Hyperemesis Gravidarum Practice Exam

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1. A 21-year old client, 6 weeks’ pregnant is diagnosed with hyperemesis gravidarum. This excessive vomiting during pregnancy will often result in which of the following conditions?

1. Bowel perforation
2. Electrolyte imbalance
3. Miscarriage
4. Pregnancy induced hypertension (PIH)

2. Which of the following statements best describes hyperemesis gravidarum?

1. Severe anemia leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems.
2. Severe nausea and vomiting leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems.
3. Loss of appetite and continuous vomiting that commonly results in dehydration and ultimately decreasing maternal nutrients
4. Severe nausea and diarrhea that can cause gastrointestinal irritation and possibly internal bleeding

3. The client with hyperemesis gravidarum is at risk for developing:

1. Respiratory alkalosis without dehydration
2. Metabolic acidosis with dehydration
3. Respiratory acidosis without dehydration
4. Metabolic alkalosis with dehydration

4. A client is being admitted to the antepartum unit for hypovolemia secondary to hyperemesis gravidarum. Which of the following factors predisposes a client to the development of this?

1. trophoblastic disease
   
2. maternal age > 35 y.o.
   
3. malnourished or underweight clients
   
4. low levels of HCG

5. Which of the following complications can be potentially life threatening and can occur in a client receiving a tocolytic agent?

1. diabetic ketoacidosis
   
2. hyperemesis gravidarum
   
3. pulmonary edema
   
4. sickle cell anemia

Answers & Rationale

1. B. Electrolyte imbalance. Excessive vomiting in clients with hyperemesis gravidarum often causes weight loss and fluid, electrolyte, and acid-base imbalances.
2. B. Severe nausea and vomiting leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems. The description of hyperemesis gravidarum includes severe nausea and vomiting, leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems. Hyperemesis is not a form of anemia. Loss of appetite may occur secondary to the nausea and vomiting of hyperemesis, which, if it continues, can deplete the nutrients transported to the fetus. Diarrhea does not occur with hyperemesis.
3. B .Metabolic acidosis with dehydration. The client with hyperemesis has persistent nausea and vomiting. With vomiting comes dehydration. When the client is dehydrated, she will have metabolic acidosis. Answers A and C are incorrect because they are respiratory dehydration. Answer D is incorrect because the client will not be in alkalosis with persistent vomiting.
4. A. Trophoblastic disease . Trophoblastic disease is associated w/ hyperemesis gravidarum obesity and maternal age younger than 20 y.o. are risk factors too. High levels of estrogen HCG have also been associated with the development.
5. C. Pulmonary edema. Tocolytics are used to stop labor contractions. The most common adverse effect associated with the use of these drugs is pulmonary edema.
   • Option A: Clients who dont have diabetes dont need to be observed for diabetic ketoacidosis.
   • Option B: Hyperemesis gravidium doesnt result from tocolytic use.
   • Option D: Sickle cell anemia is an inherited genetic condition and doesnt develop spontaneously