NU 335 EXAM 2 PRACTICE
QUESTIONS ANS ANSWERS WITH
COMPLETE SOLUTIONS 100%
CORRECT RATED A+
Question 1
A clinic nurse is evaluating the laboratory results of four pregnant clients. Which
of the following electrolyte imbalances would directly support a clinical diagnosis
of hyperemesis gravidarum? A. Hypercalcemia B. Hypokalemia C. Hyperkalemia
D. Hypocalcemia
✔✔ B. Hypokalemia
Rationale: Severe, intractable vomiting associated with hyperemesis gravidarum
leads to profound fluid volume deficits and significant loss of gastric hydrochloric
acid and potassium. This depletion results in a severe fluid-electrolyte imbalance.
A critical drop in serum potassium levels (hypokalemia) can severely
compromise and disrupt cardiac functioning. Hyperkalemia, hypercalcemia, and
hypocalcemia are not standard physiological outcomes of this condition.
Question 2
When a pregnant patient experiencing severe hyperemesis gravidarum fails to
show clinical improvement with standard, conservative home interventions, which
of the following outpatient therapies should the nurse anticipate initiating next? A.
Initiation of a low-fat, soft-textured diet B. Dietary management focusing on
complex carbohydrates with strict fluid restrictions C. Administration of
intravenous (IV) hydration and fluid replacement therapy D. Initiation of central-
line Total Parenteral Nutrition (TPN)
✔✔ C. Administration of intravenous (IV) hydration and fluid replacement
therapy
Rationale: If a client remains unresponsive to first-line, at-home antiemetic
measures and dietary adjustments, the immediate clinical priority shifts to
preventing severe dehydration and correcting electrolyte imbalances via
intravenous (IV) fluids on an outpatient or home-health basis. Total Parenteral
,Nutrition (TPN) carries higher systemic risks and is reserved strictly for refractory
cases where the patient remains unstable despite aggressive IV hydration. Dietary
advancements, such as low-fat soft foods or complex carbohydrates, are only
implemented as a progressive strategy after the patient's hydration status has been
fully stabilized.
A client at 30 weeks' gestation is admitted to the maternity unit with vaginal
bleeding. What should be the nurse's initial nursing action?
a. Count and weigh peripads.
b. Start an intravenous infusion drip.
c. Assess blood pressure and pulse.
d. Observe for pallor, clammy skin, and perspiration. -ANSWERc. Assess blood
pressure and pulse.
Rationale: The nurse's initial action for a client with vaginal bleeding at 30 weeks
would be to assess blood pressure and pulse. Counting and weighing peripads;
observing for pallor, clammy skin, and perspiration; and starting an intravenous
infusion drip are all important actions for this client; they are just not the initial
action.
A prenatal client at 16 weeks' gestation presents to the clinic with unexplained
bright red bleeding, cramping, and backache, which she has had for the past two
days. A pelvic exam reveals a closed cervix. What type of abortion does this
indicate?
a. Threatened.
b. Incomplete.
c. Missed.
d. Imminent. -ANSWERa. Threatened.
Rationale: A threatened abortion (miscarriage) has symptoms of vaginal bleeding
and backache without cervical dilation. In an imminent abortion, the internal
cervical os is dilated. Although the cervix is closed in a missed abortion, other
,symptoms would include a regression in breast changes and a brownish vaginal
discharge. Diagnosis is made based on history, pelvic exam, and a negative
pregnancy test. With an incomplete abortion, the embryo has passed out of the
uterus, but the placenta remains, and the internal os is slightly dilated.
The client asks for information about ectopic pregnancy. The nurse correctly
responds by saying ectopic pregnancy is caused by: (Select all that apply.)
a. Pelvic inflammatory disease (PID).
b. Presence of an IUD.
c. In utero exposure to diethylstilbestrol (DES).
d. Endometriosis. -ANSWERa. Pelvic inflammatory disease (PID).
d. Endometriosis.
b. Presence of an IUD.
c. In utero exposure to diethylstilbestrol (DES).
Rationale: Ectopic pregnancy can be caused by tubal damage from pelvic
inflammatory disease (PID), previous tubal surgery, congenital anomalies of the
tube, endometriosis, previous ectopic pregnancy, presence of an IUD, and in utero
exposure to diethylstilbestrol (DES).
A client presents to the physician's office with complaints of right-sided
abdominal pain, dizziness, and vaginal bleeding. A pelvic exam determines
adnexal tenderness. What diagnosis should the nurse suspect?
a. Cholelithiasis.
b. Appendicitis.
c. Threatened abortion.
d. Ectopic pregnancy. -ANSWERd. Ectopic pregnancy.
Rationale: A client with an ectopic pregnancy would present to the physician's
office with complaints of one-sided abdominal pain, dizziness, and vaginal
, bleeding, and would have adnexal tenderness on exam. Clients with a threatened
abortion would have complaints of unexplained bleeding, cramping, or backache.
A pelvic exam would reveal a closed cervix. Clients with appendicitis would have
complaints of lower right-sided tenderness, low-grade fever, nausea, and often
vomiting. Clients with cholelithiasis would have complaints of epigastric distress,
such as fullness, distention, and vague pain in the right upper quadrant of the
abdomen.
A client at 15 weeks' gestation presents to the prenatal clinic with "prune juice"-
like vaginal bleeding. Other assessment data include a hematocrit of 10 and
complaints of severe nausea and vomiting. What diagnosis should the nurse
suspect?
a. Prolapsed cord.
b. Hydatidiform mole.
c. Placenta previa.
d. Abruptio placentae. -ANSWERb. Hydatidiform mole.
Rationale: In hydatidiform mole, vaginal bleeding occurs almost universally. It is
often brownish due to liquefaction of the uterine clot. In addition, because serum
hCG levels are higher with molar pregnancy than with normal pregnancy, the
woman might experience hyperemesis gravidarum. Anemia occurs frequently due
to blood loss and poor nutrition secondary to hyperemesis. Placenta previa
symptoms include painless bright red vaginal bleeding, usually in the third
trimester of pregnancy. Prolapsed cord symptoms include a trickle of bright red
vaginal blood and possibly a visible cord at the vaginal opening. Abruptio
placentae symptoms include vaginal bleeding (bright red or dark red), abdominal
pain, and uterine tenderness.
A client is being maintained at home with a diagnosis of mild pre-eclampsia.
Which of the following complaints require further evaluation? Select all that
apply.
a. Headache.
QUESTIONS ANS ANSWERS WITH
COMPLETE SOLUTIONS 100%
CORRECT RATED A+
Question 1
A clinic nurse is evaluating the laboratory results of four pregnant clients. Which
of the following electrolyte imbalances would directly support a clinical diagnosis
of hyperemesis gravidarum? A. Hypercalcemia B. Hypokalemia C. Hyperkalemia
D. Hypocalcemia
✔✔ B. Hypokalemia
Rationale: Severe, intractable vomiting associated with hyperemesis gravidarum
leads to profound fluid volume deficits and significant loss of gastric hydrochloric
acid and potassium. This depletion results in a severe fluid-electrolyte imbalance.
A critical drop in serum potassium levels (hypokalemia) can severely
compromise and disrupt cardiac functioning. Hyperkalemia, hypercalcemia, and
hypocalcemia are not standard physiological outcomes of this condition.
Question 2
When a pregnant patient experiencing severe hyperemesis gravidarum fails to
show clinical improvement with standard, conservative home interventions, which
of the following outpatient therapies should the nurse anticipate initiating next? A.
Initiation of a low-fat, soft-textured diet B. Dietary management focusing on
complex carbohydrates with strict fluid restrictions C. Administration of
intravenous (IV) hydration and fluid replacement therapy D. Initiation of central-
line Total Parenteral Nutrition (TPN)
✔✔ C. Administration of intravenous (IV) hydration and fluid replacement
therapy
Rationale: If a client remains unresponsive to first-line, at-home antiemetic
measures and dietary adjustments, the immediate clinical priority shifts to
preventing severe dehydration and correcting electrolyte imbalances via
intravenous (IV) fluids on an outpatient or home-health basis. Total Parenteral
,Nutrition (TPN) carries higher systemic risks and is reserved strictly for refractory
cases where the patient remains unstable despite aggressive IV hydration. Dietary
advancements, such as low-fat soft foods or complex carbohydrates, are only
implemented as a progressive strategy after the patient's hydration status has been
fully stabilized.
A client at 30 weeks' gestation is admitted to the maternity unit with vaginal
bleeding. What should be the nurse's initial nursing action?
a. Count and weigh peripads.
b. Start an intravenous infusion drip.
c. Assess blood pressure and pulse.
d. Observe for pallor, clammy skin, and perspiration. -ANSWERc. Assess blood
pressure and pulse.
Rationale: The nurse's initial action for a client with vaginal bleeding at 30 weeks
would be to assess blood pressure and pulse. Counting and weighing peripads;
observing for pallor, clammy skin, and perspiration; and starting an intravenous
infusion drip are all important actions for this client; they are just not the initial
action.
A prenatal client at 16 weeks' gestation presents to the clinic with unexplained
bright red bleeding, cramping, and backache, which she has had for the past two
days. A pelvic exam reveals a closed cervix. What type of abortion does this
indicate?
a. Threatened.
b. Incomplete.
c. Missed.
d. Imminent. -ANSWERa. Threatened.
Rationale: A threatened abortion (miscarriage) has symptoms of vaginal bleeding
and backache without cervical dilation. In an imminent abortion, the internal
cervical os is dilated. Although the cervix is closed in a missed abortion, other
,symptoms would include a regression in breast changes and a brownish vaginal
discharge. Diagnosis is made based on history, pelvic exam, and a negative
pregnancy test. With an incomplete abortion, the embryo has passed out of the
uterus, but the placenta remains, and the internal os is slightly dilated.
The client asks for information about ectopic pregnancy. The nurse correctly
responds by saying ectopic pregnancy is caused by: (Select all that apply.)
a. Pelvic inflammatory disease (PID).
b. Presence of an IUD.
c. In utero exposure to diethylstilbestrol (DES).
d. Endometriosis. -ANSWERa. Pelvic inflammatory disease (PID).
d. Endometriosis.
b. Presence of an IUD.
c. In utero exposure to diethylstilbestrol (DES).
Rationale: Ectopic pregnancy can be caused by tubal damage from pelvic
inflammatory disease (PID), previous tubal surgery, congenital anomalies of the
tube, endometriosis, previous ectopic pregnancy, presence of an IUD, and in utero
exposure to diethylstilbestrol (DES).
A client presents to the physician's office with complaints of right-sided
abdominal pain, dizziness, and vaginal bleeding. A pelvic exam determines
adnexal tenderness. What diagnosis should the nurse suspect?
a. Cholelithiasis.
b. Appendicitis.
c. Threatened abortion.
d. Ectopic pregnancy. -ANSWERd. Ectopic pregnancy.
Rationale: A client with an ectopic pregnancy would present to the physician's
office with complaints of one-sided abdominal pain, dizziness, and vaginal
, bleeding, and would have adnexal tenderness on exam. Clients with a threatened
abortion would have complaints of unexplained bleeding, cramping, or backache.
A pelvic exam would reveal a closed cervix. Clients with appendicitis would have
complaints of lower right-sided tenderness, low-grade fever, nausea, and often
vomiting. Clients with cholelithiasis would have complaints of epigastric distress,
such as fullness, distention, and vague pain in the right upper quadrant of the
abdomen.
A client at 15 weeks' gestation presents to the prenatal clinic with "prune juice"-
like vaginal bleeding. Other assessment data include a hematocrit of 10 and
complaints of severe nausea and vomiting. What diagnosis should the nurse
suspect?
a. Prolapsed cord.
b. Hydatidiform mole.
c. Placenta previa.
d. Abruptio placentae. -ANSWERb. Hydatidiform mole.
Rationale: In hydatidiform mole, vaginal bleeding occurs almost universally. It is
often brownish due to liquefaction of the uterine clot. In addition, because serum
hCG levels are higher with molar pregnancy than with normal pregnancy, the
woman might experience hyperemesis gravidarum. Anemia occurs frequently due
to blood loss and poor nutrition secondary to hyperemesis. Placenta previa
symptoms include painless bright red vaginal bleeding, usually in the third
trimester of pregnancy. Prolapsed cord symptoms include a trickle of bright red
vaginal blood and possibly a visible cord at the vaginal opening. Abruptio
placentae symptoms include vaginal bleeding (bright red or dark red), abdominal
pain, and uterine tenderness.
A client is being maintained at home with a diagnosis of mild pre-eclampsia.
Which of the following complaints require further evaluation? Select all that
apply.
a. Headache.
