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The nurse in a prenatal clinic is reviewing the files of four patients scheduled for visits.
Which patient does the nurse identify as having the highest-risk pregnancy?

A.

The patient who is 37 years of age, obese, and experiencing pregnancy-induced hypertension.

B.

The patient with preexisting hypertension who is currently pregnant with twins.

C.

The patient who is 16 years of age just diagnosed with gestational diabetes.

D.

The patient who is 28 years old and delivered a premature neonate 3 years prior.

Answer and Explanation

The Correct Answer is A

Choice A rationale

A 37-year-old patient with obesity and pregnancy-induced hypertension presents multiple risk factors. Advanced maternal age, obesity, and hypertension collectively increase the

likelihood of complications such as preeclampsia, gestational diabetes, and cesarean delivery, necessitating close monitoring and management.

 

Choice B rationale

A patient with preexisting hypertension and twins is indeed high-risk due to the combined strain on the cardiovascular system and potential for preterm labor or other complications

associated with multiple gestations. However, the presence of pregnancy-induced hypertension and obesity in the first patient poses a slightly higher cumulative risk.

 

Choice C rationale

A 16-year-old patient with newly diagnosed gestational diabetes is at increased risk, particularly because of age and the potential for poorly managed diabetes leading to

complications. However, this scenario presents fewer immediate cumulative risks compared to older age and existing hypertension.

 

Choice D rationale

A 28-year-old patient who had a premature birth three years prior must be monitored for signs of recurrent preterm labor. Yet, this history alone does not present as high a cumulative

risk as older maternal age, obesity, and pregnancy-induced hypertension. .

 


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View Related questions

Correct Answer is C

Explanation

Choice A rationale

Prolonged labor is not directly linked to drug use and does not present as an immediate complication.

Choice B rationale

Prolapsed cord is not associated with substance abuse and lacks direct connection to this scenario.

Choice C rationale

Cocaine use heightens the risk of abruptio placentae, a serious condition where the placenta detaches prematurely.

Choice D rationale

Retained placenta is a concern but less likely than abruptio placentae in the context of cocaine use.

Correct Answer is D

Explanation

Choice A rationale

Bleeding is typically not associated with a vaginal hematoma; it is more indicative of other postpartum complications such as uterine atony or retained placenta fragments.

Choice B rationale

Warmth is usually associated with infection or inflammation. A hematoma is a collection of clotted blood outside the blood vessels, not typically characterized by warmth.

Choice C rationale

Redness might be seen in cases of infection or inflammation. A vaginal hematoma is a localized collection of blood and does not inherently cause redness.

Choice D rationale

Pain is a common symptom of a vaginal hematoma due to the pressure and swelling from the accumulated blood.

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