Answer to Question 1
ANS: C
Causes of nausea and vomiting associated with pregnancy are unknown but believed to be related to increased levels of estrogen, hCG, estradiol, and progesterone (Baxley, 2008; Richter, 2007). Persistent or severe nausea and vomiting, to the point of affecting the woman's nutritional status and known as hyperemesis gravidarum, may be an early symptom of hyperthyroidism. Beta-hCG has a thyroid-stimulating hormonelike effect on the maternal thyroid, and hyperthyroidism may be evident only by an increase in free T4 instead of by both the TSH decrease and the free T4 increase that are usually seen in women who are not pregnant (Turok & Schultz, 2008).
Answer to Question 2
ANS: A
Hyperemesis gravidarum is defined as vomiting severe enough to cause weight loss, dehydration, alkalosis from loss of hydrochloric acid, and hypokalemia. Hyperemesis gravidarum is associated with increases or changes in pregnancy-related hormones, such as hCG, estrogen, and progesterone (Cunningham et al., 2010; Harvey-Banchik, 2007). More than 50 of patients with hyperemesis gravidarum have elevated aminotransferase levels (Harvey-Banchik, 2007).