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1.5 CE Test Hours


Current Approaches to Nursing Management

Contrada, Emily

AJN The American Journal of Nursing: November 2017 - Volume 117 - Issue 11 - p 39,40
doi: 10.1097/01.NAJ.0000526746.76550.a8
Feature Articles
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Preeclampsia: Current Approaches to Nursing Management


To provide a clinical update about diagnostic criteria and management of preeclampsia.

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After completing this continuing nursing education activity, you should be able to

  • identify risk factors and signs and symptoms of preeclampsia.
  • recognize prevention and management strategies for preeclampsia.
  1. The American College of Obstetricians and Gynecologists (ACOG) Task Force on Hypertension in Pregnancy has removed which of the following findings as a diagnostic criterion for preeclampsia?
    1. thrombocytopenia
    2. severe headache
    3. proteinuria
  2. Which of the following does the ACOG Task Force consider a severe feature of preeclampsia in a patient on bedrest?
    1. systolic blood pressure ≥ 160 mmHg on 2 occasions at least 4 hours apart
    2. diastolic blood pressure ≥ 100 mmHg on 2 occasions at least 4 hours apart
    3. systolic blood pressure ≥ 160 mmHg on 2 occasions at least 8 hours apart
  3. In the United States, preeclampsia complicates what percentage of pregnancies?
    1. 1.2% to 2.2%
    2. 2.3% to 3.8%
    3. 3.9% to 4.8%
  4. Hypertensive disorders are responsible for about what percentage of pregnancy-related maternal deaths worldwide?
    1. 2%
    2. 8%
    3. 14%
  5. The most common hypertensive disorder of pregnancy is
    1. chronic hypertension.
    2. preeclampsia.
    3. gestational hypertension.
  6. For infants exposed to preeclampsia in utero, preeclampsia-related morbidity is associated primarily with
    1. premature birth.
    2. hypertension in adolescence or adulthood.
    3. a high body mass index in adolescence or adulthood.
  7. Signs and symptoms of preeclampsia
    1. appear in the first trimester of pregnancy.
    2. do not appear until the second half of pregnancy.
    3. do not appear until the third trimester of pregnancy.
  8. The classic signs and symptoms that form the basis for a preeclampsia diagnosis are a result of
    1. an inflammatory process.
    2. an autoimmune process.
    3. a hypoxemic process.
  9. A recent meta-analysis evaluated the relationship between preeclampsia and multiple clinical factors that can be assessed at or before 16 weeks’ gestation, one of which is
    1. multiparity.
    2. adolescent pregnancy.
    3. prior placental abruption.
  10. In this meta-analysis, one of the two factors with the highest pooled unadjusted relative risks for preeclampsia was
    1. chronic hypertension.
    2. prior stillbirth.
    3. obesity.
  11. A preventive recommendation for women who have had preeclampsia in more than one prior pregnancy is to start taking which of the following medications daily in the first trimester of pregnancy?
    1. a low-dose diuretic
    2. low-dose aspirin
    3. fish oil
  12. The greatest potential for identifying preeclampsia before the onset of signs and symptoms lies in combining clinical parameters and
    1. biomarkers.
    2. immune factors.
    3. placental perfusion.
  13. Dietary recommendations for a healthy pregnancy include limiting foods that are high in
    1. gluten.
    2. fiber.
    3. fat.
  14. One possible warning sign of preeclampsia is
    1. nausea.
    2. tinnitus.
    3. ankle edema.
  15. A recommendation for accurately measuring blood pressure is to
    1. measure the pressure in each arm.
    2. base the cuff size on the patient's weight.
    3. make sure the patient's feet are flat on the floor.
  16. Which of the following findings suggests preeclampsia-associated fluid imbalance, especially during the second half of pregnancy?
    1. a mild but persistent headache
    2. a reduction in urine output
    3. weight gain of 1 to 2 pounds in one week
  17. Fetal surveillance includes serial nonstress testing to
    1. evaluate fetal oxygenation.
    2. estimate fetal growth.
    3. assess fetal–placental perfusion.
  18. The biophysical profile that accompanies this testing is scored based on ultrasound measurements of several parameters, one of which is
    1. gestational age.
    2. fetal muscle tone.
    3. maternal blood pressure.
  19. The ACOG Task Force recommends delivery for women with preeclampsia who are at or beyond how many weeks’ gestation?
    1. 34
    2. 35
    3. 37
  20. Nursing management of preeclampsia includes assessment for magnesium toxicity by identifying which of the following manifestations?
    1. loss of consciousness
    2. tachypnea
    3. insomnia
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