A primigravida client at 32-weeks gestation presents to the clinic with a report of a pounding headache. The client demonstrates hyperreflexia. The nurse should recognize the client's symptoms may be caused by which condition?

Rationale: A. Cerebral edema: Cerebral edema can occur with severe preeclampsia or eclampsia, causing neurologic symptoms such as seizures or altered consciousness. While serious, it is less directly associated with hyperreflexia and pounding headache than retinal arteriolar changes. B. Severe anxiety: Anxiety may cause headache or mild physiologic changes, but it does not produce hyperreflexia or other neurologic signs associated with preeclampsia. Anxiety alone is unlikely to explain the combination of symptoms in this client. C. Intravascular coagulation: Disseminated intravascular coagulation (DIC) involves widespread clotting and bleeding and can occur as a complication of preeclampsia. However, hyperreflexia and headache are earlier signs, and DIC is not the primary cause at this stage. D. Retinal arteriolar spasms: Retinal arteriolar spasms occur in preeclampsia and contribute to symptoms such as pounding headache, visual disturbances, and hyperreflexia. These vascular changes are indicative of increased systemic vascular resistance and elevated blood pressure, explaining the client’s current presentation.