A patient with no prenatal care delivers a healthy male infant via the vaginal route, with minimal blood loss. During the labor period, vital signs were normal. At birth, significant maternal hypertension is noted. When the patient is questioned, she relates that there is history of heart disease in her family; but, that she has never been treated for hypertension. Blood pressure is treated in the hospital setting and the patient is discharged. The patient returns at her scheduled 6-week checkup and is found to be hypertensive. Which type of hypertension is the patient is exhibiting?

Correct Answer: D

Rationale: The patient in this scenario exhibits signs of chronic hypertension, particularly due to the history of heart disease in her family, the postpartum persistence of elevated blood pressure, and the diagnosis of hypertension at the 6-week checkup. While pregnancy-induced hypertension (PIH), gestational hypertension, and preeclampsia can occur during pregnancy, they typically resolve within a few weeks after delivery. The fact that the patient's hypertension persists beyond the postpartum period suggests that she likely had preexisting, undiagnosed chronic hypertension. Therefore, option D is the most appropriate choice in this case.

Correct Answer: A

Rationale: Rho(D) immune globulin (RhoGAM) needs to be administered within 72 hours postpartum to Rh-negative patients who have given birth to Rh-positive infants to prevent Rh sensitization. The patient delivered at 6:30 AM on January 10, so the RhoGAM should be administered prior to that time on January 13, which is 72 hours postpartum. Therefore, the correct choice is A. 6:30 AM on January 10.

Correct Answer: C

Rationale: Rheumatoid arthritis shows marked improvement during pregnancy, although the reason for this is not entirely clear. The improvement is often significant, leading to relief from symptoms for many pregnant individuals with this condition. However, it's important to note that this improvement is temporary, as relapse typically occurs within 36 months postpartum. The exact mechanisms behind this temporary improvement are not fully understood, but hormones and changes in the immune system during pregnancy are believed to play a role in modifying the disease process.

Correct Answer: B

Rationale: A person who has a history of high-risk behaviors, such as drug use, should be retested for hepatitis B during the third trimester. This is because the virus can have a long incubation period before showing up in blood tests. Retesting in the third trimester ensures that if the infection was acquired after the initial screening, it will be detected in time to provide appropriate care and interventions. Retesting is important in high-risk individuals to ensure proper management and prevention of hepatitis B transmission.

Correct Answer: B

Rationale: The signs of magnesium toxicity that the nurse should monitor for in a patient with severe preeclampsia on IV magnesium sulfate include an altered sensorium (confusion, lethargy, slurred speech) and a respiratory rate of less than 12 breaths per minute. Altered sensorium is a common symptom of magnesium toxicity, reflecting the drug's central nervous system depressant effects. A decreased respiratory rate can indicate respiratory depression, a potentially serious complication of magnesium toxicity. Monitoring for these signs is crucial to promptly identifying and managing magnesium toxicity in patients on magnesium sulfate therapy. Signs such as cool, clammy skin and a pulse oximeter reading of 95% would not be indicative of magnesium toxicity.