and prepares the mother for blood loss during delivery. A 50% increase in maternal blood volume during pregnancy does not cause hypotension or dizziness in pregnant women.

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Correct Answer is B

Explanation

Choice A Reason: Pulmonary edema is a condition where ﬂuid accumulates in the lungs, causing shortness of breath and difficulty breathing. It can occur in preeclampsia due to increased blood pressure and ﬂuid retention, but it is not a definitive sign of eclampsia.

Choice B Reason: Convulsion (seizure) is a sudden, involuntary contraction of muscles that can cause loss of consciousness, shaking, and twitching. It is the main symptom of eclampsia and distinguishes it from preeclampsia.

Choice C Reason: Renal failure is a condition where the kidneys fail to filter waste products from the blood, resulting in high levels of creatinine and urea. It can occur in preeclampsia due to reduced blood ﬂow to the kidneys, but it is not a specific indicator of eclampsia.

Choice D Reason: Retinal edema is a condition where ﬂuid leaks into the retina, causing blurred vision and ﬂashes of light. It can occur in preeclampsia due to increased blood pressure and damage to the blood vessels in the eye, but it is not a characteristic feature of eclampsia.

A. Retained placental fragments. B. Cervical or vaginal lacerations. C. Uterine inversion. D. Uterine atony.

Correct Answer is D

Explanation

Choice A Reason: Retained placental fragments. This is an incorrect answer that refers to a diﬀerent cause of late postpartum hemorrhage, which is less common than uterine atony. Retained placental fragments are pieces of placenta that remain atached to the uterine wall after delivery, which prevent uterine contraction and involution, and provide a source of bleeding and infection. Retained placental fragments can be caused by abnormal placentation (such as placenta accreta), manual removal of placenta, or incomplete separation of placenta.

Choice B Reason: Cervical or vaginal lacerations. This is an incorrect answer that refers to a diﬀerent cause of late postpartum hemorrhage, which is more likely to cause early postpartum hemorrhage than late postpartum hemorrhage. Cervical or vaginal lacerations are tears or cuts in the cervix or vagina that occur during delivery, which can cause bleeding from the damaged blood vessels. Cervical or vaginal lacerations can be caused by rapid or instrumental delivery, large or malpositioned fetus, or episiotomy.

Choice C Reason: Uterine inversion. This is an incorrect answer that refers to a diﬀerent cause of late postpartum hemorrhage, which is rare and life-threatening. Uterine inversion is a condition where the uterus turns inside out and protrudes through the cervix and vagina after delivery, which can cause massive bleeding and shock. Uterine inversion can be caused by excessive traction on the umbilical cord, fundal pressure, or uterine relaxation.

Choice D Reason: Uterine atony. This is because uterine atony is a condition where the uterus fails to contract and retract after delivery, which leads to bleeding from the placental site. Uterine atony is the most common cause of late postpartum hemorrhage, accounting for about 75% of cases. Late postpartum hemorrhage is excessive bleeding from the uterus or genital tract that occurs more than 24 hours but less than 12 weeks after delivery. Late postpartum hemorrhage can be caused by retained placental fragments, subinvolution of the uterus, infection, or coagulation disorders.

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In a client's seventh month of pregnancy, she reports feeling "dizzy, like I'm going to pass out, when I lie down ﬂat on my back". The nurse explains that this is due to: Select one:

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Naxlex Comprehensive Predictor Exams

The primary factor that diﬀerentiates eclampsia from preeclampsia is: Select one:

Correct Answer is B

Explanation

When reviewing the causes of late postpartum hemorrhage, which of the following would the nurse identify as the most common cause? Select one:

Correct Answer is D

Explanation

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After the birth of a newborn, the nursing intervention that most eﬀectively promotes parental atachment is: Select one:

Which of the following would be essential to implement to prevent late postpartum hemorrhage? Select one:

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In a client's seventh month of pregnancy, she reports feeling "dizzy, like I'm going to pass out, when I lie down ﬂat on my back". The nurse explains that this is due to:
Select one: