A 39-year-old pregnant woman in labor with preeclampsia develops chest tenderness and right upper quadrant pain, as well as pain when breathing deeply. Her lab results are as follows: hemoglobin 7.8 g/dL; aspartate aminotransferase 313 U/L; alanine aminotransferase 225 U/L; platelets 85,000/mcL. Which of the following most closely aligns with this clinical scenario?
HELLP syndrome
Gestational diabetes
Toxoplasmosis
Cytomegalovirus
The Correct Answer is A
Choice A reason: HELLP syndrome is a severe form of preeclampsia characterized by Hemolysis, Elevated Liver enzymes, and Low Platelets. The patient’s lab values and clinical symptoms of right upper quadrant pain and chest tenderness are classic indicators of HELLP.
Choice B reason: Gestational diabetes involves hyperglycemia during pregnancy and does not typically present with liver enzyme elevations, hemolysis, or low platelets.
Choice C reason: Toxoplasmosis is an infectious condition that can affect the fetus but does not produce the constellation of maternal lab abnormalities seen here.
Choice D reason: Cytomegalovirus infection can cause systemic symptoms, but it does not explain the combination of preeclampsia, elevated liver enzymes, low platelets, and hemolysis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is correct; most low back pain is nonspecific and does not require imaging unless there are red flags.
Choice B reason: Imaging may be indicated if pain persists despite conservative management or if there are neurologic deficits, making this statement accurate.
Choice C reason: Combining cognitive behavioral therapy with physical therapy is evidence-based and effective in improving outcomes for chronic low back pain.
Choice D reason: This is incorrect. Opioids are not first-line treatment due to risks of dependence, overdose, and limited efficacy. First-line management emphasizes non-pharmacologic strategies and non-opioid medications.
Correct Answer is D
Explanation
Choice A reason: Referral to an oncologist is premature without diagnostic confirmation of malignancy.
Choice B reason: CA-125 is mainly used for ovarian cancer, which is unlikely after bilateral oophorectomy.
Choice C reason: Pap smear screens for cervical cancer and is not indicated for evaluating postmenopausal or post-oophorectomy bleeding.
Choice D reason: Correct. Endometrial biopsy or transvaginal ultrasound helps evaluate uterine pathology, including endometrial cancer, and is the most appropriate initial diagnostic step.
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