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 correct answer is D: Undiagnosed chronic hypertension. The patient's history of significant maternal hypertension at birth and subsequent hypertension at the 6-week checkup indicates that she likely had pre-existing chronic hypertension that went undiagnosed. This type of hypertension can be asymptomatic and may only present during pregnancy or postpartum. Choices A, B, and C all involve hypertension that develops during pregnancy and are typically transient, whereas chronic hypertension persists before and after pregnancy.

Correct Answer: B

Rationale: The correct answer is B: Administration of methotrexate. This is the priority intervention for a patient with an intact tubal pregnancy as it helps to stop the growth of the pregnancy tissue in the fallopian tube, reducing the risk of rupture and potentially saving the patient's life. Administering methotrexate promptly is crucial in managing tubal pregnancies. Assessing pain level (choice A) is important but not the priority in this case. Administration of Rh immune globulin (choice C) is not necessary for an intact tubal pregnancy. Explanation of common side effects (choice D) can be done after the priority intervention.

Correct Answer: A

Rationale: The correct answer is A: 6:30 AM on January 13. RhoGAM should be administered within 72 hours after delivery to prevent Rh isoimmunization. Since the patient delivered at 6:30 AM on January 10, the administration should be done before 6:30 AM on January 13 to ensure it falls within the 72-hour window. Choices B, C, and D fall outside this critical timeframe and would not be appropriate for administering RhoGAM.

Correct Answer: A

Rationale: The correct answer is A: Hypoglycemia. Infants of diabetic mothers are at risk for hypoglycemia due to excessive insulin production in response to high maternal blood glucose levels. Monitoring blood glucose levels is crucial to prevent complications. Hypercalcemia (B) is not typically associated with infants of diabetic mothers. Hypoinsulinemia (C) refers to low insulin levels, which is not a major concern in this context. Hypobilirubinemia (D) is low levels of bilirubin and is not a common complication in infants of diabetic mothers.

Correct Answer: B

Rationale: The correct answer is B: Mitral valve prolapse. Mitral valve prolapse is a common condition in women of childbearing years and usually has a benign effect on pregnancy due to its typically mild symptoms and low risk of complications. The mitral valve leaflets bulging back into the left atrium during systole do not typically interfere with pregnancy. On the other hand, choices A, C, and D (Cardiomyopathy, Rheumatic heart disease, and Congenital heart disease) are more likely to have serious implications for pregnancy due to the potential for heart failure, arrhythmias, or other complications that can impact both the mother and the fetus.