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hypertension RELIAS exam questions
accurate solutions
- All of the following biochemical markers/laboratory tests can have value in evaluating patients with suspected preeclampsia, but which of these is NOT included in establishing the actual diagnosis?: put, creat, liver enzymes.. not uric acid?
- According to the recent American College of Obstetricians and Gynecologists guidelines, which of the following is a contraindication to expectant manage- ment (for up to 48 hours for full corticosteroid benefit) of preeclampsia with severe features?: uncontrollable hypertension
- Magnesium sulfate is the medication of choice to prevent and treat eclamptic seizures. Which of the following statements about magnesium sulfate is accu- rate?Can only be administered intravenously even if an intravenous line is not in place.In a patient with recurrent seizures who is currently on magnesium sulfate, this
2 / 47 medication should be immediately abandoned.The typical main- tenance dose for magnesium sulfate is between 4- grams/hour.*Magnesium levels may need to be monitored in patients with renal insufficiency.: *Magnesium levels may need to be monitored in patients with renal insuflciency.$$$$
- If a nulligravid patient would like to know her risk of preeclampsia with pregnancy, which lab tests are most useful in predicting the risk of developing preeclampsia?: Anticardiolipin antibody Calcium Magnesium Creatinine *None of the choices
- Ms. Lee is a 33-year-old G1P1 who had labor induction for preeclampsia with severe features, resulting in a vaginal delivery 3 hours ago. She remains on magnesium sulfate IV. Her BPs have remained in the 150s/90s mm Hg on oral labetalol, and her lab exams were all within normal limits except creatinine, which is 1.5mg/dL. She reports that she is short of breath and feels chest heaviness. She then becomes unresponsive. What are the correct
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- A 30-year-old G2P1 at 36 weeks is diagnosed with mild gestational hyper- tension (blood pressure range 140-150/90-95 mm Hg), and close maternal and fetal outpatient monitoring is initiated. If the patient presents 1 week later with a persistent headache but no proteinuria, how would your diagnosis change?: *Change the diagnosis to severe gestational hypertension. Change the diagnosis to preeclampsia with severe features. Change the diagnosis to preeclampsia without severe features. No change in diagnosis
- Hematologic abnormalities are common clinical manifestations of preeclampsia and other hypertensive disorders of pregnancy. Which of the following statements are accurate?: $. *Hemolysis can result when red blood cells pass through vasoconstricted microvasculature and become fragmented. *Thrombocytopenia can occur from the accelerated use of platelets to form clots in damaged microvasculature.
- Which of the following are considered major risk factors for the development of preeclampsia?
5 / 47 Select 3 answers. Chronic hypertension Caucasian race Cigarette smoking Multiple gestation Antiphospholipid syndrome: Chronic htx, smoking, anti phospholipid
- A 40-year-old G1P0 is admitted at 34 weeks' gestation with a diagnosis of preeclampsia with severe features. The patient's blood pressure is 170/110 mm Hg. Her nurse is starting magnesium sulfate when the provider walks into the room. The provider requests that the nurse give labetalol 10 mg IV push. Which communication tool will the nurse use in this situation?SBAR"Stop the Line" phrase*CUSSValidate and VerifyShout out/call back: SBAR "Stop the Line" phrase *CUSS Validate and Verify
- Which of the following statements are true about mode of
7 / 47 *Administer beta steroids and begin labor induction. *Start magnesium sulfate for seizure prophylaxis. Cesarean delivery. Stop IV antihypertensives, and convert to long-acting oral antihypertensives.
- Which of the following statements regarding the use of low- dose aspirin for preeclampsia prevention is correct? Select an answer. Use of low-dose aspirin is associated with an increased risk for placental abrup- tion. The minimal effective dose of baby aspirin is 81mg/D. Is advised for low-risk patients. Should be initiated before 12-16 weeks' gestation.: Should be initiated before 12- 16 weeks' gestation.$
- While a team is doing a simulation, a provider has a question about what medication would be best in this situation. What should the sim leader do?: An- swer the provider's question and then continue with the simulation. Point to the book that has the answer so that the provider can look up the answer. *Join the simulation for a few minutes, and provide the answer. Continue the simulation, and let the team work through the clinical situation.
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- Ms. Sato is a 19-year-old G1P0 who presents for prenatal care at 14 weeks' gestation. Her initial blood pressure is 142/90 mm Hg. She denies any medical or surgical history, stating that she does not see a doctor regularly because she "is healthy." Her BMI is 35. Her second prenatal visit occurs at 16 weeks' gesta- tion, and her blood pressure is 144/90 mm Hg. What hypertensive disorder of pregnancy do you suspect that Ms. Sato is suffering from?: Gestational hypertension Preeclampsia *Chronic hypertension Superimposed preeclampsia
- The key to patient safety when treating a hypertensive disease of pregnancy, or any obstetric emergency, is: Select all that apply. Effective communication, especially during emergency situations, and change in shift/provider care. Always following the physician's plan of care as he or she is the clinician with the most knowledge. Utilizing a shared mental model where all team members have a
10 / 47 Then the initial diagnosis becomes...: strongly invalid?
- Patients who have a high risk of preeclampsia should have which of the following done in the first trimester? Select all that apply. Nutrition consult regarding salt intake Daily aspirin initiation Baseline preeclamptic labs Ultrasound for dating: Nutrition consult regarding salt intake Baseline preeclamptic labs Ultrasound for dating?
- A 27-year-old G1P0 with a twin gestation at 32 weeks presents to labor and delivery for a preeclampsia evaluation after elevated blood pressures were noted at her scheduled prenatal visit. The patient's blood pressures on labor and delivery range from 130- 142/90-94 mm Hg. Urine protein/creatinine ratio is 0.2 mg/dL, and all preeclamptic labs are within normal limits. Fetal testing is reassuring. The provider diagnoses gestational hypertension.
11 / 47 If the plan is to... Discharge the patient home; follow-up with weekly blood pressure checks, labs, and fetal testing. And then you find... The patient develops a headache unrelieved with acetaminophen. Then the initial plan becomes...: possibly invalidated
- In The American College of Obstetricians and Gynecologists' 2013 Task Force publication on Hypertension in Pregnancy, important classification and nomenclature updates were released. Which of the following terms is consis- tent with the new guidelines?: *Preeclampsia without severe features *Preeclampsia with mild features Pregnancy-induced hypertension Mild preeclampsia *Gestational hypertension
- A 36-year-old G2P1001 at 31 weeks' gestation presents to her PCP's office with complaints of nausea and epigastric discomfort
13 / 47 Immediately ask for an order for an antihypertensive.: white coat syndrome? check cutt? swap arms? noi idea wtf
- Ms. Sandoval is a 28-year-old G1P0 at 33 4/7 weeks' gestation on your antepartum unit to rule out superimposed preeclampsia. Ms. Sandoval suffers from chronic hypertension that has been previously controlled with oral anti- hypertensive medication. At her last prenatal visit, her hypertension had wors- ened, so she was sent to your unit for evaluation. She declines symptoms of severe features. Her obstetrician has ordered serial blood pressures, a 24- hour urine collection, preeclampsia labs, and an ultrasound for fetal growth. What other interventions or orders can you anticipate from the obstetrician?: *Corticos- teroid administration, if not already administered during this pregnancy Immediate cesarean delivery Induction of labor Discharge to follow up in the oflce
- The obstetric team is called to a room to see a 23-year-old G1 who arrived at the unit 5 minutes ago. She has a history of
14 / 47 chronic hypertension and now has a severe headache and visual changes. The nurse presents an SBAR about this event, asks for orders, and is asked to obtain preeclamptic labs. She asks if the provider would like to treat the BP, which has now been over 170/ mm Hg twice in 15 minutes. The provider asks that they be called when the labs are back to make another decision. What is the appropriate tool for the nurse to use?: Call out Validate and verify IPASS ***"Stop the Line"
- Ms. Williams is a 32-year-old African American, nulliparous woman who presents to labor and delivery triage for evaluation of headache. You find that she is obese, with a BMI of 43, and suffers from type II diabetes and chronic hypertension. Which risk factors increase her risk of developing preeclampsia? Select all that apply. Age Chronic hypertension Race Type II diabetes
16 / 47 onset disease. Associated with greater fetal and maternal morbidity and mortality. Progresses more slowly than late-onset disease.: ??Associated with greater fetal and maternal morbidity and mortality
- Contraindications to expectant management of gestational hypertension at 35 weeks' gestation include which of the following? Select all that apply. Ultrasound estimated fetal weight <5th percentile Suspected placental abruption Premature rupture of membranes Amniotic fluid volume <8 cm Elevated umbilical artery S/D ratio: Ultrasound estimated fetal weight <5th percentileSuspected placental abruptionPremature rupture of membranes$
- Why is it important to know the renal function of a patient with preeclampsia with severe features? Select an answer. It affects magnesium sulfate dosing. It will influence which antihypertensives are
17 / 47 given. It is used to determine the severity of preeclampsia. Patients with increased creatinine will also have increased proteinuria.: Patients with increased creatinine will also have increased proteinuria.??
- Which maternal condition(s) increase the risk of abnormal placentation or preeclampsia development? Select all that apply. Chronic hypertension Diabetes SLE Chronic asthma Chronic kidney disease: Chronic hypertension Diabetes
- A 35-year-old G1P0 at 32 weeks presents to labor and delivery triage with vague symptoms of malaise and decreased fetal movement over the past 12 hours. She vomited shortly before coming in today but, otherwise, denies abnormal symptoms. The fetal heart rate tracing shows a baseline rate of 130
19 / 47 check in 1 week. Increase labetalol to 300 mg PO BID. Referral to labor and delivery for further evaluation. Send home to collect a 24-hour urine protein.: further evaluation
- A 36-year-old G1P0 at 32 weeks' gestation presents to labor and delivery with a 1-day history of new-onset headaches and worsening lower extremity edema over the preceding 2-3 weeks. Her blood pressure on presentation is 150/94 mm Hg, and a urine dipstick reveals trace protein. If the plan is to... Admit patient to the hospital for preeclampsia management. And then you find... Maternal platelet count is 110,000/microliter.: supported
- Which of the following are considered major risk factors for the development of preeclampsia? Select all that apply. Chronic hypertension Family history of preeclampsia
20 / 47 Smoking Multiparity: Chronic hypertension Family history of preeclampsia Smoking
- Ms. Sato is a 21-year-old G1P0 who begins prenatal care at 12 weeks' ges- tation. She is obese, with a BMI of 41, and suffers from chronic hypertension. Which of the following proven strategies will be recommended to Ms. Sato to lower her risk of developing preeclampsia? Select all that apply. Low-dose aspirin daily Dietary salt restriction Restriction of physical activity Additional antioxidant medications such as vitamins C and E: Low-dose aspirin daily Dietary salt restriction
- Daily baby aspirin started in the late first trimester may help to reduce the risks from preeclampsia in patients at risk based
