Assessment of a primigravida at 32 weeks' gestation shows a blood pressure of 160/110 mm Hg, 4+ proteinuria and edema of the face and extremities.
Which complication are these findings consistent with?
Preeclampsia with severe features.
Gestational hypertension.
Eclampsia.
Preeclampsia without severe features.
The Correct Answer is A
Choice A rationale
A blood pressure of 160/110 mm Hg meets the criteria for severe hypertension (≥ 160/≥ 110 mm Hg). The presence of 4+ proteinuria and facial/extremity edema, coupled with severe range hypertension, precisely defines preeclampsia with severe features, indicating significant maternal risk.
Choice B rationale
Gestational hypertension is characterized by a blood pressure ≥ 140/90 mm Hg on two occasions, without proteinuria. This client's blood pressure is in the severe range, and proteinuria is present, ruling out isolated gestational hypertension as the correct diagnosis.
Choice C rationale
Eclampsia is diagnosed when a patient with preeclampsia develops new-onset generalized tonic-clonic seizures or unexplained coma. While the patient's findings indicate severe preeclampsia, the absence of seizure activity or coma means the condition has not progressed to eclampsia yet.
Choice D rationale
Preeclampsia without severe features is defined by blood pressure ≥ 140/90 mm Hg but < 160/110 mm Hg and proteinuria ≥ 0.3 g in a 24-hour urine specimen. This client's blood pressure of 160/110 mm Hg places her directly in the severe features category.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Lanolin cream is used to treat or prevent sore, cracked nipples by providing a moisturizing barrier. It is not an effective measure for treating breast engorgement, which is caused by venous and lymphatic stasis and milk accumulation, leading to painful swelling. Treatment focuses on relief of swelling and efficient milk removal.
Choice B rationale
Encouraging the mother to wear a firm-fitting, supportive bra or apply breast binding provides compression to the breasts. This compression helps to inhibit milk production by mechanically interfering with milk removal and reducing local circulation, which alleviates the swelling and discomfort associated with engorgement.
Choice C rationale
Decreasing fluid intake to an extremely low level (<500 mL/24 hours) is ineffective and potentially detrimental to the mother's overall hydration status. Engorgement is a local breast issue involving fluid shifts and milk stasis, and systemic hydration levels do not directly resolve the breast swelling.
Choice D rationale
Discontinuing breastfeeding will worsen engorgement because the breasts will become fuller and the pressure will increase, leading to more discomfort. The appropriate management for engorgement is frequent and effective milk removal, typically through continued nursing or pumping, along with local comfort measures.
Correct Answer is B
Explanation
Choice A rationale
Stronger contractions are not a specific complication of breech presentation. Contraction strength is related to uterine action and response to oxytocin, not solely to fetal presentation. Breech presentation primarily poses risks related to the birthing process itself, such as cord prolapse and birth trauma.
Choice B rationale
In a breech presentation, the presenting part (buttocks or feet) is less effective than the head in filling the pelvic inlet, potentially leaving space for the umbilical cord to prolapse, especially upon rupture of membranes. Cord prolapse causes nonreassuring fetal signs such as sudden, severe variable decelerations or prolonged bradycardia due to cord compression and subsequent fetal hypoxia.
Choice C rationale
Precipitate labor is characterized by very rapid cervical dilation and fetal descent, usually occurring within three hours of labor onset. This is not directly caused by a breech presentation. The mechanism of labor in breech is often slower and more complicated due to the less efficient presenting part.
Choice D rationale
Cessation of contractions often indicates uterine fatigue or uterine inertia, which can occur in prolonged labor or with specific uterine conditions, but it is not a direct or common complication of breech presentation. Overstretching of the uterus is typically associated with polyhydramnios or multiple gestation.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.