A woman comes in to her physician’s office at 16 weeks of pregnancy complaining of headache. On examination her Blood Pressure is 169/94. As the physician looks over her record he notices that she has a prior history of hypertension. He explains to her that she has

Chronic Hypertension

This is a normal Blood Pressure

Preeclampsia

Pregnancy induced hypertension.

Answer and Explanation

The Correct Answer is A

A. Chronic Hypertension. Chronic hypertension is diagnosed when a woman has hypertension (≥140/90 mmHg) that was present before pregnancy or develops before 20 weeks gestation. Since this patient has a history of hypertension and is only 16 weeks pregnant, her condition is classified as chronic hypertension rather than pregnancy-related hypertension.

B. This is a normal Blood Pressure. A blood pressure of 169/94 mmHg is not normal. This reading indicates hypertension, which requires monitoring and possible medication adjustments to prevent complications such as preeclampsia or fetal growth restriction.

C. Preeclampsia. Preeclampsia is diagnosed after 20 weeks of gestation and includes hypertension along with signs of organ dysfunction (e.g., proteinuria, liver abnormalities, or neurological symptoms). Since this patient is only 16 weeks pregnant and does not show other preeclampsia symptoms, this diagnosis is incorrect.

D. Pregnancy-induced hypertension. Pregnancy-induced hypertension, also known as gestational hypertension, develops after 20 weeks gestation in women with previously normal blood pressure. Because this patient has a prior history of hypertension and is only 16 weeks pregnant, her condition is classified as chronic hypertension, not pregnancy-induced hypertension.

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Correct Answer is C

Explanation

A. To prevent uterine atony. Suprapubic pressure is not used to prevent uterine atony. Uterine atony, which leads to postpartum hemorrhage, is managed through uterine massage and medications such as oxytocin.

B. To facilitate the delivery of the baby's head. The baby's head has already been delivered in shoulder dystocia. The emergency arises because the shoulders are stuck behind the pubic bone, requiring specific maneuvers to release them.

C. To facilitate the delivery of the baby's shoulders. Shoulder dystocia occurs when the anterior shoulder becomes impacted behind the maternal pubic bone, preventing delivery. Suprapubic pressure is applied to help dislodge the shoulder by compressing it downward, allowing it to pass under the pubic bone. This maneuver, along with the McRoberts position, is commonly used to resolve the dystocia.

D. To prepare for the third stage of labor. The third stage of labor refers to the delivery of the placenta, which occurs after the baby is born. Suprapubic pressure is specifically used to assist in the second stage of labor when shoulder dystocia occurs.

A. "I don't need to see the doctor for another year when I will come back for follow-up B. I will use contraception for the next year C. I need to be monitored for choriocarcinoma during the next year D. I am so sad that I lost this baby

Correct Answer is A

Explanation

A. "I don't need to see the doctor for another year when I will come back for follow-up." This statement is incorrect because close follow-up is essential after a molar pregnancy to monitor for gestational trophoblastic disease (GTD) or choriocarcinoma. Regular hCG level monitoring is required weekly until levels are undetectable, then monthly for at least 6–12 months. Delaying follow-up for a year could lead to missed complications.

B. "I will use contraception for the next year." This statement is correct. Pregnancy should be avoided for at least one year after a molar pregnancy to ensure accurate monitoring of hCG levels. A rising hCG level could indicate malignant transformation rather than a new pregnancy.

C. "I need to be monitored for choriocarcinoma during the next year." This statement is correct. Choriocarcinoma is a potential complication of molar pregnancy, and early detection through serial hCG monitoring is crucial. Any persistent or rising hCG levels may indicate malignancy requiring chemotherapy.

D. "I am so sad that I lost this baby." This statement is understandable. A molar pregnancy is an emotionally distressing event, and feelings of grief and loss are valid. Emotional support, counseling, or support groups may be beneficial for the patient’s mental well-being.

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A woman comes in to her physician’s office at 16 weeks of pregnancy complaining of headache. On examination her Blood Pressure is 169/94. As the physician looks over her record he notices that she has a prior history of hypertension. He explains to her that she has

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Naxlex Comprehensive Predictor Exams

An emergency shoulder dystocia delivery occurred that requires the nurse to apply suprapubic pressure. What is the rationale for this action?

Correct Answer is C

Explanation

A patient is being discharged from the hospital after the evacuation of a molar pregnancy. The nurse recognizes that additional discharge teaching is required when the patient makes which statement?

Correct Answer is A

Explanation

The least common cause of long. difficult, or abnormal labor (dystocia) is:

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