A woman comes in to her physician’s office at 16 weeks of pregnancy complaining of headache. On examination her Blood Pressure is 169/94. As the physician looks over her record he notices that she has a prior history of hypertension. He explains to her that she has

Chronic Hypertension

This is a normal Blood Pressure

Preeclampsia

Pregnancy induced hypertension.

Answer and Explanation

The Correct Answer is A

A. Chronic Hypertension. Chronic hypertension is diagnosed when a woman has hypertension (≥140/90 mmHg) that was present before pregnancy or develops before 20 weeks gestation. Since this patient has a history of hypertension and is only 16 weeks pregnant, her condition is classified as chronic hypertension rather than pregnancy-related hypertension.

B. This is a normal Blood Pressure. A blood pressure of 169/94 mmHg is not normal. This reading indicates hypertension, which requires monitoring and possible medication adjustments to prevent complications such as preeclampsia or fetal growth restriction.

C. Preeclampsia. Preeclampsia is diagnosed after 20 weeks of gestation and includes hypertension along with signs of organ dysfunction (e.g., proteinuria, liver abnormalities, or neurological symptoms). Since this patient is only 16 weeks pregnant and does not show other preeclampsia symptoms, this diagnosis is incorrect.

D. Pregnancy-induced hypertension. Pregnancy-induced hypertension, also known as gestational hypertension, develops after 20 weeks gestation in women with previously normal blood pressure. Because this patient has a prior history of hypertension and is only 16 weeks pregnant, her condition is classified as chronic hypertension, not pregnancy-induced hypertension.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Tell the client to take a warm shower, rest, and call back tomorrow. While rest and hydration can sometimes help with mild discomfort, this client’s symptoms—pelvic pressure, low back pain, abdominal pain, and increased vaginal discharge—are concerning for preterm labor and require immediate evaluation. Delaying care could increase the risk of preterm birth.

B. Schedule an appointment for the client at the clinic tomorrow. Waiting until the next day is not appropriate, as preterm labor is an urgent condition that needs immediate assessment to prevent premature birth. Prompt intervention may allow for tocolytic therapy or steroid administration to improve fetal lung maturity if preterm birth is imminent.

C. Instruct the client to drink cranberry juice and call if she experiences a fever. Cranberry juice is sometimes used to prevent urinary tract infections (UTIs), but this client’s symptoms are more indicative of preterm labor rather than an infection. Fever is not a defining symptom of preterm labor, and delaying care could result in complications.

D. Instruct the client to go to labor triage at the hospital for evaluation. This is the best response because the symptoms suggest possible preterm labor. Evaluation in the hospital can include cervical checks, fetal monitoring, and tests such as fetal fibronectin (fFN) to assess the risk of preterm birth. Immediate intervention can help delay labor and improve neonatal outcomes.

A. The cervix is effacing and dilated to 2 cm B. Irregular, mild uterine contractions are occurring every 15-30 minutes C. Estriol is not found in maternal saliva D. Fetal fibronectin is present in vaginal secretions

Correct Answer is A

Explanation

A. The cervix is effacing and dilated to 2 cm. Cervical changes, including effacement and dilation, are the most definitive signs of preterm labor. Uterine contractions alone do not confirm preterm labor unless they result in cervical dilation, indicating that labor is progressing.

B. Irregular, mild uterine contractions are occurring every 15-30 minutes. Irregular contractions, known as Braxton Hicks contractions, can be common in pregnancy and do not necessarily indicate preterm labor. True preterm labor involves regular contractions that lead to cervical changes.

C. Estriol is not found in maternal saliva. The absence of estriol in maternal saliva does not confirm or rule out preterm labor. Salivary estriol testing is not a widely used or reliable diagnostic tool for determining the onset of preterm labor.

D. Fetal fibronectin is present in vaginal secretion. Fetal fibronectin (fFN) is a protein found in vaginal secretions between 22-34 weeks of pregnancy and can indicate a risk of preterm labor, but its presence alone does not confirm that labor is actively occurring. A positive fFN test means the patient may be at increased risk for preterm labor, but cervical changes remain the best indicator of actual labor.

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A woman comes in to her physician’s office at 16 weeks of pregnancy complaining of headache. On examination her Blood Pressure is 169/94. As the physician looks over her record he notices that she has a prior history of hypertension. He explains to her that she has

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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