A nurse is assessing a client with severe pre-eclampsia who reports a headache and blurred vision.
What other sign or symptom would indicate a worsening of the condition?
Epigastric pain
Facial edema
Proteinuria
Brisk reflexes
The Correct Answer is A
Epigastric pain is a sign of worsening pre-eclampsia that indicates liver damage. It can also be associated with HELLP syndrome, a severe complication of pre-eclampsia that involves hemolysis, elevated liver enzymes and low platelet count.
Choice B is wrong because facial edema is a common symptom of pregnancy and not specific to pre-eclampsia.
Choice C is wrong because proteinuria is a diagnostic criterion for pre-eclampsia, but not a sign of worsening condition.
Choice D is wrong because brisk reflexes are a normal finding in pregnancy and do not indicate pre-eclampsia severity.
Normal ranges for blood pressure are below 140/90 mmHg, and for proteinuria are less than 300 mg in 24-hour urine collection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B"]
Explanation
The correct answer is choice A and B.Sudden weight gain and decreased fetal movement are signs of pre-eclampsia, a condition that develops in pregnant women and is marked by high blood pressure and presence of proteins in urine.Pre-eclampsia can affect the blood supply to the placenta and the growth of the baby.
Choice C is wrong because vaginal bleeding is not a symptom of pre-eclampsia, but it may indicate other problems such as placental abruption or miscarriage.
Choice D is wrong because nausea and vomiting are not specific symptoms of pre-eclampsia, but they may occur in some cases.However, excessive vomiting and nausea may be a sign of severe pre-eclampsia.
Correct Answer is B
Explanation
Decreased fibrinogen level.This indicates that the client has a risk of disseminated intravascular coagulation (DIC), which is a condition where the blood clots abnormally and causes bleeding in various organs.Fibrinogen is a protein that is essential for blood clotting, and a low level means that the clotting factors are being consumed faster than they can be produced.
Choice A is wrong because elevated platelet count is not a sign of DIC, but rather of normal pregnancy or other conditions that cause thrombocytosis.Platelets are blood cells that help form clots, and a high count means that there is an increased production or decreased destruction of platelets.
Choice C is wrong because increased prothrombin time (PT) is not a specific sign of DIC, but rather of any condition that affects the extrinsic pathway of coagulation.PT measures how long it takes for the blood to clot by adding tissue factor, which activates factor VII.A prolonged PT means that there is a deficiency or dysfunction of factor VII or other factors in the common pathway (X, V, II, I).
Choice D is wrong because reduced partial thromboplastin time (PTT) is not a sign of DIC, but rather of hypercoagulable states or antiphospholipid syndrome.PTT measures how long it takes for the blood to clot by adding phospholipids and an activator, which activate factor XII.A shortened PTT means that there is an increased activity or presence of factor XII or other factors in the intrinsic or common pathway.
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