A patient in her first trimester complains of nausea and vomiting. The patient asks, “Why is this happening?” What is the nurse’s best response?

Correct Answer: B

Rationale: The correct answer is B: "It may be due to changes in hormones." During the first trimester of pregnancy, hormonal changes, particularly an increase in human chorionic gonadotropin (hCG) and estrogen levels, can trigger nausea and vomiting. This is known as morning sickness. These hormonal fluctuations can affect the gastrointestinal system, leading to symptoms of nausea and vomiting. Choice A (increase in gastric motility) is incorrect because nausea and vomiting in pregnancy are more commonly attributed to hormonal changes rather than an increase in gastric motility. Choice C (increase in glucose levels) is also incorrect as there is no direct link between elevated glucose levels and nausea and vomiting in pregnancy. Choice D (decrease in gastric secretions) is incorrect as there is no evidence to support that a decrease in gastric secretions causes nausea and vomiting in pregnancy.

Correct Answer: C

Rationale: Rationale: - Choice C is correct because heartburn is a common symptom during pregnancy due to hormonal changes and pressure from the growing uterus. - The nurse should educate the patient that experiencing heartburn is a normal physiological response during pregnancy. - It is important for the nurse to reassure the patient that her symptoms are expected and not a cause for concern. - Choices A, B, and D are incorrect as they do not address the normalcy of heartburn during pregnancy and may cause unnecessary worry or unnecessary interventions.

Correct Answer: D

Rationale: The correct answer is D: Prolonged emptying time. During pregnancy, hormonal changes can lead to gallbladder stasis, causing bile to become concentrated and leading to the formation of gallstones. Prolonged emptying time indicates poor gallbladder motility, increasing the risk of gallstone formation. A: Decrease in alkaline phosphatase levels is not directly related to gallstone formation during pregnancy. B: Increase in albumin and total protein is a common finding in pregnancy due to hemodilution, but it is not directly linked to gallstone development. C: Hypertonicity of gallbladder tissue is not a typical physiologic finding related to gallbladder function during pregnancy and is not a known risk factor for gallstone formation.

Correct Answer: C

Rationale: The correct answer is C because scheduling the patient to be seen by a healthcare provider within the next 4 weeks is important for further evaluation and management of the patient's amenorrhea. This timeline allows for timely assessment and potential interventions if needed. Choice A is incorrect as simply having a positive urine hCG test does not provide enough information on its own to determine the appropriate nursing action. Choice B is incorrect as asking about nausea or vomiting does not address the need for a comprehensive assessment and evaluation of the patient's amenorrhea. Choice D is incorrect as sending the patient to the maternity screening area assumes a pregnancy-related issue without proper evaluation and could lead to unnecessary testing or interventions.

Correct Answer: C

Rationale: The correct response is C: "There is nothing to worry about." This answer acknowledges the patient's concerns while providing reassurance. By stating that there is nothing to worry about, the nurse addresses the patient's anxiety and helps alleviate her fears without dismissing them. Option A is too dismissive, B encourages the patient to share concerns but doesn't provide immediate reassurance, and D shifts the focus to the doctor instead of directly addressing the patient's worries.