A nurse is reinforcing education for a client who is at 9 weeks of gestation and who has chosen a medical abortion.
Which of the following medications should the nurse anticipate the provider prescribing?
Clomiphene and letrozole.
Methotrexate and vincristine.
Mifepristone and misoprostol.
Dinoprostone and oxytocin.
The Correct Answer is C
Choice A rationale
Clomiphene and letrozole are medications primarily used in the treatment of infertility rather than pregnancy termination. Clomiphene is a selective estrogen receptor modulator that induces ovulation by stimulating the release of gonadotropins. Letrozole is an aromatase inhibitor that similarly promotes ovulation. Neither of these drugs possesses the pharmacological properties required to interrupt an established pregnancy or induce the uterine contractions necessary for a medical abortion procedure in the first trimester.
Choice B rationale
Methotrexate and vincristine are potent cytotoxic chemotherapy agents. While methotrexate is occasionally used off-label to treat ectopic pregnancies by inhibiting rapidly dividing fetal cells, it is not the standard primary protocol for a planned medical abortion at nine weeks. Vincristine is used to treat various malignancies and has no role in elective pregnancy termination. The combination of these two drugs is inappropriate for the client's requested procedure and would pose unnecessary systemic toxicity.
Choice C rationale
This is the evidence-based pharmacological combination for medical abortion up to 10 or 11 weeks of gestation. Mifepristone acts as a progesterone antagonist, blocking the hormone necessary to maintain the uterine lining and pregnancy. Misoprostol, a prostaglandin E1 analogue, is administered subsequently to induce cervical softening and uterine contractions, leading to the expulsion of the products of conception. This regimen is highly effective and widely accepted as the gold standard in reproductive medicine.
Choice D rationale
Dinoprostone and oxytocin are typically reserved for cervical ripening and the induction of labor in the second or third trimesters. Dinoprostone is a prostaglandin used to prepare the cervix, while oxytocin stimulates powerful uterine contractions to facilitate vaginal delivery. These medications are not used for medical abortions at nine weeks of gestation because the uterus is not yet sensitive enough to oxytocin, and more effective oral or vaginal options like misoprostol exist.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
At 33 weeks of gestation, an infant is considered moderately preterm, and while many organs are functional, the musculoskeletal system is still in a significant phase of development. Muscle tone is often decreased compared to a full-term infant, and the infant may exhibit a more extended posture rather than the flexed position seen in babies born closer to 40 weeks. The accumulation of muscle mass and the refinement of neuromuscular coordination continue throughout the final weeks of pregnancy.
Choice B rationale
By 33 weeks, the eyes are generally well-developed. The eyelids, which are fused earlier in pregnancy, typically open between weeks 26 and 28. A 33-week infant can blink and has some pupillary response to light, although the visual system continues to mature after birth. The suggestion that the eyes are still in a primary developmental stage is more accurate for extremely preterm infants born before the third trimester begins, rather than at 33 weeks.
Choice C rationale
The skin of a 33-week infant is usually not smooth; it is often thin, translucent, and may still be covered in vernix caseosa and lanugo. Smooth, plump skin is a characteristic of full-term infants who have had more time to accumulate subcutaneous fat. In a preterm infant, the lack of this insulating fat layer makes the skin appear wrinkled or red, and makes the baby much more susceptible to heat loss and temperature instability.
Choice D rationale
The pancreas begins producing insulin as early as the end of the first trimester, around week 10 to 12. By 33 weeks, the fetal pancreas is fully capable of secreting insulin in response to glucose levels in the blood. While preterm infants may struggle with glucose regulation due to immature liver function and limited glycogen stores, the statement that the pancreas is not producing insulin at all is physiologically incorrect for this stage of development.
Correct Answer is D
Explanation
Step 1 is September 17 minus 3 months is June 17.
Step 2 is June 17 plus 7 days is June 24. The final calculated answer is June 24.
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