A 32-year-old primigravid woman at 36 weeks gestation presents to the emergency department with a severe headache, blurry vision, and epigastric pain. Her blood pressure is 170/110 mmHg. Urine dipstick shows 3+ proteinuria. Deep tendon reflexes are 4+ with clonus. Which of the following is the most appropriate initial management step?

The correct answer to the question "A 32-year-old primigravid woman at 36 weeks gestation presents to the emergency department with a severe headache, blurry vision, and epigastric pain. Her blood pressure is 170/110 mmHg. Urine dipstick shows 3+ proteinuria. Deep tendon reflexes are 4+ with clonus. Which of the following is the most appropriate initial management step?" is Option B: Initiate continuous fetal heart rate monitoring and administer magnesium sulfate.

The other options — A) Administer oral nifedipine, C) Perform immediate induction of labor, D) Order a 24-hour urine collection for protein — are incorrect for this USMLE Exam Prep question. As explained above: This patient has severe preeclampsia with features of impending eclampsia (hyperreflexia with clonus). Magnesium sulfate is crucial for seizure prophylaxis. Fetal monitoring is also essential for ass…