A nurse is caring for a client who has hyperemesis gravidarum. The nurse should identify that the client is at risk for which of the following conditions?

Elevated blood pressure

Leukopenia

Hydramnios

Ketonuria

Answer and Explanation

The Correct Answer is C

A. Elevated blood pressure is typically associated with gestational hypertension or preeclampsia rather than hyperemesis gravidarum. In hyperemesis, the significant fluid loss through protracted vomiting more commonly leads to hypovolemia and a subsequent decrease in systemic blood pressure. While compensatory tachycardia may occur, hypertension is not a direct scientific expectation for this clinical condition.

B. Leukopenia, which is a decrease in the white blood cell count, is not a typical finding in clients suffering from hyperemesis gravidarum. Hemoconcentration caused by severe dehydration may actually result in a relative increase in various laboratory values, including hematocrit and occasionally white cell counts. There is no physiological mechanism within this disorder that causes the bone marrow suppression required for leukopenia.

C. Hydramnios, or excessive amniotic fluid volume, is generally associated with fetal anomalies or maternal diabetes rather than severe vomiting. Hyperemesis gravidarum is characterized by a state of maternal fluid volume deficit rather than an excess of amniotic fluid. In severe, untreated cases, maternal dehydration might actually lead to decreased placental perfusion and a potential reduction in amniotic fluid.

D. Ketonuria is a critical finding in hyperemesis gravidarum that indicates the body has shifted to an anaerobic metabolic state. Because the client cannot retain sufficient carbohydrates for energy, the body begins catabolizing adipose tissue to produce fuel, resulting in the accumulation of ketone bodies. The presence of these ketones in the urine confirms that the client is experiencing metabolic starvation and requires immediate intervention.

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Correct Answer is C

Explanation

A) Incorrect- Checking urine for ketones is not necessary if the newborn's blood glucose level is low but stable and the baby is asymptomatic.
B) Incorrect- Administering glucagon is not indicated for an asymptomatic newborn with a low but stable blood glucose level.
C) Correct - Encouraging additional feeding is appropriate for an asymptomatic newborn with a low blood glucose level. Regular feeding can help increase blood glucose levels.
D) Incorrect- Waiting 4 hours to recheck blood glucose might not be appropriate if the baby's blood glucose is currently low. Addressing the low blood glucose level is more immediate.

A. "You will have a group B strep culture at 36 weeks of gestation." B. "You will have to produce a clean catch urine specimen every 2 months." C. "You will have a maternal serum alpha-fetoprotein screening at 6 weeks of gestation. D. "You will have a screening for gestational diabetes at 12 weeks of gestation."

Correct Answer is A

Explanation

A) Correct - Group B streptococcus (GBS) screening is typically performed around 36 weeks of gestation to identify colonization. It helps determine whether antibiotic prophylaxis is necessary during labor to prevent transmission to the newborn.
B) Incorrect- Producing a clean catch urine specimen every 2 months is not a standard recommendation during pregnancy. Urine testing is common but does not usually occur this frequently.
C) Incorrect- Maternal serum alpha-fetoprotein screening is typically done around 15-20 weeks of gestation, not 6 weeks.
D) Incorrect- Screening for gestational diabetes typically occurs between 24 and 28 weeks of gestation, not 12 weeks.

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A nurse is caring for a client who has hyperemesis gravidarum. The nurse should identify that the client is at risk for which of the following conditions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a newborn whose mother has gestational diabetes. The newborn has a blood glucose level of 30 mg/dL and is asymptomatic. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is reinforcing teaching about laboratory testing with a client who is at 6 weeks of gestation. Which of the following statements should the nurse include?

Correct Answer is A

Explanation

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