A nurse has received a change-of-shift report for four clients. Which of the following clients should the nurse identify as being at the highest risk for a complication of pregnancy?
A 30-year-old client who has chronic hypertension.
A 37-year-old client who has a BMI over 30 and is experiencing elevated blood pressure.
A 16-year-old client who is pregnant for the first time.
A 28-year-old client with a history of fetal demise.
The Correct Answer is B
Choice A rationale
Chronic hypertension increases the risk of complications but is not necessarily the highest risk compared to elevated blood pressure and obesity combined in pregnancy.
Choice B rationale
Elevated blood pressure and a high BMI significantly increase the risk for complications like preeclampsia, gestational diabetes, and preterm birth in pregnancy.
Choice C rationale
A 16-year-old pregnant client is at risk due to age, but not as high as the compounded risks of hypertension and obesity.
Choice D rationale
A history of fetal demise increases risk, but current elevated blood pressure and high BMI in an older client present higher immediate pregnancy complication risks.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Not all STIs are transmitted during delivery. For example, infections like trichomoniasis are not typically transmitted during birth, whereas others like herpes simplex virus can be.
Choice B rationale
Some STIs, such as herpes and HIV, can be transmitted during vaginal delivery, posing a risk to the newborn. Preventative measures, including antiviral treatment, can reduce this risk.
Choice C rationale
A cesarean section is not always required to prevent STI transmission. It is recommended in cases of active genital herpes or uncontrolled HIV to reduce transmission risk.
Choice D rationale
Some STIs, such as HIV, can be transmitted through breastfeeding. It is important to follow medical guidelines to prevent postnatal transmission via breast milk.
Correct Answer is C
Explanation
Choice A rationale
Thickening of the uterine lining is not characteristic of gestational trophoblastic disease (GTD). Instead, GTD involves abnormal growth of trophoblast cells, which form part of the placenta, leading to its distinct appearance.
Choice B rationale
Enlargement of the fallopian tubes is not associated with GTD. GTD involves abnormal placental development rather than tubal changes. Ultrasound imaging reveals characteristic findings in the placenta.
Choice C rationale
GTD's hallmark ultrasound finding is grape-like clusters in the placenta, indicative of molar pregnancy. This appearance results from the proliferation of abnormal trophoblast cells and hydropic villi.
Choice D rationale
Multiple cysts in the ovaries are not characteristic of GTD. This description may relate to polycystic ovary syndrome (PCOS) but does not align with GTD’s specific ultrasound findings involving the placenta.
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