# Stage 6 — Evaluate outcomes. Review the stabilization and postpartum trend and answer both questions.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=568581&lang=en  
> language: en  
> subject: Management of Care  
> category: MOC

## Question

Stage 6 — Evaluate outcomes. Review the stabilization and postpartum trend and answer both questions.

| Time | Data |
| --- | --- |
| Before intervention | BP 164/110; RR 10; reflexes absent; urine 15 mL/hour; severe headache |
| 30 minutes | BP 148/94; RR 16; reflexes 1+; urine 30 mL/hour; headache improving |
| 2 hours postpartum | BP 142/90; RR 16; reflexes 2+; urine 45 mL/hour; platelets and liver enzymes stable |
| 6 hours postpartum | Alert; no visual symptoms or right-upper-quadrant pain; bleeding within expected range |

Q1. Which interpretation is best supported by the trend?

Magnesium toxicity and severe hypertension are worsening
Respiratory, renal, neurologic, and blood-pressure findings are improving after intervention
The client no longer needs postpartum assessment
Stable liver enzymes prove preeclampsia has permanently resolved

Q2. Which handoff plan is most appropriate?

Discontinue blood-pressure checks because delivery is complete
Restart magnesium without a new order because reflexes returned
Continue ordered blood-pressure, neurologic, respiratory, urine-output, bleeding, and laboratory surveillance and escalate recurrent severe symptoms
Transfer care without mentioning the magnesium event

## Explanation

Improving respiratory rate, reflexes, urine output, blood pressure, symptoms, and laboratory values show response. Preeclampsia risk persists postpartum, so handoff must continue blood-pressure, neurologic, respiratory, renal, bleeding, and laboratory surveillance with clear escalation cues.

## In-depth explanation

Quick answer
The trend shows improvement, but the postpartum handoff must continue surveillance because severe hypertension, seizure, organ injury, bleeding, and medication effects can recur.

Why this is correct
Multiple measures improve after treatment: breathing, reflexes, urine output, pressure, symptoms, and laboratory stability. Delivery does not instantly end preeclampsia risk, so closed-loop handoff is part of the treatment outcome.

Easy analogy or mental picture
The alarm is quieter after delivery, but the control room stays staffed. Improvement lowers danger; it does not switch monitoring off.

Memory hook
Postpartum is after birth, not after risk.

NCLEX decision rule
When severe preeclampsia improves, trend several organ systems and communicate the adverse medication event; never use one reassuring value to end surveillance.

Why the other choices are wrong
Stopping checks ignores postpartum disease. Magnesium cannot be restarted independently, stable liver tests do not prove permanent resolution, and omitting the toxicity event breaks continuity.

References
1ACOG: Preeclampsia and High Blood Pressure During PregnancySevere features, maternal-fetal deterioration, hospitalization, and delivery planning
2ACOG Practice Bulletin 222: Gestational Hypertension and PreeclampsiaUrgent blood-pressure control, magnesium monitoring, and severe-feature management; reaffirmed 2026

## Clinical scenario

Case update
Magnesium was stopped, respiratory support was provided, prescribed calcium gluconate and antihypertensive therapy were given, and delivery occurred after maternal stabilization.

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