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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Correct Answer is ["A","B","D"]

Explanation

A. Do you have any headaches or blurry vision? Headaches and blurry vision are common neurological symptoms of preeclampsia. These occur due to cerebral edema and hypertension-related vascular changes. Persistent headaches or visual disturbances (such as seeing spots or flashing lights) warrant further evaluation.

B. I am going to check your reflexes now. Hyperreflexia (brisk deep tendon reflexes) is a key neurological sign of worsening preeclampsia. Severe hyperreflexia can indicate impending eclampsia and increased seizure risk. Checking for clonus (involuntary rhythmic muscle contractions) is also important.

C. Have you been having trouble with urinary incontinence? Urinary incontinence is not a sign of preeclampsia. However, decreased urine output (oliguria) would be concerning as it may indicate worsening renal impairment, but incontinence itself is unrelated.

D. Do you have any right upper quadrant pain? Right upper quadrant or epigastric pain is a concerning sign of liver involvement in severe preeclampsia or HELLP syndrome. It occurs due to liver swelling and can be a precursor to serious complications such as hepatic rupture.

E. Have you had any nausea or vomiting recently? While nausea and vomiting are common in pregnancy, they are not defining symptoms of preeclampsia unless they are sudden and severe. If present in the third trimester, they may suggest worsening disease, but they are not primary indicators.

F. Do you feel safe at home? Screening for domestic violence is important in pregnancy, but it is not a diagnostic question for preeclampsia. While stress and abuse can impact blood pressure, this question does not help in determining preeclampsia.

A. Perform vaginal exam and apply upward digital pressure to the presenting part. B. Immediately turn the client to her side. C. Call the physician immediately. D. Place a moist, clean towel over the cord to prevent drying.

Correct Answer is A

Explanation

A. Perform vaginal exam and apply upward digital pressure to the presenting part. A prolapsed umbilical cord is an obstetric emergency that can lead to cord compression and fetal hypoxia. The priority intervention is for the nurse to manually lift the presenting part (usually the fetal head) off the cord to relieve pressure and restore blood flow. The nurse should maintain this position until an emergency cesarean section is performed.

B. Immediately turn the client to her side. Positioning changes, such as the knee-chest or Trendelenburg position, can help relieve pressure on the cord, but they are secondary to manually lifting the presenting part. While turning the client may assist, it is not the most immediate life-saving action.

C. Call the physician immediately. While notifying the provider is essential, relieving pressure on the umbilical cord takes priority. Delaying intervention to make a call could result in prolonged fetal hypoxia and compromise.

D. Place a moist, clean towel over the cord to prevent drying. Covering the cord with a moist towel helps prevent vasospasm and drying, but it does not relieve the compression that is cutting off oxygen to the fetus. The priority is to relieve pressure on the cord first before taking other measures.

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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

Correct Answer is ["A","B","D"]

Explanation

The nurse discovers a loop of the umbilical cord protruding through the vagina when preparing to perform a vaginal examination. The priority intervention is to:

Correct Answer is A

Explanation

When working with a woman who has just experienced a fetal demise you should offer supportive care, give her the opportunity to grieve, and provide for a chaplain to come in if the patient wants one. You know that the Chaplain is non-denominational and can also provide comforting words.

A pregnant woman is just admitted to the emergency room after a head on auto accident. Her body appears to be uninjured. The nurse carefully monitors the woman for which complication(s) of pregnancy? (Select all that apply)

A patient has just spontaneously ruptured her membranes. Which of the following factors makes her especially high risk for having a prolapsed cord? Select all that apply.

Professor Proctor: Always wants us to be safe while traveling anywhere- especially when coming to class. This is prioritized even over being on time.

A client has been admitted to the labor and delivery suite for induction of labor for post-term pregnancy. Misoprostol (Cytotec) has been inserted. Which of the following findings would warrant stopping the Cytotec treatment?