NURS 5432 Exam Study Guide
Diagnosis (this is where your notes + boards intersect)
Classic / traditional teaching (older emphasis)
• New-onset hypertension after 20 weeks
• PLUS proteinuria
This is why your transcripts keep hammering proteinuria — that’s the foundational teaching.
Modern diagnostic criteria (what boards now accept)
Preeclampsia =
Hypertension after 20 weeks PLUS EITHER:
• Proteinuria, OR End-organ dysfunction
👉 So you’re right:
• Hypertension alone = NOT preeclampsia
• Proteinuria alone = NOT preeclampsia
• You need hypertension + something else End-organ features include:
• Thrombocytopenia
• Renal insufficiency (↑ creatinine)
• Elevated liver enzymes / RUQ pain
• Pulmonary edema
• New-onset cerebral or visual symptoms
Why your notes still emphasize proteinuria Because:
• It’s high-yield
• It’s easy to test
• And many exam questions still anchor there first
,But boards will accept HTN + organ dysfunction even without proteinuria.
So you’re not wrong — you’re just seeing two teaching eras overlap.
Management
1. Seizure prevention
• Magnesium sulfate
• NOT for BP control
• Purpose = prevent eclampsia (seizures)
That’s why the board book keeps saying seizure precautions
2. Blood pressure control (if severe)
Used to reduce maternal stroke risk, not to cure disease.
Common agents:
• Labetalol (very common in ER)
• Nifedipine
• Hydralazine (another board favorite)
3. Eclampsia
• Defined as preeclampsia + seizures Immediate treatment: o Magnesium sulfate o
Stabilize mother o DELIVER THE BABY
👉 Yes — delivery is the treatment
Timing of delivery (board nuance)
• Severe features → deliver ≥ 34 weeks (or sooner if unstable)
• Eclampsia → deliver regardless of gestational age
, • Mild preeclampsia → may monitor until ~37 weeks
One more thing you mentioned 👀 “Painless, third-
trimester bleeding suggests…” That is NOT preeclampsia.
That points toward:
• Placenta previa (classic board phrase: painless, bright red bleeding) So if that was in the
stem:
• That’s a separate diagnosis
• And it helps rule against preeclampsia as the primary issue
Ultra-high-yield board summary (memorize this)
• ❌ No drug cures preeclampsia
• ✅ Magnesium = seizure prevention
• ✅ Labetalol / nifedipine = BP control
• ✅ Diagnosis = HTN + proteinuria OR HTN + organ dysfunction
• ✅ Definitive treatment = delivery
You’re thinking like an NP already — your instincts are right.
If you want, drop the exact question stem, and I’ll tell you why the right answer wins and the
others are traps 💙
Yes — you’re thinking exactly right, and what you said makes clinical sense 👍
You’re basically saying: don’t stop at a dipstick if proteinuria is suspected — quantify it.
Here’s how to frame it cleanly (and confidently) in NP-speak:
How to explain it clearly
If proteinuria is present or suspected, additional testing is warranted to quantify it rather than
stopping at a screening result.
Next steps would include either:
, • Urine protein-to-creatinine ratio (UPCR)
👉 Preferred, faster, correlates well with 24-hour urine
• 24-hour urine protein collection
👉 Gold standard, but more burdensome for the patient
Both provide a more accurate assessment of protein excretion and help guide diagnosis and
management.
If you want a polished sentence (for class / oral response)
“If proteinuria is identified, I would not stop at the initial finding. I would proceed with
quantification using either a urine protein-to-creatinine ratio or a 24-hour urine protein
collection to better assess severity and guide further evaluation.”
Clinical pearl (exam-worthy 💡)
• Dipstick = screening
• UPCR or 24-hr urine = diagnostic
• UPCR is often preferred in practice because it’s reliable and easier for patients
Bottom line:
✅ You’re correct
✅ Your logic is solid
✅ That answer would land very well with faculty or on an exam
If you want, tell me what condition this question is tied to (preeclampsia? CKD?
glomerulonephritis?) and I’ll help you tailor it perfectly for that scenario 💙
I didn't get that far on my med notes, but I'm pretty sure you give magnesium if contractions,
right? And then I think labetalol was one, nifedipine was one. Isn't that the set? Yeah, I think
it's, yeah, it's the board book is emphasizing on seizure precautions. There is no
pharmacotherapeutic cure for preeclampsia. Magnesium sulfate therapy is recommended for
prevention of seizures. So you're basically trying to prevent the seizure. Yeah, and then blood
pressure medicine if that's what they need, but we usually give labetalol in the ER, and then I
guess like for eclampsia, the only treatment is delivering the baby. And um. Delivering the baby.
Oh, okay. Yeah. So on the rationale, it's telling us the diagnosis has to be hypertension and
Diagnosis (this is where your notes + boards intersect)
Classic / traditional teaching (older emphasis)
• New-onset hypertension after 20 weeks
• PLUS proteinuria
This is why your transcripts keep hammering proteinuria — that’s the foundational teaching.
Modern diagnostic criteria (what boards now accept)
Preeclampsia =
Hypertension after 20 weeks PLUS EITHER:
• Proteinuria, OR End-organ dysfunction
👉 So you’re right:
• Hypertension alone = NOT preeclampsia
• Proteinuria alone = NOT preeclampsia
• You need hypertension + something else End-organ features include:
• Thrombocytopenia
• Renal insufficiency (↑ creatinine)
• Elevated liver enzymes / RUQ pain
• Pulmonary edema
• New-onset cerebral or visual symptoms
Why your notes still emphasize proteinuria Because:
• It’s high-yield
• It’s easy to test
• And many exam questions still anchor there first
,But boards will accept HTN + organ dysfunction even without proteinuria.
So you’re not wrong — you’re just seeing two teaching eras overlap.
Management
1. Seizure prevention
• Magnesium sulfate
• NOT for BP control
• Purpose = prevent eclampsia (seizures)
That’s why the board book keeps saying seizure precautions
2. Blood pressure control (if severe)
Used to reduce maternal stroke risk, not to cure disease.
Common agents:
• Labetalol (very common in ER)
• Nifedipine
• Hydralazine (another board favorite)
3. Eclampsia
• Defined as preeclampsia + seizures Immediate treatment: o Magnesium sulfate o
Stabilize mother o DELIVER THE BABY
👉 Yes — delivery is the treatment
Timing of delivery (board nuance)
• Severe features → deliver ≥ 34 weeks (or sooner if unstable)
• Eclampsia → deliver regardless of gestational age
, • Mild preeclampsia → may monitor until ~37 weeks
One more thing you mentioned 👀 “Painless, third-
trimester bleeding suggests…” That is NOT preeclampsia.
That points toward:
• Placenta previa (classic board phrase: painless, bright red bleeding) So if that was in the
stem:
• That’s a separate diagnosis
• And it helps rule against preeclampsia as the primary issue
Ultra-high-yield board summary (memorize this)
• ❌ No drug cures preeclampsia
• ✅ Magnesium = seizure prevention
• ✅ Labetalol / nifedipine = BP control
• ✅ Diagnosis = HTN + proteinuria OR HTN + organ dysfunction
• ✅ Definitive treatment = delivery
You’re thinking like an NP already — your instincts are right.
If you want, drop the exact question stem, and I’ll tell you why the right answer wins and the
others are traps 💙
Yes — you’re thinking exactly right, and what you said makes clinical sense 👍
You’re basically saying: don’t stop at a dipstick if proteinuria is suspected — quantify it.
Here’s how to frame it cleanly (and confidently) in NP-speak:
How to explain it clearly
If proteinuria is present or suspected, additional testing is warranted to quantify it rather than
stopping at a screening result.
Next steps would include either:
, • Urine protein-to-creatinine ratio (UPCR)
👉 Preferred, faster, correlates well with 24-hour urine
• 24-hour urine protein collection
👉 Gold standard, but more burdensome for the patient
Both provide a more accurate assessment of protein excretion and help guide diagnosis and
management.
If you want a polished sentence (for class / oral response)
“If proteinuria is identified, I would not stop at the initial finding. I would proceed with
quantification using either a urine protein-to-creatinine ratio or a 24-hour urine protein
collection to better assess severity and guide further evaluation.”
Clinical pearl (exam-worthy 💡)
• Dipstick = screening
• UPCR or 24-hr urine = diagnostic
• UPCR is often preferred in practice because it’s reliable and easier for patients
Bottom line:
✅ You’re correct
✅ Your logic is solid
✅ That answer would land very well with faculty or on an exam
If you want, tell me what condition this question is tied to (preeclampsia? CKD?
glomerulonephritis?) and I’ll help you tailor it perfectly for that scenario 💙
I didn't get that far on my med notes, but I'm pretty sure you give magnesium if contractions,
right? And then I think labetalol was one, nifedipine was one. Isn't that the set? Yeah, I think
it's, yeah, it's the board book is emphasizing on seizure precautions. There is no
pharmacotherapeutic cure for preeclampsia. Magnesium sulfate therapy is recommended for
prevention of seizures. So you're basically trying to prevent the seizure. Yeah, and then blood
pressure medicine if that's what they need, but we usually give labetalol in the ER, and then I
guess like for eclampsia, the only treatment is delivering the baby. And um. Delivering the baby.
Oh, okay. Yeah. So on the rationale, it's telling us the diagnosis has to be hypertension and
