Sarah, a 34-year-old pregnant woman, has had a blood pressure consistently ranging from 140/90 to 160/98 since she was 26. Her weight gain and urinalysis have been normal.

What is this condition called? At 32 weeks’ gestation, Sarah experiences a seizure.

Her blood pressure has been elevated since 28 weeks, her urine dipstick shows 4+ protein, and she exhibits generalized edema.

What is this condition called?

Gestational hypertension; preeclampsia

Chronic hypertension; eclampsia

Gestational hypertension; eclampsia

Chronic hypertension; HELLP Syndrome

Answer and Explanation

The Correct Answer is B

Choice A rationale
Gestational hypertension is characterized by high blood pressure that develops after 20 weeks of pregnancy and typically resolves within a few weeks postpartum. Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of kidney damage.
However, Sarah’s condition does not fit this description because her blood pressure has been consistently high since she was 26, not just during pregnancy.
Choice B rationale
Chronic hypertension refers to high blood pressure before pregnancy or early in pregnancy. Eclampsia is a severe form of preeclampsia that causes seizures. Given Sarah’s history of consistent high blood pressure since age 26 and her recent seizure at 32 weeks’ gestation, this choice fits her condition.
Choice C rationale
Gestational hypertension refers to high blood pressure that begins during pregnancy. Eclampsia is a severe form of preeclampsia that causes seizures. However, Sarah’s high blood pressure did not begin during pregnancy, making this choice incorrect.
Choice D rationale
Chronic hypertension refers to high blood pressure before pregnancy or early in pregnancy. HELLP Syndrome (Hemolysis, Elevated Liver enzyme levels, and Low Platelet levels) is a serious health condition that can affect pregnant women3. However, Sarah’s symptoms do not indicate HELLP Syndrome, making this choice incorrect.

Nursing Test Bank

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Correct Answer is C

Explanation

Choice A rationale
Decreased muscle tone is not typically associated with neonatal abstinence syndrome (NAS). NAS is a condition that affects newborns who have been exposed to addictive opiate drugs while in the mother’s womb.
Choice B rationale
Sleeping for 2 hours after feeding is not a specific symptom of NAS. While changes in sleep patterns can occur in NAS, they are not definitive indicators of the condition.
Choice C rationale
A continuous high-pitched cry is a common symptom of NAS123. This is because the baby is going through withdrawal from the drugs they were exposed to in the womb.
Choice D rationale
Mild tremors when disturbed are indeed a symptom of NAS123. However, this symptom alone is not enough to diagnose NAS as it can be seen in other conditions as well.

A. Restrain the client. B. Place the client in a side-lying position. C. Place a tongue depressor in the client’s mouth. D. Assess the client’s airway patency. E. Remove objects from the client’s bed.

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

Explanation

Choice A rationale
Restraining a child during a seizure is not recommended. It does not stop the seizure and can lead to injury. The child’s movements during a seizure are involuntary, so trying to stop them can cause harm.
Choice B rationale
Placing the child in a side-lying position is recommended during a seizure. This position helps to prevent aspiration, which can occur if the child vomits during the seizure.
Choice C rationale
It is a common misconception that a person having a seizure can swallow their tongue, but this is not true. Attempting to place a tongue depressor or any other object in the child’s mouth during a seizure can cause injury to the child’s teeth or jaw.
Choice D rationale
Assessing the child’s airway patency is crucial during a seizure. Seizures can cause changes in breathing patterns and can potentially lead to respiratory distress. Therefore, monitoring the child’s breathing during a seizure is important.
Choice E rationale
Removing objects from the child’s bed or surrounding area can help prevent injury during a seizure. During a seizure, the child may have uncontrolled movements, and removing nearby objects can help ensure the child’s safety.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care for a newborn suspected of having neonatal abstinence syndrome. Which symptom would support this diagnosis?

Correct Answer is C

Explanation

A nurse is caring for a child who is having a seizure. Which of the following actions should the nurse take? (Select all that apply.)

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

Explanation

A nurse is providing care to multiple clients on the postpartum unit. Which of the following clients is at the greatest risk for developing a puerperal infection?

Can you identify the structural anomalies that make up Tetralogy of Fallot?

A nurse is caring for a client who is at 28 weeks of gestation and received terbutaline. What findings should the nurse expect?

A nurse is caring for a laboring patient with an external fetal monitor. The nurse notices late decelerations on the monitor strip. What does the nurse interpret this as indicating?

A nurse is caring for an infant diagnosed with Tetralogy of Fallot. The infant has been feeding poorly and has difficulty gaining weight. What actions should the nurse plan to take? (Select all that apply.)

A nurse is monitoring a patient in labor who has received epidural anesthesia for pain management. What should the nurse recognize as a potential complication from the epidural block?

Given the medical history and nurses’ notes of an infant diagnosed with Tetralogy of Fallot, which of the following actions should the nurse take?

A nurse is admitting a client who is at 33 weeks of gestation and has a diagnosis of placenta previa. What is the priority nursing action?