Each of the following pregnant women is scheduled for a 14-week antepartal visit.In planning care, the nurse would give priority teaching on Quad screening to which client?

28-year-old with history of rheumatic heart disease.

40-year-old with a history of preterm labor.

18-year-old with exposure to HIV.

35-year-old with a child with spina bifida.

Answer and Explanation

The Correct Answer is D

Choice A rationale

While a history of rheumatic heart disease is significant, it does not directly correlate with the need for priority teaching on Quad screening. This condition requires careful cardiac monitoring and management during pregnancy.

Choice B rationale

A history of preterm labor is important and may require additional monitoring and interventions, but it is not a direct indication for priority teaching on Quad screening, which assesses risk for certain fetal conditions.

Choice C rationale

Exposure to HIV requires careful management and monitoring to reduce the risk of mother-to-child transmission. However, it is not specifically linked to the need for Quad screening, which is focused on detecting chromosomal abnormalities.

Choice D rationale

A history of having a child with spina bifida places this client at higher risk for having another child with neural tube defects or chromosomal abnormalities. Therefore, priority teaching on Quad screening, which includes markers for such conditions, is essential. .

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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"C"},"D":{"answers":"A"},"E":{"answers":"A"}}

Explanation

Weight loss of 2.8 kg (6.2 lb): Consistent - Significant weight loss is a classic symptom of hyperemesis gravidarum. The client has lost more than 5% of her pre-pregnancy weight, which is concerning and supports this diagnosis.

Hematocrit: 30%: Not Consistent - Hematocrit measures the proportion of red blood cells in the blood. In hyperemesis gravidarum, the hematocrit may be elevated due to dehydration, not decreased. Therefore, this value is not consistent with the typical presentation.

Vaginal spotting: Not Relevant - While vaginal spotting can be concerning in pregnancy, it is not a specific sign of hyperemesis gravidarum and does not directly relate to the diagnosis of severe nausea and vomiting.

Heart rate: 110/min: Consistent - Tachycardia (elevated heart rate) can occur due to dehydration and the body’s response to prolonged vomiting, making this finding consistent with hyperemesis gravidarum.

BUN: 28 mg/dL: Consistent - Blood urea nitrogen (BUN) is elevated in this client, suggesting dehydration. Dehydration is a common complication of hyperemesis gravidarum due to persistent vomiting and poor oral intake.

A. Increased fibrinogen and decreased fibrinolysis. B. Increased blood volume and increased cardiac output. C. Decreased hematocrit and increased red blood cell level (RBC). D. Decreased blood pressure and decreased hemoglobin.

Correct Answer is A

Explanation

Choice A rationale

During pregnancy, there is an increase in fibrinogen and a decrease in fibrinolysis. These changes increase the risk of thromboembolic events, as they promote clot formation.

Choice B rationale

Increased blood volume and cardiac output are normal in pregnancy but do not directly increase the risk of thromboembolic events. They are adaptations to meet the increased metabolic demands.

Choice C rationale

Decreased hematocrit and increased RBC levels are typical in pregnancy but are related to the physiological dilution of blood, not thromboembolic risks.

Choice D rationale

Decreased blood pressure and hemoglobin are common in pregnancy due to increased blood volume but are not associated with increased thromboembolic risks. .

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Each of the following pregnant women is scheduled for a 14-week antepartal visit.In planning care, the nurse would give priority teaching on Quad screening to which client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"C"},"D":{"answers":"A"},"E":{"answers":"A"}}

Explanation

The nurse knows that a normal physiologic alteration of the circulatory system associated with thromboembolic events in pregnancy is:

Correct Answer is A

Explanation

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