1
HESI Exit Exam OB
Hypertension Bank: Pre-
eclampsia, Eclampsia &
Magnesium Sulfate Review
Table of Contents
Subtopic 1: Pathophysiology and Risk Factors of Hypertensive Disorders in
Pregnancy........................................................................................................3
Subtopic 2: Clinical Manifestations, Assessment & Diagnosis........................11
Subtopic 3: Emergency Interventions & Seizure Management in Eclampsia. 20
Subtopic 4: Pharmacologic Management & Antihypertensives in Pregnancy 29
Subtopic 5: Maternal and Fetal Monitoring Strategies in Hypertensive
Pregnancies...................................................................................................37
Subtopic 6: Timing and Mode of Delivery in Hypertensive Pregnancies........46
Subtopic 7: Magnesium Sulfate Therapy – Monitoring and Management......55
Subtopic 8: Postpartum Monitoring and Complications in Hypertensive
Disorders........................................................................................................64
Subtopic 9: Chronic Hypertension in Pregnancy – Long-Term Outcomes and
Management..................................................................................................72
Subtopic 10: Hypertensive Disorders – Ethical, Cultural & Health Disparity
Considerations...............................................................................................81
,2
, 3
Subtopic 1: Pathophysiology and Risk Factors
of Hypertensive Disorders in Pregnancy
(Questions 1–20)
Question 1
Which pathophysiologic mechanism is most responsible for the development
of pre-eclampsia?
A. Increased renal perfusion
B. Endothelial cell dysfunction and vasospasm
C. Decreased platelet aggregation
D. Hypervolemia during pregnancy
Correct Answer: B. Endothelial cell dysfunction and vasospasm
Rationale: Pre-eclampsia arises from abnormal placental implantation, which
leads to systemic endothelial dysfunction and vasospasm, resulting in
hypertension and multi-organ involvement.
Question 2
Which of the following is a known risk factor for developing pre-eclampsia?
A. Multiparity
B. First pregnancy
C. Maternal age 20–25
D. Gestational age under 20 weeks
Correct Answer: B. First pregnancy
, 4
Rationale: Nulliparity is a significant risk factor. Pre-eclampsia commonly
occurs in women during their first pregnancy due to immune maladaptation
between maternal and fetal tissues.
Question 3
Which condition is most closely associated with early-onset pre-eclampsia
(<34 weeks)?
A. Maternal smoking
B. Diet high in protein
C. Twin gestation
D. Chronic hypertension
Correct Answer: D. Chronic hypertension
Rationale: Chronic hypertension predisposes patients to more severe forms
of pre-eclampsia, particularly early-onset cases, which have higher maternal
and fetal risks.
Question 4
Why is proteinuria included as a diagnostic criterion for pre-eclampsia?
A. It confirms infection in the urinary tract
B. It indicates kidney damage due to endothelial injury
C. It reflects dehydration
D. It is a sign of labor initiation
Correct Answer: B. It indicates kidney damage due to endothelial injury
Rationale: In pre-eclampsia, damage to the glomerular endothelium causes
protein leakage into the urine, resulting in proteinuria.
Question 5
HESI Exit Exam OB
Hypertension Bank: Pre-
eclampsia, Eclampsia &
Magnesium Sulfate Review
Table of Contents
Subtopic 1: Pathophysiology and Risk Factors of Hypertensive Disorders in
Pregnancy........................................................................................................3
Subtopic 2: Clinical Manifestations, Assessment & Diagnosis........................11
Subtopic 3: Emergency Interventions & Seizure Management in Eclampsia. 20
Subtopic 4: Pharmacologic Management & Antihypertensives in Pregnancy 29
Subtopic 5: Maternal and Fetal Monitoring Strategies in Hypertensive
Pregnancies...................................................................................................37
Subtopic 6: Timing and Mode of Delivery in Hypertensive Pregnancies........46
Subtopic 7: Magnesium Sulfate Therapy – Monitoring and Management......55
Subtopic 8: Postpartum Monitoring and Complications in Hypertensive
Disorders........................................................................................................64
Subtopic 9: Chronic Hypertension in Pregnancy – Long-Term Outcomes and
Management..................................................................................................72
Subtopic 10: Hypertensive Disorders – Ethical, Cultural & Health Disparity
Considerations...............................................................................................81
,2
, 3
Subtopic 1: Pathophysiology and Risk Factors
of Hypertensive Disorders in Pregnancy
(Questions 1–20)
Question 1
Which pathophysiologic mechanism is most responsible for the development
of pre-eclampsia?
A. Increased renal perfusion
B. Endothelial cell dysfunction and vasospasm
C. Decreased platelet aggregation
D. Hypervolemia during pregnancy
Correct Answer: B. Endothelial cell dysfunction and vasospasm
Rationale: Pre-eclampsia arises from abnormal placental implantation, which
leads to systemic endothelial dysfunction and vasospasm, resulting in
hypertension and multi-organ involvement.
Question 2
Which of the following is a known risk factor for developing pre-eclampsia?
A. Multiparity
B. First pregnancy
C. Maternal age 20–25
D. Gestational age under 20 weeks
Correct Answer: B. First pregnancy
, 4
Rationale: Nulliparity is a significant risk factor. Pre-eclampsia commonly
occurs in women during their first pregnancy due to immune maladaptation
between maternal and fetal tissues.
Question 3
Which condition is most closely associated with early-onset pre-eclampsia
(<34 weeks)?
A. Maternal smoking
B. Diet high in protein
C. Twin gestation
D. Chronic hypertension
Correct Answer: D. Chronic hypertension
Rationale: Chronic hypertension predisposes patients to more severe forms
of pre-eclampsia, particularly early-onset cases, which have higher maternal
and fetal risks.
Question 4
Why is proteinuria included as a diagnostic criterion for pre-eclampsia?
A. It confirms infection in the urinary tract
B. It indicates kidney damage due to endothelial injury
C. It reflects dehydration
D. It is a sign of labor initiation
Correct Answer: B. It indicates kidney damage due to endothelial injury
Rationale: In pre-eclampsia, damage to the glomerular endothelium causes
protein leakage into the urine, resulting in proteinuria.
Question 5
