A client with severe hyperemesis gravidarum is admitted to the facility after being cared for at home without success. What would the nurse expect to include in the client's plan of care?

clear liquid diet

administration of labetalol

small frequent meals

nothing by mouth

Answer and Explanation

The Correct Answer is D

A. Clear liquid diet may be appropriate later in treatment once symptoms improve, but it is not typically initiated immediately in a client with severe hyperemesis gravidarum, especially if they are unable to keep any fluids down.

B. Administration of labetalol is used to treat hypertension, particularly in preeclampsia, and is not related to the treatment of hyperemesis gravidarum.

C. Small frequent meals are part of long-term management or mild cases, but for severe hyperemesis gravidarum requiring hospitalization, oral intake is usually withheld initially.

D. Nothing by mouth (NPO) is correct. In severe hyperemesis gravidarum, the client is often kept NPO to rest the gastrointestinal tract and prevent further vomiting. Intravenous (IV) fluids, electrolytes, and sometimes antiemetic medications are administered to manage dehydration and nutritional deficits before gradually resuming oral intake.

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Correct Answer is B

Explanation

A. Polyhydramnios refers to an excessive amount of amniotic fluid and typically presents with maternal discomfort, dyspnea, and possibly preterm labor, but not with vaginal bleeding as a primary symptom.

B. Placenta previa is the most likely diagnosis based on the assessment findings. It typically presents with painless, bright red vaginal bleeding in the second or third trimester, a soft, nontender uterus, no contractions, and a normal fetal heart rate. The bleeding may start spontaneously and often recurs. This fits the client's clinical picture precisely.

C. Placental abruption usually involves painful vaginal bleeding, a firm or tender uterus, and may be associated with uterine contractions or abnormal fetal heart rate patterns. The absence of pain and uterine tenderness in this case makes placental abruption less likely.

D. Ruptured ectopic pregnancy would not be expected at 33 weeks’ gestation. Ectopic pregnancies typically present in the first trimester and are accompanied by severe abdominal pain, vaginal bleeding, and signs of hypovolemic shock if ruptured.

A. nonshivering thermogenesis B. cold stress C. convection D. bilirubin conjugation

Correct Answer is A

Explanation

A. Nonshivering thermogenesis is the primary method of heat production in newborns. Unlike adults, newborns do not generate heat through shivering. Instead, they rely on the metabolism of brown adipose tissue (brown fat) to produce heat. This process is triggered by exposure to cold and helps maintain body temperature.

B. Cold stress is a condition, not a heat production mechanism. It occurs when the newborn is exposed to cold temperatures, leading to increased oxygen and energy demands as the body attempts to produce heat — which can be dangerous.

C. Convection is a method of heat loss, not production. It occurs when heat is lost from the body surface to cooler surrounding air (e.g., drafts in the room).

D. Bilirubin conjugation is related to the liver's processing of bilirubin and has nothing to do with thermoregulation.

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A client with severe hyperemesis gravidarum is admitted to the facility after being cared for at home without success. What would the nurse expect to include in the client's plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

After teaching an in-service program to a group of nurses working in newborn nursery about a neutral thermal environment, the nurse determines that the teaching was successful when the group identifies which process as the newborn's primary method of heat production?

Correct Answer is A

Explanation

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