The nurse in a prenatal clinic is reviewing the files of four patients scheduled for visits.
Which patient does the nurse identify as having the highest-risk pregnancy?
The patient who is 37 years of age, obese, and experiencing pregnancy-induced hypertension.
The patient with preexisting hypertension who is currently pregnant with twins.
The patient who is 16 years of age just diagnosed with gestational diabetes.
The patient who is 28 years old and delivered a premature neonate 3 years prior.
The Correct Answer is A
Choice A rationale
A 37-year-old patient with obesity and pregnancy-induced hypertension presents multiple risk factors. Advanced maternal age, obesity, and hypertension collectively increase the likelihood of complications such as preeclampsia, gestational diabetes, and cesarean delivery, necessitating close monitoring and management.
Choice B rationale
A patient with preexisting hypertension and twins is indeed high-risk due to the combined strain on the cardiovascular system and potential for preterm labor or other complications associated with multiple gestations. However, the presence of pregnancy-induced hypertension and obesity in the first patient poses a slightly higher cumulative risk.
Choice C rationale
A 16-year-old patient with newly diagnosed gestational diabetes is at increased risk, particularly because of age and the potential for poorly managed diabetes leading to complications. However, this scenario presents fewer immediate cumulative risks compared to older age and existing hypertension.
Choice D rationale
A 28-year-old patient who had a premature birth three years prior must be monitored for signs of recurrent preterm labor. Yet, this history alone does not present as high a cumulative risk as older maternal age, obesity, and pregnancy-induced hypertension. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E"]
Explanation
Choice A rationale
Hypertensive disorders, such as preeclampsia, increase the risk of placental abruption. They can cause changes in the blood vessels of the placenta, reducing blood flow and increasing the likelihood of separation.
Choice B rationale
Uterine fibroids, which are noncancerous growths in the uterus, can interfere with the proper attachment of the placenta, raising the risk of placental abruption.
Choice C rationale
Cigarette smoking contributes to placental abruption by reducing oxygen supply to the placenta, causing placental insufficiency and increasing the risk of premature separation.
Choice D rationale
Abdominal trauma, such as from a fall or car accident, can cause mechanical disruption of the placenta, leading to abruption.
Choice E rationale
Methamphetamine use can cause vasoconstriction and hypertension, which compromise placental blood flow and increase the risk of abruption.
Correct Answer is A
Explanation
Choice A rationale
Blood pressure of 160/110 indicates severe preeclampsia and warrants immediate intervention to prevent complications. Stopping oxytocin is part of the management of severe preeclampsia to avoid exacerbating the condition.
Choice B rationale
Frequency of contractions every 3 minutes is within the normal range during labor induction and does not warrant stopping the infusion unless there are other concerns.
Choice C rationale
A fetal heart rate of 155 bpm with early decelerations may require close monitoring but does not necessarily warrant stopping the oxytocin infusion. Early decelerations are typically a normal physiological response.
Choice D rationale
Frequency of contractions every 3 minutes is expected during active labor and is generally not a cause to stop the oxytocin infusion. The nurse should continue to monitor the labor progression closely.
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