Hypertension RELIAS Test Questions and Answers Rated A
All of the following biochemical induction for preeclampsia with severe features,
markers/laboratory tests can have value in resulting in a vaginal delivery 3 hours ago. She
evaluating patients with suspected preeclampsia, remains on magnesium sulfate IV. Her BPs have
but which of these is NOT included in remained in the 150s/90s mm Hg on oral
establishing the actual diagnosis? - labetalol, and her lab exams were all within
ANSWER -put, creat, liver enzymes.. not normal limits except creatinine, which is
uric acid? 1.5mg/dL. She reports that she is short of breath
and feels chest heaviness. She then becomes
unresponsive. What are the correct actions at this
According to the recent American College of time? - ANSWER -Check creatinine
Obstetricians and Gynecologists guidelines, immediately
which of the following is a contraindication to IV labetalol immediately
expectant management (for up to 48 hours for *Calcium gluconate immediately
full corticosteroid benefit) of preeclampsia with *Stop magnesium sulfate
severe features? - ANSWER -
uncontrollable hypertension
A 30-year-old G2P1 at 36 weeks is diagnosed
with mild gestational hypertension (blood
Magnesium sulfate is the medication of choice to pressure range 140-150/90-95 mm Hg), and
prevent and treat eclamptic seizures. Which of close maternal and fetal outpatient monitoring is
the following statements about magnesium initiated. If the patient presents 1 week later with
sulfate is accurate?Can only be administered a persistent headache but no proteinuria, how
intravenously even if an intravenous line is not in would your diagnosis change? - ANSWER -
place.In a patient with recurrent seizures who is *Change the diagnosis to severe gestational
currently on magnesium sulfate, this medication hypertension.
should be immediately abandoned.The typical Change the diagnosis to preeclampsia with
maintenance dose for magnesium sulfate is severe features.
between 4-6 grams/hour.*Magnesium levels may Change the diagnosis to preeclampsia without
need to be monitored in patients with renal severe features.
insufficiency. - ANSWER -*Magnesium No change in diagnosis
levels may need to be monitored in patients with
renal insufficiency.$$$$
Hematologic abnormalities are common clinical
manifestations of preeclampsia and other
If a nulligravid patient would like to know her risk hypertensive disorders of pregnancy. Which of
of preeclampsia with pregnancy, which lab tests the following statements are accurate? -
are most useful in predicting the risk of ANSWER -$.
developing preeclampsia? - ANSWER - *Hemolysis can result when red blood cells pass
Anticardiolipin antibody through vasoconstricted microvasculature and
Calcium become fragmented.
Magnesium *Thrombocytopenia can occur from the
Creatinine accelerated use of platelets to form clots in
*None of the choices damaged microvasculature.
Ms. Lee is a 33-year-old G1P1 who had labor Which of the following are considered major risk
, Hypertension RELIAS Test Questions and Answers Rated A
factors for the development of preeclampsia? likelihood of cesarean delivery increases with
Select 3 answers. decreasing gestational age.???
Chronic hypertension Cesarean delivery rates are >90% when labor
Caucasian race induction is attempted at a gestational age <28
Cigarette smoking weeks.???
Multiple gestation
Antiphospholipid syndrome - ANSWER -
Chronic htx, smoking, anti phospholipid A 34-year-old G1 at 33 weeks with chronic
hypertension is admitted for further evaluation
after a BP of 164/98 mm Hg was found in the
A 40-year-old G1P0 is admitted at 34 weeks' clinic. Her repeat BPs are in the 160s-110s mm
gestation with a diagnosis of preeclampsia with Hg and do not decrease with IV
severe features. The patient's blood pressure is antihypertensives. What are the next steps in her
170/110 mm Hg. Her nurse is starting care? - ANSWER -*Administer beta steroids
magnesium sulfate when the provider walks into and begin labor induction.
the room. The provider requests that the nurse *Start magnesium sulfate for seizure prophylaxis.
give labetalol 10 mg IV push. Which Cesarean delivery.
communication tool will the nurse use in this Stop IV antihypertensives, and convert to long-
situation?SBAR"Stop the Line" acting oral antihypertensives.
phrase*CUSSValidate and VerifyShout out/call
back - ANSWER -SBAR
"Stop the Line" phrase Which of the following statements regarding the
*CUSS use of low-dose aspirin for preeclampsia
Validate and Verify prevention is correct?
Select an answer.
Use of low-dose aspirin is associated with an
Which of the following statements are true about increased risk for placental abruption.
mode of delivery in patients with The minimal effective dose of baby aspirin is
preeclampsia/HIP? 81mg/D.
Select all that apply. Is advised for low-risk patients.
Induction of labor is not recommended in Should be initiated before 12-16 weeks'
patients with HELLP syndrome. gestation. - ANSWER -Should be initiated
Induction of labor should not be attempted in before 12-16 weeks' gestation.$
patients who are on magnesium sulfate.
For women undergoing labor induction, the
likelihood of cesarean delivery increases with While a team is doing a simulation, a provider
decreasing gestational age. has a question about what medication would be
Cesarean delivery rates are >90% when labor best in this situation. What should the sim leader
induction is attempted at a gestational age <28 do? - ANSWER -Answer the provider's
weeks. question and then continue with the simulation.
If cesarean delivery is indicated, magnesium Point to the book that has the answer so that the
sulfate should be discontinued during the provider can look up the answer.
procedure. - ANSWER -Induction of labor is *Join the simulation for a few minutes, and
not recommended in patients with HELLP provide the answer.
syndrome.??? Continue the simulation, and let the team work
For women undergoing labor induction, the through the clinical situation.
All of the following biochemical induction for preeclampsia with severe features,
markers/laboratory tests can have value in resulting in a vaginal delivery 3 hours ago. She
evaluating patients with suspected preeclampsia, remains on magnesium sulfate IV. Her BPs have
but which of these is NOT included in remained in the 150s/90s mm Hg on oral
establishing the actual diagnosis? - labetalol, and her lab exams were all within
ANSWER -put, creat, liver enzymes.. not normal limits except creatinine, which is
uric acid? 1.5mg/dL. She reports that she is short of breath
and feels chest heaviness. She then becomes
unresponsive. What are the correct actions at this
According to the recent American College of time? - ANSWER -Check creatinine
Obstetricians and Gynecologists guidelines, immediately
which of the following is a contraindication to IV labetalol immediately
expectant management (for up to 48 hours for *Calcium gluconate immediately
full corticosteroid benefit) of preeclampsia with *Stop magnesium sulfate
severe features? - ANSWER -
uncontrollable hypertension
A 30-year-old G2P1 at 36 weeks is diagnosed
with mild gestational hypertension (blood
Magnesium sulfate is the medication of choice to pressure range 140-150/90-95 mm Hg), and
prevent and treat eclamptic seizures. Which of close maternal and fetal outpatient monitoring is
the following statements about magnesium initiated. If the patient presents 1 week later with
sulfate is accurate?Can only be administered a persistent headache but no proteinuria, how
intravenously even if an intravenous line is not in would your diagnosis change? - ANSWER -
place.In a patient with recurrent seizures who is *Change the diagnosis to severe gestational
currently on magnesium sulfate, this medication hypertension.
should be immediately abandoned.The typical Change the diagnosis to preeclampsia with
maintenance dose for magnesium sulfate is severe features.
between 4-6 grams/hour.*Magnesium levels may Change the diagnosis to preeclampsia without
need to be monitored in patients with renal severe features.
insufficiency. - ANSWER -*Magnesium No change in diagnosis
levels may need to be monitored in patients with
renal insufficiency.$$$$
Hematologic abnormalities are common clinical
manifestations of preeclampsia and other
If a nulligravid patient would like to know her risk hypertensive disorders of pregnancy. Which of
of preeclampsia with pregnancy, which lab tests the following statements are accurate? -
are most useful in predicting the risk of ANSWER -$.
developing preeclampsia? - ANSWER - *Hemolysis can result when red blood cells pass
Anticardiolipin antibody through vasoconstricted microvasculature and
Calcium become fragmented.
Magnesium *Thrombocytopenia can occur from the
Creatinine accelerated use of platelets to form clots in
*None of the choices damaged microvasculature.
Ms. Lee is a 33-year-old G1P1 who had labor Which of the following are considered major risk
, Hypertension RELIAS Test Questions and Answers Rated A
factors for the development of preeclampsia? likelihood of cesarean delivery increases with
Select 3 answers. decreasing gestational age.???
Chronic hypertension Cesarean delivery rates are >90% when labor
Caucasian race induction is attempted at a gestational age <28
Cigarette smoking weeks.???
Multiple gestation
Antiphospholipid syndrome - ANSWER -
Chronic htx, smoking, anti phospholipid A 34-year-old G1 at 33 weeks with chronic
hypertension is admitted for further evaluation
after a BP of 164/98 mm Hg was found in the
A 40-year-old G1P0 is admitted at 34 weeks' clinic. Her repeat BPs are in the 160s-110s mm
gestation with a diagnosis of preeclampsia with Hg and do not decrease with IV
severe features. The patient's blood pressure is antihypertensives. What are the next steps in her
170/110 mm Hg. Her nurse is starting care? - ANSWER -*Administer beta steroids
magnesium sulfate when the provider walks into and begin labor induction.
the room. The provider requests that the nurse *Start magnesium sulfate for seizure prophylaxis.
give labetalol 10 mg IV push. Which Cesarean delivery.
communication tool will the nurse use in this Stop IV antihypertensives, and convert to long-
situation?SBAR"Stop the Line" acting oral antihypertensives.
phrase*CUSSValidate and VerifyShout out/call
back - ANSWER -SBAR
"Stop the Line" phrase Which of the following statements regarding the
*CUSS use of low-dose aspirin for preeclampsia
Validate and Verify prevention is correct?
Select an answer.
Use of low-dose aspirin is associated with an
Which of the following statements are true about increased risk for placental abruption.
mode of delivery in patients with The minimal effective dose of baby aspirin is
preeclampsia/HIP? 81mg/D.
Select all that apply. Is advised for low-risk patients.
Induction of labor is not recommended in Should be initiated before 12-16 weeks'
patients with HELLP syndrome. gestation. - ANSWER -Should be initiated
Induction of labor should not be attempted in before 12-16 weeks' gestation.$
patients who are on magnesium sulfate.
For women undergoing labor induction, the
likelihood of cesarean delivery increases with While a team is doing a simulation, a provider
decreasing gestational age. has a question about what medication would be
Cesarean delivery rates are >90% when labor best in this situation. What should the sim leader
induction is attempted at a gestational age <28 do? - ANSWER -Answer the provider's
weeks. question and then continue with the simulation.
If cesarean delivery is indicated, magnesium Point to the book that has the answer so that the
sulfate should be discontinued during the provider can look up the answer.
procedure. - ANSWER -Induction of labor is *Join the simulation for a few minutes, and
not recommended in patients with HELLP provide the answer.
syndrome.??? Continue the simulation, and let the team work
For women undergoing labor induction, the through the clinical situation.
