A postpartum client on magnesium sulfate for preeclampsia suddenly developed severe headaches, floating spots in the field of vision, and right upper quadrant abdominal pain.
Vital signs are BP= 164/100, HR= 96, RR= 16. Laboratory results show liver enzymes are AST = 890, ALT= 980, and platelets = 25,000.This client most likely developed which condition?

HELLP Syndrome.

Postpartum hypertension.

Hypertension in pregnancy.

Superimposed preeclampsia.

Answer and Explanation

The Correct Answer is A

Choice A rationale
The client’s symptoms and lab results are consistent with HELLP Syndrome, a severe form of preeclampsia. HELLP stands for Hemolysis, Elevated Liver enzymes, and Low Platelet count. The client’s elevated liver enzymes and low platelets, along with the reported symptoms, are indicative of this condition.
Choice B rationale
While the client’s high blood pressure could suggest Postpartum hypertension, the presence of severe headaches, visual disturbances, right upper quadrant pain, and abnormal lab results point more towards HELLP Syndrome.
Choice C rationale
Hypertension in pregnancy could be a possibility, but it does not explain all of the client’s symptoms and lab results, particularly the elevated liver enzymes and low platelets.
Choice D rationale

Superimposed preeclampsia is a condition where a pregnant woman with chronic hypertension develops preeclampsia. However, the client’s severe symptoms and lab results are more indicative of HELLP Syndrome.

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Correct Answer is C

Explanation

Choice A rationale
While accidental lacerations can occur during a cesarean delivery, they are not typically the primary concern immediately after delivery.

Choice B rationale
Acrocyanosis, or bluish discoloration of the hands and feet, is common in newborns and is not typically a priority concern immediately after delivery.
Choice C rationale
Respiratory distress is a priority concern in a newborn after a cesarean delivery. Newborns delivered by cesarean may have transient tachypnea of the newborn (TTN), a condition characterized by rapid breathing during the first few hours of life.
Choice D rationale
While hypothermia is a concern in newborns, it is not typically the immediate priority following a cesarean delivery.

A. I will reduce my exercise schedule to 3 days a week. B. I should limit my carbohydrates to 50% of caloric intake. C. I will take my glyburide daily with breakfast. D. I know I am at increased risk to develop type 2 diabetes.

Correct Answer is A

Explanation

Choice A rationale

Regular physical activity is an important part of managing gestational diabetes. Most guidelines recommend at least 30 minutes of moderate-intensity exercise on most days of the week. Reducing the exercise schedule to only 3 days a week may not provide enough activity to help regulate blood glucose levels.
Choice B rationale
Limiting carbohydrates to 50% of caloric intake can be a part of a balanced diet for managing gestational diabetes. Carbohydrates have the biggest effect on blood sugar levels, so monitoring and regulating carbohydrate intake is key.
Choice C rationale
Glyburide is an oral medication that can be used to manage gestational diabetes when diet and exercise are not enough. It helps to lower blood glucose levels by stimulating the pancreas to release more insulin.
Choice D rationale
It is true that women who have had gestational diabetes are at an increased risk of developing type 2 diabetes later in life. Therefore, this statement does not indicate a need for further teaching.

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a newborn immediately after a scheduled cesarean delivery. Which of the following assessments should be the nurse’s priority?

Correct Answer is C

Explanation

A nurse in a prenatal clinic is teaching a client who is in her second trimester and has a new diagnosis of gestational diabetes. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is A

Explanation

A nurse is performing a physical examination of a client who is 1 day postpartum. Which finding requires immediate attention?

What is the estimated date of birth (EDB) for a client who is pregnant and whose last menstrual period began on July 27? (State the date in MMDD. For example, July 27 is 0727)

A nurse is caring for a client who is receiving heparin 3,800 units subcutaneously daily. Available is heparin 5,000 units/mL. How many ml should the nurse administer? (Round the answer to the nearest tenth.) .

Select the 4 assessment findings the nurse should report to the provider. Exhibits A nurse in an antepartum clinic is caring for a client who is pregnant. Exhibits:

A nurse is caring for a newborn who has macrosomia and whose mother has diabetes mellitus. The nurse should recognize which of the following complications as the priority focus of care?

A nurse is caring for a patient who is 7 days postpartum and calls the clinic to report pain and redness in her left calf. Besides seeing her provider, which interventions should the nurse suggest?

A nurse is caring for a client who gave birth 2 hours ago. The nurse notes that the client’s blood pressure is 60 mm Hg. Which of the following actions should the nurse take first?