Download NU 375 Exam 1: EAQ Ch 13, 14, & 15 Questions With Complete Solutions 2025 Graded A+ Pass. and more Exams Nursing in PDF only on Docsity!
NU 375 Exam 1: EAQ Ch 13, 14, & 15 Questions With Complete
Solutions 2025 Graded A+ Pass.
Why does the evaluation of abnormal Papanicolaou (Pap) tests during pregnancy become complicated?1. The cervix is larger.2. The cervix is more oval in shape.3. The cervix is more soft and velvety.4. The squamocolumnar junction is located away from cervix.(EAQ - CH 12 and 13) - ANSWERS- Which term describes the pregnant client who has a child and is in the 25th week of pregnancy? - ANSWERS-Multipara Which nursing action is appropriate when caring for a client who reports that she missed her period this month and suspects that she is a pregnant?1) assess for Hegar sign2) assess for Chadwick sign3) obtain an order for a urine test4) obtain an order for a serum blood test - ANSWERS- Which reason is appropriate for a false positive result in the client with a history of epilepsy? - ANSWERS-The client is taking tranquilizers Interpreting the results of a pregnancy test requires some judgment. Many factors, such as menstrual cycle, substance abuse, and medications, interfere with the test results. Medications such as anticonvulsants and tranquilizers may give false-positive results. Taking the test too early may return a false-negative result. Promethazine and diuretics affect the pregnancy test by causing false-negative results. In which condition is the pregnant client at risk for having high-than normal levels of human chorionic gonadotropic (hCG), excessive vomiting, and mild vagial bleeding? - ANSWERS-Gestational trophoblastic disease
Associated with abnormal gestation, sucha s a fetus with gestational trophoblastic disease, multiple gestation, or a fetus with Down syndrome An abnormally slow increase in hCG, or lower levels of hCG, indicates miscarriage or ectopic pregnancy Intruterine growth restriction occurs as a result of poor palcental perfusion or lack of adequate oxygen supply to the fetus Which nursing intervention would be anticipated for a client with type 1 diabetes at 14 weeks of gestation based on evaluation of the laboratory results? (image couldn't be uploaded) - ANSWERS-Review the client's diet Which statement made by a student nurse indicates the need for further teaching about acid-base values in the arterial blood of pregnant clients? - ANSWERS-"Sodium bicarbonate levels increase during pregnancy" During pregnancy, acid-base values change in the arterial blood. Sodium bicarbonate levels decrease during pregnancy. Hence, the student nurse stating that sodium bicarbonate levels increase during pregnancy indicates the need for further teaching. Blood pl increases during pregnancy as a result of decrease in base excess. Partial pressure of oxygen increases, and partial pressure of carbon dioxide decreases during pregnancy as a result of increased sensitivity of the respiratory center. Along with changes in partial pressures, the base excess also decreases as a result of increased sensitivity of the respiratory center.
Which hepatic changes are considered normal during pregnancy? SATA - ANSWERS-Increase serum albumin Increased serum alkaline phosphate Increase serum cholesterol During pregnancy, hepatic changes are observed. Serum albumin, serum alkaline phospohatase, and serum cholesterol increase. The increase in serum albumin is caused by increased synthesis of proteins during pregnancy. Decreased serum creatinine levels are caused by increased protein utilization by the fetus. There is increased breakdown of fatty acids during pregnancy, which results in increased serum cholesterol levels. Which factors change significantly during pregnancy? SATA - ANSWERS-Albumin levels Hematocrit value Gastric secretions The albumin levels in urine increase during pregnancy. This is because of increased glomerular filtration rate (GFR) and impaired proximal tubular function. The hematocrit value decreases as a result of rapid expansion of plasma volume, leading to physiologic anemia. Because fo the influence of estrogen and progesterone, gastric secretions such as pepsin and hydrochloric acid may decrease significantly Which finding is considered normal for a client in her second trimester? - ANSWERS-Increased pulse rate Between 14 and 20 weeks of gestation, the pulse increases about 10 to 15 beats/minute, which persists to term. Splitting of S1 and S2 is more audible. In the
first trimester, blood pressure usually remains the same as the prepregnancy level, but it gradually decreases up to about 20 weeks of gestation. During the second rimester botht he systolic and diastolic pressures decrease by about 5 to 10 mm Hg Which represents a positive sign of rpegnancy? - ANSWERS-Fetal heart rate auscultated with doppler/fetoscope Which sign of rpegnancy may manifest as an increase of urinary frequency in the cleint? - ANSWERS-Hegar sign Characterized by softening and compressibility of the lower uterine segment (uterine isthmus), which is observed at approximately 6 weeks of gestation Uterine fundus presses on the urinary baldder, casuing the woman to have icnreased urinary frequency Which hematocrit (Hct) and hemoglobin (Hgb) results represent the lowest acceptable values for a client in hte third trimester of pregnancy? - ANSWERS-33% Hct; 12 g/dL Hgb represents the lowest acceptable values during the first and third trimesters Which is te mena arterial pressure of the client witha blood pressure of 180/ mm Hg? - ANSWERS- ( Systolic + 2(diastolic) ) / 3 Whicht echnology test for hCG is used in over the cunter (OTC) pregnancy tests? - ANSWERS-Enzyme linked immunosorbernt assay (ELISA)
Hg? - ANSWERS-85 mm Hg Which nursing information is appropriate when teaching about blood coagulation and fibrinolytic activity in pregnant women? SATA - ANSWERS-Fibronogen levels increase during pregnancy Prothrombin time decreases during pregnancy Partial thromboplastin time decreases during pregnancy Hormonal changes during pregnancy cause alterations in the serum levels of the clotting factors. Therefore, during rpegnancy, prothrombin time decreases, fibrinogen levels increase, and partial thromboplastin time decreases. During pregnancy, clotting and bleeding time are unafffected, as there are no appreciable changes in bone marrow factors Whichr elevant drug history is appropriate for the client who had a dark complexion with brownish pigmentation over the cheeks, nose, and forehead during pregnancy, which faded and has recurred? - ANSWERS-Contraceptives Facial pigmentation that occurs during pregnancy and fades away with childbirth is referred to as melasma. This occurs as a result of increased production of melanotropin during pregnancy. Oral contraceptive use can also cause stimulation of melanotropin production. This may cause melasma to recur. Which related signs are appropriate for the pegnancy client whose hormonal reports reveal increased estrogen elvels? SATA - ANSWERS-Mucoid discharge fro the cervix Heaviness in the breasts
Well-defined pink blotches on the palm High levels of estrogen during pregnancy increase the production of cervical mucus. Therefore pregnant women have copious white or gray cervical discharges. Increases estrogen levels increase the blood supply to the breasts, therby causing breast heaviness. Well-defined pink blotches on the palm, which are referred to as palmar erythema, are also an effect of increased estrogen levels during rpegnancy. Which nursing conclusion about a 6-month primigravida is appropriate when blood tests report a hemoglobin of 11 g/gL, red blood cell count of 5. million/mm^3, hematocrit of 33%, and white blood cell count of 12,000/mm^3? - ANSWERS-Physiologic anemia Hemoglobin and hematocrit levels tend to decrease during pregnancy. A hemoglobin level of 11 g/dL and hematocrit of 33% are indicative of physiologic anemia. Hemoglobin levels less than 11 g/dL would indicate that the dient has iron deficiency. Based on the information, the nurse cannot predict that the dient is at a risk of bleeding. The nurse would check the prothrombin time to determine the risk of bleeding. Because the white blood cell count is elevated (normal is 5000 to 10,000/mm *), the nurse cannot conclude that the client has myelosuppression. Which changes are considered the presumptive signs of pregnancy? SATA - ANSWERS-Fatigue Quickening
when the lower uterine segment is soft on palpation? - ANSWERS-Hegar sign At approximately 6 weeks of gestation, softening and compressibility of the lower uterine segmenet occur Which findings indicate a healthy 5-month-pregnant cleint? SATA - ANSWERS- Hemoglobin value is 13 g/dL Mena corpuscular hemoglobin value is 30 pg Mean corpuscular hemoglobin concentration is 34 g/dL The laboratory findings may indicate the health condition of the dient. The hemoglobin value is 13 g/dL, which is within the normal range (greater than 1l g/dL). The mean corpuscular hemoglobin value of 30 pg (normal range = 27 to 31 pg) and the mean corpuscular hemoglobin concentration of 34 g/dL (normal range = 32 to 36 g/dL) also imply normal findings. The bladder capacity of 1000 mL is less than the normal value ( mL). The total serum protein value of 5.1 g/dL is not within the normal range (5. to 7.5 g/dL). These findings would not indicate that the client is normal. Which nursing information is appropriate when reassuring and educating the pregnant client about changes in her blood pressure? - ANSWERS-Compression of te iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the latter stage f term pregnancy
Can also lead to varicose veins in the legs and vulva Which statement explains why a gravida 5 para 4 client can "feel the baby move already" at 14 weeks of gestation? - ANSWERS-"After already having a baby, it is cmmon to feel movement earlier." Multiparous women can detect fetal movement as early as 14 to 16 weeks of gestation. The mother's uterus would be larger than anticipated if the fetus is larger, the pregnancy is farther advanced, or there are multiple fetuses Which nursing explanation is appropriate for a client who is estimated to be at 16 weeks of gestation by ultrasonography and states, "I don't undertand how I can be pregnant, i just had my period"? - ANSWERS-The bleeding was a result of the embryo attahcing to the uterine lining." Implantation bleeding often occurs 6 to 12 days after conception, which is the time at which the client would expect her menstrual epriod to begin. Mnestruation does not occur during rpegnancy Which presumptive signs (felt by the woman) or probably signs (observed by the examiner) of pregnancy are matched with another possible cause? SATA - ANSWERS-Amenhorrhea: stress, endocrine problems Quickening: gas, peristalsis Chadwick sign: pelvic congestion Urinary frequency: infection Which are consequences of low estrogen levels in the pregnant client? SATA - ANSWERS-Peristalsis increases Fat deposition is reduced
Which physiologic system would be appropriate to evaluate with laboratory testing for a client who is at 37 weeks of gestation and is having itching all over her body? - ANSWERS-Hepatic A client who is late in preganncy may experience intrahepatic cholestasis in response to placental steroids. This condition can result in severe itching and may or may not be accompanied by jaundice. Laboratory findings of elevated serum bile acid and alkaline phosphate confirm the diagnosis Which nursing action is anticipated to be in the plan of care based on laboratory results for a client at 37 weeks gestation with gestational hypertension? - ANSWERS-Continue to monitor the client The nurse would continue to monitor the clinet, "The laboratory findings are within acceptable limits, and there is no indication that the client is unstable. A preterm delivery, obtaining at 24-hour urine test, or obtaining clotting studies is not necessary. Which condition would affect a client at 10 weeks of gestation whose breasts have been leaking colostrum? - ANSWERS-Inaccurate gestational age During the second trimester, the lactogenesis stage occurs in which human placentatl lactogen strimulates the secretion of colostrum. The client is in the first tirmester of pregnancy during which prolactin stimulates the production of colostrum by the end of the tfirst trimester. Which assessment finding is most concerning for a client who is at 38 weeks of gestation and is having difficulty catching her breath, even when sitting? - ANSWERS-5-pound weight gain over the past week
The recommended weight gain in the third trimester is 1 pound per week for a client with a normal BMI, A 5-pound weight gain in 1 week for any pregnant client is significant, and ma indicated cardiac dysfunction. An irregular heartbeat is not uncommon during pregnancy and occurs as a result of increaded cardiac vascular volume. Which nursing action is appropriate for the client at 16 weeks of gestation based on evaluation of the laboratory results? Laboratory retults: Factor VII: 135, factor VIII: 160, Factor IX: 155, Factor X: 145, factor XI: 130 - ANSWERS-Take initiatives to reduce venous thromboembolism (VTE) risk The normal randes is 55 to 145 for factor VIII and 45 to 155 for factor X. the client's factors VIII and XI are elevated, which contributes to the formation of fibrin and places the client at risk for deep vein thrombosis. The plan of care for the client would be adjusted to implement measures to prevent VTE. the client wouldnt require factor replacement therapy or bleeding precautions Which outcome is appropriate when comparing a client's current vital signs at 40 weeks of gestation with her pre-pregnancy vital signs in the elctronic health recrod (EHR)? - ANSWERS-Blood pressure is abnormally elevated The cleitn's blood pressure is abnormally elevated. There would be a slight or no increase in systolic pressure. There would be a light decrease in diastolic pressure na dmid rpegnanancy and then a gradual return to prepregnancy levels by the end of the rpegnancy. The client's temperature, pulse, and respirations are normal. All vital signs except blood pressure reflect the anticipated changes Which arterial blood gas is anticipated fora rpegnant cleint? - ANSWERS-pH 7.47, PaCO2 30 mm Hg, HCO3- 20 mEq/L The alterations in acid-base balance in pregnancy create a state of respiratory
Hemophilia A carriers have a deficiency in factor VIII. Normally these levels increase in pregnancy, but they may not increaseenough in a client with hemophilia, which results in an increased risk of bleeding. An evaluation of the coagulation factors, specifically facotr VII, is helpful in evaluating the level of factor and the client's risk for bleeding. Hemophilia A would not affect the client's platelet count. A prothrombin time or complete blood count would not provide information about the level of deficiency in factor VIII Which findign is appropriate when explaining why a 3-month pregnant woman experiences increased thirst? - ANSWERS-Increases loss of water from the body In early pregnancy, the kidneys have increased capacity to excrete water. Therefore the client may feel thirsty as a result of increased loss of water. A low- fiber diet may cause constipation in pregnant women. Fiber does not interfere with the water levels in the body. Consumption of fatty food in the proper amount is necessary in pregnancy, and fatty foods usually do not cause excess thirst. Sodium ions trigger fluid retention in the body; they do not cause thirst Which nursing symptom information is appropriate to share with a pregnant client who is expereincing some integumentary changes that are normal abnormal findings? SATA - ANSWERS-Melasma Linea nigra Vascular spiders Melasma is also known as the mask of pregnancy, or chloasma, and is considered to be a normal abnormal finding of pregnancy. Linea nigra is a hyperpigmentation line extending from the fundus to the symphysis pubic and is considered to be a normal abnormal finding of pregnancy. The presence of vascular spiders is considered a normal abnormal finding of pregnancy. Facial edema is a concern, because it can indicate toxemia of pregnancy. Superficial thrombophlebitis is a concer, because it can indicate a risk factor for development of a deep vein
thrombosis during pregnancy. The presence of allodynia (pain on normal touch) is considered a significant finding and requires additional investigation Which nursing interpretation is appropriate when hemorrhoids are found during the prenatal examination of a pregnant client? - ANSWERS-The venous pressure has increased, and there is reduced blood flow to the legs The causes of hemorrhoids in the pregnant client are increased venous pressure and reduced blood flow to the legs. The enlarged uterus compresses the iliac veins and the inferior vena cava, resulting in increased venous pressure. This increases the blood rpessure in the anal vasculature and predisposes the rpegnant woamn to having homorrhoids. Increased levels of estrogen and progesterone cause fullness, heightened sensitivity, tingling, and heaviness of the breasts. The fetal blood coursing through the umbilical cord causes the funic souffle sign of fetal heart rate. Cervical stimulation by estrogen and progesterone results in leucorrhea, which is the white or slightly gray mucoid discharge from the vagina with a faint musty odor Which cause is appropriate fro the pregnant client reporting constipation? SATA - ANSWERS-Abdominal distention Iron supplementation Decreased intake of fluids Increased progesterone levels Constipation can result from abdominal distention by the pregnant uterus, displacement and compression of the intestine, iron supplementation, and lack of fluids. Smooth muscle relaxation and reduced peristalsis cauased by increased progesterone and estrogen levels result in increased water absorption, thereby resulting in constipation. Increased physical activity facilitates bowel-elimination. It does not cause constipation
volume decreases by 33% During pregnancy, a lot of changes in the maternal respiratory system occur, including a 33% increase in tidal volume. The ligaments of the rib cage relax as a result of increased levels of estrogen and progesterone. In addition, expiratory reserve volume decreases by 20% and oxygen consumption increases by 20% to 40% to compensate for the oxygen demand of the fetus. A client in the 8th week of gestation reports abdominal cramps and pain and shows an abnormally slow increase in human chorionic gonadotropin (hCG) levels. Which condition is this client at risk for - ANSWERS-Ectopic pregnancy The earliest biomarker of pregnancy is hCG. A woman's hCG levels peak after 60 to 70 days of pregnancy and decline to the lowest level at 100 to 130 days of pregnancy. An abnormally slow rise in hCG levels accompanied by abdominal pan and cramping indicates the risk of ectopic pregnancy or miscarriage. hCG levels higher than the normal range indicate the risk for multiple fetuses, Down syndrome, or gestational trophoblastic disease. Which finding is appropriate for the client in the 8th week of pregnancy showing a very high level of human chorionic gonadotropin (hCG) on a laboratory report? - ANSWERS-There is a potential risk of the fetus having Down syndrome
High levels of hCG indicate abnormal gestation, resulting from the fetus having Down syndrome or gestational trophoblastic disease. Human chorionic gonadotropin (hCG) is present at the onset of pregnancy and increases for 60 days, and then starts to decline at about 16 weeks. The presence of high levels of hCG even at the 8th week of pregnancy is not a normal parameter. An abnormally low level of hCG may indicate ectopic pregnancy or impending miscarriage. Ectopic pregnancy is a complication of pregnancy in which the embryo gets implanted outside the uterine cavity. Which statement made by the client correlates with a probable pregnancy? - ANSWERS-I can feel my uterus contract, but it does not hurt Uterine contractions that do not hurt are characteristic of Braxton Hicks contractions, which are a sign of a probable pregnancy. Which nursing explanation is appropriate for a newly pregnant client who asks how pregnancy will affect her systemic lupus erythematosus? - ANSWERS-It is most likely that your symptoms will improve throughout the pregnancy Changes in the maternal immune system cause some women with autoimmune disorders to experience improvement of their symptoms during pregnancy. Pregnancy would not cause
