The nurse is caring for a woman who is at 24 weeks of gestation with suspected severe preeclampsia. Which signs and symptoms would the nurse expect to observe? (Select all that apply)

Seizure activity and hypotension

Platelet count of less than 100,000/mm3 and visual problems

Ankle clonus and epigastric pain

Decreased urinary output and irritability

Answer and Explanation

Correct Answer : B,C,D

Choice A reason: Seizure activity and hypotension are not signs and symptoms of severe preeclampsia, but rather of eclampsia, which is a life-threatening complication of preeclampsia. Eclampsia is characterized by convulsions and coma, and it requires immediate treatment to prevent maternal and fetal death.

Choice B reason: Platelet count of less than 100,000/mm3 and visual problems are signs and symptoms of severe preeclampsia, as they indicate hematologic and neurologic complications. Severe preeclampsia can cause thrombocytopenia, which is a low platelet count that increases the risk of bleeding. It can also cause cerebral edema, which can impair the vision and cause blurred vision, spots, or flashes of light.

Choice C reason: Ankle clonus and epigastric pain are signs and symptoms of severe preeclampsia, as they indicate neuromuscular and hepatic complications. Severe preeclampsia can cause hyperreflexia, which is an exaggerated reflex response that can be elicited by dorsiflexing the ankle and observing rhythmic jerking of the foot. It can also cause liver damage, which can manifest as epigastric pain or right upper quadrant pain.

Choice D reason: Decreased urinary output and irritability are signs and symptoms of severe preeclampsia, as they indicate renal and central nervous system complications. Severe preeclampsia can cause oliguria, which is a reduced urine output of less than 500 mL in 24 hours. It can also cause increased intracranial pressure, which can affect the mood and behavior and cause irritability, anxiety, or confusion.

Choice E reason: Transient headache and +1 proteinuria are not signs and symptoms of severe preeclampsia, but rather of mild preeclampsia, which is a less severe form of the condition. Mild preeclampsia is characterized by blood pressure of 140/90 mm Hg or higher, proteinuria of 1+ or higher, and mild edema. It does not cause severe complications or organ damage, but it can progress to severe preeclampsia if not treated.

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Correct Answer is D

Explanation

Choice A reason: Maternal placenta previa is not a common complication of gestational diabetes mellitus. Placenta previa is a condition in which the placenta covers the cervix, which can cause bleeding and preterm labor. The risk factors for placenta previa include previous cesarean delivery, multiple pregnancy, advanced maternal age, and smoking.

Choice B reason: Maternal hyperemesis and neonatal low birth weight are not directly related to gestational diabetes mellitus. Hyperemesis is a severe form of nausea and vomiting during pregnancy that can cause dehydration and weight loss. The causes of hyperemesis are not well understood, but it may be influenced by hormonal changes, genetic factors, and psychological factors². Neonatal low birth weight is defined as a birth weight of less than 2,500 grams, which can be caused by many factors, such as prematurity, intrauterine growth restriction, maternal infection, and maternal malnutrition.

Choice C reason: Maternal premature rupture of membranes and neonatal sepsis are not specific to gestational diabetes mellitus. Premature rupture of membranes is a condition in which the amniotic sac breaks before labor begins, which can increase the risk of infection and preterm delivery. The causes of premature rupture of membranes are not clear, but some possible factors include infection, inflammation, stress, and trauma. Neonatal sepsis is a life-threatening infection in newborns, which can be caused by bacteria, viruses, or fungi. The risk factors for neonatal sepsis include prematurity, low birth weight, maternal infection, and invasive procedures⁵.

Choice D reason: Maternal preeclampsia and fetal macrosomia are the most common and serious complications of gestational diabetes mellitus. Preeclampsia is a condition characterized by high blood pressure and protein in the urine, which can lead to organ damage, seizures, and death. The exact cause of preeclampsia is unknown, but it may be related to abnormal placental development, immune system dysfunction, and genetic factors⁶. Fetal macrosomia is a condition in which the baby is larger than normal, usually weighing more than 4,000 grams at birth. This can cause difficulties during labor and delivery, such as shoulder dystocia, birth trauma, and cesarean section. The main cause of fetal macrosomia is excessive maternal glucose, which stimulates fetal insulin production and growth.

A. February 6-7 B. January 22-23 C. January 30-31 D. January 14-15

Correct Answer is B

Explanation

Choice A: February 6-7 is incorrect. This is too late for the woman's fertile period, which occurs around the time of ovulation. Ovulation usually happens about 14 days before the next period starts, which would be around January 22 for a 28-day cycle¹.

Choice B:In a 28-day menstrual cycle, ovulation typically occurs around day 14 (counting from the first day of the last menstrual period). Since the first day of the last period is January 8, day 14 falls on January 22. The fertile window consists of the five days leading up to ovulation and the day of ovulation (January 17–22), as sperm can survive in the reproductive tract for up to 5 days, and the egg remains viable for about 24 hours after ovulation.January 22-23 is the most fertile period, with ovulation occurring around January 22 and the egg remaining viable for fertilization on January 23.

Choice C: January 30-31 is incorrect. This is after the woman's fertile period, which ends about a day after ovulation. Ovulation usually happens about 14 days before the next period starts, which would be around January 22 for a 28-day cycle.

Choice D: January 14-15 corresponds to cycle days 7-8, which is too early for ovulation in a typical 28-day cycle. Ovulation generally occurs around day 14 (January 22). The follicular phase (the first half of the cycle) is when the follicles in the ovary mature, and estrogen levels rise to trigger ovulation. At this point (January 14-15), the egg is not yet released, and the uterus is still preparing for ovulation, making conception unlikely.

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The nurse is caring for a woman who is at 24 weeks of gestation with suspected severe preeclampsia. Which signs and symptoms would the nurse expect to observe? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

What are the maternal and neonatal risks associated with gestational diabetes mellitus?

Correct Answer is D

Explanation

The nurse is counseling a woman who wants to become pregnant. The woman tells the nurse that she has a 28-day menstrual cycle and the first day of her menstrual period was January 8. The nurse correctly calculates that the woman's next fertile period is?

Correct Answer is B

Explanation

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