Which of the following signs indicate pre-eclampsia?

Appeared in: NHM MP Staff Nurse-2019

Explanation

Pre-eclampsia is a pregnancy-specific disorder defined by new-onset hypertension occurring after 20 weeks of gestation.
The classic diagnostic criteria include a blood pressure of 140/90 mmHg or higher on two separate occasions, accompanied by significant proteinuria.
This option correctly identifies all the key components: the specific blood pressure threshold, the presence of proteinuria, and the critical time of onset from 20 weeks of gestation onwards.

Option A: The onset of hypertension and proteinuria in the first trimester is not characteristic of pre-eclampsia.
Option C: The onset of hypertension in the first trimester points towards chronic hypertension, not pre-eclampsia.
Option D: This option is incorrect because a correct choice is available.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Diagnostic criteria for pre-eclampsia as background academic context rather than a clinical decision trigger.
Accurate identification of pre-eclampsia is critical for timely management to prevent severe maternal and fetal complications, such as eclampsia, HELLP syndrome, and placental abruption.
Nurses play a vital role in screening for pre-eclampsia by consistently measuring blood pressure and checking for proteinuria at every antenatal visit, particularly after the 20-week mark.
Patient education on warning signs like severe headaches, visual disturbances, and upper abdominal pain is a key nursing responsibility for early detection.

How to Approach the Question

First, identify the key term in the question, which is 'pre-eclampsia'.
Recall the definitive diagnostic criteria for pre-eclampsia. The most crucial elements are new-onset hypertension (BP ≥ 140/90 mmHg) and the specific timing of its appearance.
Remember the single most important time-based differentiator: Pre-eclampsia is a disorder that begins after 20 weeks of gestation. Any hypertension diagnosed before 20 weeks is classified as chronic hypertension.
Systematically evaluate each option against these core criteria.
Eliminate options A and C because they state the signs appeared 'since first trimester,' which is before the 20-week cutoff.
Analyze option B. It includes the correct blood pressure threshold, the presence of proteinuria, and the correct time of onset ('20 weeks onwards'). This perfectly matches the definition of pre-eclampsia.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 2 p. 1803-1805

E6 Obstetrics Williams p. 2-9

Practise the full NHM MP Staff Nurse-2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.