A nurse is assisting in the care of a client at 30 weeks of gestation who has a blood pressure reading of 160/116 mm Hg and 4 hours previously it was 164/114 mm Hg. The client reports blurred vision and a persistent frontal headache.
Which of the following complications of gestation should the nurse suspect?

Gestational hypertension.

Preeclampsia with severe features.

Preeclampsia without severe features.

Chronic hypertension.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Gestational hypertension is diagnosed when high blood pressure develops after 20 weeks of pregnancy without other symptoms of preeclampsia, such as proteinuria or end-organ dysfunction.

Choice B rationale

Preeclampsia with severe features includes high blood pressure, proteinuria, and symptoms like blurred vision and headaches. These indicate severe disease, which can endanger both the mother and the fetus if left untreated.

Choice C rationale

Preeclampsia without severe features involves high blood pressure and proteinuria but without the additional severe symptoms like blurred vision and headache.

Choice D rationale

Chronic hypertension refers to high blood pressure that was present before pregnancy or diagnosed before 20 weeks of gestation. It does not typically present with acute symptoms like blurred vision and headache that develop suddenly.

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Correct Answer is B

Explanation

Choice A rationale

Hyperthyroidism is more likely to occur in women of childbearing age and does not have a higher incidence post-menopause. It is often associated with autoimmune disorders such as Graves' disease, which can affect individuals at any age.

Choice B rationale

Graves' disease is an autoimmune disorder that is a common cause of hyperthyroidism. It results from the immune system producing antibodies that stimulate the thyroid gland to produce excessive thyroid hormones.

Choice C rationale

Cardiovascular disease is not a direct cause of hyperthyroidism. However, untreated hyperthyroidism can lead to complications such as atrial fibrillation and heart failure due to the overproduction of thyroid hormones.

Choice D rationale

Hyperthyroidism results in excessive production of thyroid hormones, not too little. This excess leads to symptoms such as weight loss, heat intolerance, tremors, and increased metabolism, distinguishing it from hypothyroidism.

A. Platelet aggregation. B. Autoregulation dysfunction of the cerebral vasculature. C. Oxidative stress inflammatory response. D. Uteroplacental ischemia.

Correct Answer is B

Explanation

Choice A rationale

Platelet aggregation is associated with the formation of blood clots, which may contribute to complications like stroke but is not the primary cause of the client's symptoms of blurred vision and cognitive impairment in preeclampsia.

Choice B rationale

Autoregulation dysfunction of the cerebral vasculature causes increased cerebral blood flow and edema, leading to neurological symptoms such as blurred vision and impaired cognitive function. This dysfunction is a primary factor in the pathophysiology of preeclampsia with severe features.

Choice C rationale

Oxidative stress and inflammatory response contribute to endothelial dysfunction in preeclampsia but are not directly responsible for the neurological symptoms described. These factors play a broader role in the progression of the disease.

Choice D rationale

Uteroplacental ischemia affects the placenta and fetal environment, contributing to fetal growth restriction and distress but does not directly cause neurological symptoms like blurred vision in the mother.

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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching about hyperthyroidism with a client at 10 weeks of gestation who has the condition. Which of the following statements should the nurse reinforce in the teaching?

Correct Answer is B

Explanation

A nurse is assisting in the care of a client who has preeclampsia with severe features and is reporting blurred vision and the inability to think clearly. Which of the following factors should the nurse recognize as the primary cause of the client's clinical manifestations?

Correct Answer is B

Explanation

A nurse is reinforcing teaching about newborn care with a client who is 2 hours postpartum. Which of the following statements by the client indicates a need for further teaching?

A nurse in the antepartum unit is assisting with the care of a client who is at 36 weeks of gestation and reports continuous abdominal pain and vaginal bleeding. The nurse should identify that the client is likely experiencing which of the following complications?

A nurse is reviewing the medical record of a client who is in active labor. Which of the following conditions increases the client's risk for postpartum hemorrhage (PPH)?

A nurse is assisting in the care of a newborn who is scheduled for a heel stick for genetic screening. Which of the following actions by the nurse demonstrates correct pain relief techniques for newborns?

A client who is 1 day postpartum receives a varicella vaccine in the hospital. Which of the following responses indicates that the client will need further teaching about the vaccine?

A nurse is reinforcing discharge instructions to a client who is 24 hr postpartum and has reported urge incontinence. Which of the following should the nurse reinforce as a first referral to treat the client?

A nurse is reinforcing teaching to a parent about breastfeeding. Which of the following statements by the parent demonstrates understanding of the teaching?

A nurse is meeting a new client for a genetic counseling visit and wants to identify the main role of the nurse during this process. Which of the following statements should the nurse make?