The nurse is continuing to assist with the care of the client.
The nurse is reviewing the findings. For each finding, click to specify if the finding is consistent with preeclampsia or HELLP syndrome. Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.
Platelet count
Hemoglobin
Alanine aminotransferase (ALT)
Blood pressure
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A,B"}}
This question focuses on distinguishing between preeclampsia and HELLP syndrome, both severe hypertensive disorders of pregnancy that can occur after 20 weeks of gestation. The client presents with severe hypertension, proteinuria, neurological symptoms (headache, hyperreflexia), and significant laboratory abnormalities. Preeclampsia is characterized by new-onset hypertension and proteinuria with end-organ involvement, while HELLP syndrome is a more severe variant involving hemolysis, elevated liver enzymes, and low platelets. Recognizing overlapping and distinguishing findings is critical because both conditions require urgent maternal and fetal intervention.
Rationale for correct choices:
• Platelet count: A decreased platelet count (thrombocytopenia) is a defining feature of HELLP syndrome, where platelets are consumed due to microangiopathic hemolysis and endothelial damage. The client’s platelet count of 98,000/mm³ is significantly below normal, indicating increased risk for bleeding and worsening systemic involvement. While mild thrombocytopenia can sometimes occur in severe preeclampsia, it is more characteristic and diagnostic of HELLP syndrome.
• Hemoglobin: Hemoglobin elevation in this context (18.0 g/dL) is more consistent with preeclampsia and reflects hemoconcentration due to plasma volume contraction. In preeclampsia, endothelial dysfunction leads to fluid shifting out of the vascular space, increasing blood viscosity and hemoglobin concentration. This finding is less specific for HELLP syndrome, where hemolysis would typically lead to anemia rather than elevated hemoglobin. Therefore, this value aligns more with preeclampsia-related hemoconcentration.
• Alanine aminotransferase (ALT): Elevated liver enzymes, including ALT and AST, are hallmark findings of HELLP syndrome due to hepatic microvascular injury and hepatocellular damage. The client’s ALT of 40 Units/L is above the normal range, indicating hepatic involvement. In HELLP syndrome, liver dysfunction is a key component of the disease process and may progress to hepatic rupture in severe cases. While mild elevations can be seen in preeclampsia, significant liver involvement strongly supports HELLP syndrome.
• Blood pressure: Severe hypertension is a core diagnostic feature of both preeclampsia and HELLP syndrome. The client’s blood pressure readings of 162/112 mm Hg and 166/110 mm Hg meet criteria for severe hypertension in pregnancy. Both conditions arise from abnormal placental implantation leading to systemic vasoconstriction and endothelial dysfunction. Therefore, elevated blood pressure is not specific to either condition and is consistent with both disease processes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Management of hypoglycemia in a client with Type 1 diabetes mellitus involves rapid recognition and prompt administration of fast-acting carbohydrates to restore blood glucose levels. Mild hypoglycemia commonly presents with symptoms such as shakiness, sweating, hunger, irritability, or dizziness when blood glucose falls below normal levels. The priority treatment for a conscious client is administration of rapidly absorbable carbohydrates that can quickly raise serum glucose. Timely intervention helps prevent progression to severe neurological impairment or loss of consciousness.
Rationale:
A. Glucagon injection is typically reserved for severe hypoglycemia when the client is unconscious, unable to swallow safely, or experiencing seizures. Since the adolescent has only mild symptoms and is presumably alert enough to take oral carbohydrates, injectable glucagon is unnecessary at this stage. Oral treatment is preferred for mild hypoglycemic episodes.
B. One teaspoon of sugar alone does not provide an adequate amount of carbohydrate to effectively correct hypoglycemia. Standard treatment recommendations usually involve approximately 15 g of rapid-acting carbohydrate. A single teaspoon contains too little glucose and may not raise serum glucose sufficiently or rapidly enough.
C. A glass of orange juice is appropriate because it contains rapidly absorbed simple carbohydrates that quickly increase blood glucose levels. Fruit juice is commonly recommended for conscious clients experiencing mild hypoglycemia due to its fast onset of action. This intervention follows the “15-15 rule” commonly used in hypoglycemia management.
D. Peanut butter is not appropriate for immediate correction of hypoglycemia because its fat and protein content slows glucose absorption. Although it may help maintain glucose levels after initial correction, it does not act quickly enough to treat acute low blood sugar. Rapid-acting carbohydrates are needed first.
Correct Answer is D
Explanation
Post-gastrectomy care requires dietary modifications to prevent complications such as rapid gastric emptying, commonly known as Dumping syndrome. This condition occurs when hyperosmolar food contents move too quickly from the stomach into the small intestine, leading to fluid shifts, abdominal cramping, diarrhea, dizziness, and tachycardia. Prevention focuses on dietary adjustments that slow gastric emptying, reduce simple sugars, and increase protein intake. Clients are typically advised to consume small, frequent meals that are high in protein and moderate in fat while avoiding high-carbohydrate foods.
Rationale:
A. Ice cream is high in simple sugars and lactose, which can rapidly increase osmotic load in the small intestine. This leads to fluid shifts, abdominal cramping, and diarrhea, worsening dumping syndrome symptoms. Dairy-based sugary foods are generally discouraged in post-gastrectomy dietary planning.
B. Peppermints may worsen symptoms because they can relax the lower esophageal sphincter and contain sugar, depending on formulation. Sugar-containing foods increase osmotic activity in the intestine, triggering rapid fluid shifts. They do not provide nutritional stability needed to prevent dumping syndrome episodes.
C. Coleslaw may contain cabbage and mayonnaise, but it often includes added sugar and high-fat dressing variations. While fat slows gastric emptying, the presence of raw fibrous vegetables can also cause gastrointestinal discomfort in some post-gastrectomy clients. It is not the most appropriate choice for preventing dumping syndrome compared to high-protein options.
D. Poached eggs are an excellent source of high-quality protein with minimal carbohydrate content. Protein-rich foods slow gastric emptying and reduce the rapid osmotic shifts responsible for dumping syndrome symptoms. They are recommended in post-gastrectomy diets to promote better tolerance and nutritional stability.
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.
